Abstract
Introduction: Making care an inspiring and attractive field of work requires culture change across a number of levels, both bottom up through more decent work and top down through higher valuing of care itself. How countries manage an integrated national policy on care, care workers and unpaid carers is part of that culture and can be challenged to change.
In Scotland there are 11 National Outcomes within Scotland’s National Performance Framework, though none are focused on care, carers and care workers. In recent years, significant and welcome policy has been developed in Scotland relating to diverse aspects of care. A new National Outcome can be a focus not only for key stakeholders in policy but for a country as a whole.
Aims, Objectives, Theory or Methods: The aim was to produce a new national Outcome to impact on government and contribute to culture change to enable Scotland to be and show it is truly a country that cares. This was undertaken in a research process with a literature review, interviews with carers, and consultation on an Outcome with an advisory group including representatives of Oxfam Scotland, Scottish Care, One Parent Families Scotland, the Scottish Women’s Budget Group, and Carers Scotland.
Highlights or Results or Key Findings: A report was produced that provides a detailed blueprint for the addition of a new National Outcome on care. This suggests wording for a new Outcome on care, as well as a series of linked indicators to monitor success. The proposed Outcome covers the full spectrum of paid and unpaid care both for adults and children and for those with and without additional support needs. The cultural problem is that people in Scotland who care for others, whether paid or unpaid, and whether for adults or children, have been undervalued and under rewarded. This systemic undervaluing of care is inextricably linked to the fact that care work is overwhelmingly carried out by women. This research places a blueprint for a new National Outcome to drive and track long-term change on the table.
Conclusions:The report advocating a new National Outcome on care, bolstered by a robust monitoring framework, was published in November 2021. Scotland would be in a significantly improved position to measure whether it is valuing, and investing in its many care workers, unpaid carers and those experiencing care. What was needed next was the political vision to further refine, test and deliver this new National Outcome.
Implications for applicability/transferability, sustainability, and limitations: Lessons from this ambitious intervention on policy development in one country can be identified for Network governance, and how outcomes and benefits are assessed for care systems.
There are general implications for policy and policy-making and leadership and change management. There are also lessons around consultation with care workers, unpaid carers and organisations which represent them.