Health and Social Care Alliance Scotland (the ALLIANCE)

Report: Brexit - What Matters to You - A Local Conversation in Aberdeen

21 May 2018

Introduction

This report covers the third in a planned series of five local conversation events facilitated by the ALLIANCE for the Scottish Government (SG) to learn more about what people feel is at stake in the Brexit negotiations and to help build consensus on support for the SG position. The main theme explored at the Aberdeen event was the potential impact that leaving the European Union (EU) may have on employment locally and in Scotland.

Why the Health and Social Care Alliance are involved

The determinants of health go far beyond healthcare itself. Social issues such as poverty, unemployment, housing and inequality play as significant a role as any other factors. As a result, any social or economic considerations should have a place in the Alliance’s local conversations.

The Alliance’s members have expressed concern about the post-Brexit future for charities and communities. A summary of this survey can be found on our website, and will be provided for participants on tables.

Members raised several concerns regarding the impact of Brexit on health and social care. Amongst these was the concern that social care recruitment problems could be exacerbated after Brexit.

A recent care inspectorate report found that more than a third of social care services across Scotland have reported unfilled staff vacancies in the past year, and almost half of those faced difficulty recruiting the right staff.

This event was publicised extensively through the ALLIANCE members network, local partners and the Third Sector Interface Glasgow CVS as well on social media. It was also promoted across the city’s schools and universities.

This event was publicised extensively by the ALLIANCE’s local partners Aberdeen City Voluntary Action (ACVO) and Aberdeenshire Voluntary Action, as well as promoted via an advertisement in the local newspaper and on social media. It was

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also promoted via the Self-Management Network in Grampian and across the city’s schools and universities.

Aims

The aims of the event were

To seek local views on Brexit and its potential impact on local communities, including voices that have been left out of the national debate thus far.

To examine particular themes in different communities, giving a different dimension to each conversation.

To identify key issues and concerns about Brexit that can then feed into negotiations at a national level.

To inform the ALLIANCE’s Brexit Workshop at the Annual Conference in June, with a publication to follow in July.

Background

Maureen Watt MSP, the Minister for Mental Health set the scene for the discussion.

Welcoming the audience, the Minister stressed the importance of roundtable meetings such as this in helping the Scottish Government continue to understand the views of individuals; highlighting what’s at stake for people and enabling SG to protect what matters to them. The Minister stressed that analysis showed that continued membership of the European Single Market and Customs Union is essential for Scotland’s economy, society and people. Brexit will significantly weaken the Scottish economy compared to continued membership of the EU. Being out of the European Single Market or not securing a free trade agreement would see Scotland’s GDP around £12.7 billion lower by 2030 than it would be under continued EU membership; an equivalent loss of £2,300 per year for each person in Scotland.

Nationally there is the effect of leaving the EU on Scotland’s impact on the World. Organisations are concerned about being able to attract and retain sufficient staff, and individuals from other parts of the EU living and working in Scotland are concerned about their future employment prospects, quality of life, the impact on their families and communities.

EU impact locally

As with the rest of Scotland Aberdeen has benefited significantly from EU support; example include

The Smart Cities Strategic Intervention is a partnership of the seven Scottish Cities. Through this Aberdeen benefits by approximately £2.5M of project costs approved for a range of activities

Foresterhill Health Campus, the site of Aberdeen’s main hospitals alongside the medical school and medical science departments of the University of Aberdeen. This project is a Green Infrastructure European Regional

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Development Fund project which will transform the campus and demonstrate best practice in green infrastructure.

Scotland’s health and social care sectors also benefit greatly from the contribution of staff from across the EU and there is real concern about the impact leaving the EU will have on retaining and attracting staff in this sector. The ability to recruit staff from inside and outside EU is important and this requires cross-border mobility and freedom of movement.

Leaving the EU also raises concerns in areas such as the medicines supply chain, medical devices and clinical trials, access to future EU funding and the rights of Scottish citizens to access state-provided healthcare across the EU.

These examples are just an indication of the substantial investment in Scotland’s communities and what is going to replace this investment when the UK leaves the EU is unknown.

Question areas

Following the Minister’s introduction a roundtable discussion followed which was based around the following three questions.

1. Within the context of Brexit discussions, what are the two most important issues for your community?

2. Thinking about Brexit, do you have all the information you need? And if not, what further information would you need?

3. Going forward in relation to Brexit, what would be important to your community?

Discussion

The areas highlighted below are those expressed by participants;

Question One - Within the context of Brexit discussions, what are the two most important issues in your community?

Important to see the Third Sector as a community, and that this includes Universities

o Access to EU funding is a major issue for higher education and research facilities.

o Student numbers are already falling partially as result of Brexit; this is impacting on investment to the sector.

o This will further exacerbate the impact of changes in Oil/Gas industry investment locally (see below)

o Universities help to provide evidence bases for Third sector support for health and social care and are a source of volunteers!

Oil/gas

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o Loss of jobs is happening already.o This is impacting on Mental Health locally.

Support for family support services disappearing, includingo Homestarto Children’s Advocacy – funding been withdrawn by grant funder,

expectation that should be mainstreamed but this has not happened.

Advocacyo Even more need for this and highlighting the importance of prevention.

Mental Healtho Scotland leading the way with the first (possibly only) dedicated

Minister.o Stigma is being reduced and the profile is being raised but also the

demand on services is increasing and is not being met.o PSE in schools.o Working across portfolios is key for mental health.

Integration of health and social services gives a chance to widen conversations, particularly about recovery

o There is concern that you can only get mental health support if you have already given up substances

o This is a cart before horse approach.o Good gateway for potential recovery is needed.

Third sector data needs to go into locality planso Vital to input.o Third Sector data needs to be fed into planning process and shared.

Role of GP’s in tackling mental healtho Why does a GP need to refer someone to counselling? Why not self-

referral (as can happen with Physio etc) – the mental health professional can then refer to the GP if needed

o Community Links Practitioner role is key in breaking down barrierso There is disparity in what can be accessed via each individual GP

surgery across Aberdeen city.

Impacts on young people and the elderly in particularo £2300 a year worse off per person is the figure quoted extensively;

where does this figure come from?o People need to take Brexit more seriously.

NHS processeso There is concern about all the processes you have to go through

before you seen the right person –all the testing/physio etc before a consultant will see you – no matter if it’s been tried before or hasn’t worked.

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o The lack of availability of professionals/staff is concerning.o EU nationals in health or social care make up a lot of health and social

care staffing; including those in the independent and voluntary care sector – how many are there and how attractive are/will we be to them in future?

o People from the wider EU are concerned about the impact of Brexit on their families.

Wider impact of lack of work in the North East of Scotlando There are not the opportunities that there are in the Central Belt

Social Care Organisationso What will the impact be on primarily independent and third sector

organisations? Seniors

o What about older people from the UK who may have to come back from Europe? Potentially 1000 extra beds will be needed for those who will no longer get reciprocal healthcare

Question Two - Thinking about Brexit, do you have all the information that you need?

No, there is a sense of uncertainty/confusion. There is a lack of concrete information. There is a lack of information to inform judgement. We don’t know what we don’t know – insufficient information is available on

the real impact of Brexit. Will there be another chance to give opinion once things clearer? We should have had more facts before making the decision. So many unknowns – hard to be reassuring/feel reassured. There is a fear of unknown. Seniors are confused – consequences not clear. Can/will there be a second referendum?

o This would need to come from the bottom up.o A groundswell of opinion would be needed.o Mainstream media is not going to help with this.

Media – has there been balance? Which newspapers to trust? What will be the impact on fishing (plus fish processing)? This will have more

of an impact on Scotland. Change of focus for jobs – away from manufacturing to tech, and from oil/gas

to renewables. Media role – is this a cause of “perceptions” and intergenerational differences

to Brexit? Important to hear both sides of any argument – people can then make up their

own mind. Role of social media is important to the debate– both in a positive “information

spread” way and in the more negative focus and fact “manipulation Intergenerational acceptance is so important. Protected characteristics – what are these ‘voices’ viewpoints?

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The Scottish population is ageing and was falling but there has been an increasing population due to migration – what will be the impact of Brexit on this?

The second generation of EU nationals is very important to Scotland – many were born here and can contribute.

Question Three - and, going forward in relation to Brexit, what would be important to your community? (possible prompts include funding, networks, NHS staff, and rights).

Back to basics with regards to language, make it simple and clear, don’t use acronyms

Again - the £2300 mentioned by the Minister - where has this figure come from and how is it made up?

The need for accessible information is essentialo It needs to be easy to understando An easy read version - not a glossy brochure – just a simple

presentation of facts Clarity over the “vision” going forward is needed.

Summary and conclusion

The main issues raised in Aberdeen included the impact on higher education institutions with less students coming from the EU and an impact on research funding. Further damage to the local economy on the back of the decline in oil and gas jobs was a significant worry as was a potential reduction in personal incomes (with a figure of £2300 being mentioned). The effect on families from EU countries residing in Scotland and whose children were raised here was a further concern. The ability to retain and recruit staff from EU countries was a concern for the future staffing of Scotland’s health and social care services. This latter issue prompted a lot of discussion beyond Brexit with concerns raised about access, particularly for mental health services.

A sense of uncertainty and lack of reliable and clear information was strongly expressed along with calls for a second vote or at least the ability for voters to influence the final outcome in some way. Insufficient information on the real impact of Brexit was a significant area of debate with participants asking for the figure of £2300 to be further explained.

The Minister concluded the meeting and thanked everyone for attending. The issues raised at the meeting will help SG to better represent the views of Scotland’s people in negotiations. The themes discussed will be captured as part of a report distilling the themes emerging from all of the town hall meetings and will be made publicly available in due course.

About the ALLIANCE

The ALLIANCE is the national third sector intermediary for a range of health and social care organisations. The ALLIANCE has over 2,200 members including a large

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network of national and local third sector organisations, associates in the statutory and private sectors and individuals. Many NHS Boards and Health and Social Care Partnerships are associate members.

The ALLIANCE’s vision is for a Scotland where people who are disabled or living with long term conditions and unpaid carers have a strong voice and enjoy their right to live well.

http://www.alliance-scotland.org.uk/

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