Behind the petty politics, market-based providers were pushing hard to obstruct reforms, writes Luke Beesley
Despite years of negotiation between the Scottish Government, Disabled People’s Organisations (DPOs), unions and local authorities, the National Care Service had barely gotten past the ideas-board stage before it was scrapped by Maree Todd MSP at the end of January. As the Glasgow Disability Alliance pointed out in response to its publication, the Bill fudged questions of who was responsible for what in the proposed system, and how its rules would be enforced. The Bill also left its relationship to other legislation intolerably unclear. It guaranteed little more than a government committee in an already bloated bureaucracy, patiently awaiting empowerment by secondary legislation.
If we are to succeed in our next attempts to bring a nationalised and user-friendly care service onto the agenda, our strategy must begin from a clear explanation of how the NCS coalition collapsed, and a precise understanding of our opponents’ interests, incentives, and capacities. What follows is a provisional sketch for such an explanation.
Political Intrigue and Sectional Interests
The killing blow for the NCS was a typical piece of Holyrood psychodrama. Fearing a battering in the 2026 elections, the SNP attempted to turn the NCS Bill into a vehicle for interference in local government. By expanding Holyrood’s power over homelessness services, children’s services, and community social work (none of which have much to do with the NCS’s original mission), the SNP could then have waited for the next local scandal, before riding in to save the day. A case for centralising those functions could be made in light of a shocking lack of homeless accommodation and frequent malpractice of local social workers managed by local authorities. But including them in the NCS Bill was a hail-Mary for the SNP’s electoral chances. Taking responsibility might make one look momentarily statesmanlike, but having responsibility associates one with failure. As it turned out, the Greens, with the flexibility and platitudes of a yoga instructor, spotted an opportunity to distance themselves from their former government partners. Suddenly, anything which impinged on ‘local decision making’ had become ‘contrary to Green values’. The Greens withdrew their support to leave the Bill without a majority.
This petty drama has dominated pundits’ accounts of the NCS’s failure; but behind the operatics, deeper contradictions emerge. Local government leaders had, by their own admission, only accepted proposals for central government oversight on the understanding that it would take the form of yet another toothless ‘strategic leadership’ board. On discovering that the Bill could be used to force service standards and assessments into some kind of alignment, they gracelessly took their leave. ‘Shared accountability’ with central government (in which both sides blame the other, and all are absolved from responsibility) was something they could get behind; losing control of their departments was not. Union leaders, meanwhile, realising that their attempts to negotiate wage increases for social care staff hadn’t succeeded, astutely followed the local authorities’ lead. The initial NCS negotiations had brought these bodies together around an agreement that radical change was needed to how support services were provided, funded, and organised. By the end, only the DPOs dared stick to this blindingly obvious truth.
Disabled people’s role in this drama has been like that of Cassandra in Homer’s Iliad. They have faced the disaster going on around them with sober senses and attempted to convince those with power to turn the ship around. Cassandra was first imprisoned and then handed to her enemies as punishment for speaking uncomfortable truths. The failure of the NCS will create disability, through which people are robbed of their autonomy and dignity and denied fulfilment of their most basic human needs.
This is not necessarily because of any conscious or unconscious value judgement made by the able-bodied world – let alone a psychological need to remove disabled people from mainstream society to control what counts as human. While there are doubtless bigots in the Scottish Government, local councils, political parties, and trade unions, their abandonment of the NCS was a result of sectoral interests and incentives. They saw first an opportunity, and then a threat, to their own power and influence
A Different Way of Explaining Disability
In the 1970s and 80s, Marxists in the Disabled People’s Movement developed a model for explaining how disability is produced by social contradictions inherent in capitalist societies. There is nothing in any bodily state which implies that its owner should have no control over her life, or no meaningful place in her society; but she is transformed into social surplus through the operations of the capitalist accumulation process, the need to manage social problems which arises from it, and the street-level conflicts inherent in a world designed for economic value, not human flourishing. It is this model which we will now apply to the NCS’s failure.
The accumulation of capital depends, for our purposes, on two rules. The first is that workers must be adaptable to consistently produce more value than the value of the goods they receive in wages, regardless of how labour is organised. This first rule leads to the most basic creation of disablement: when bodies and minds are not infinitely adaptable, they will be excluded from labour regimes which demand workers’ adaptability.
The second rule is that the value created by labourers can be profitably invested somewhere in the capitalist economy. This rule leads to both the attractiveness, and impossibility, of something like the NCS for the ruling class at this juncture. Faced with a global fall in the rate of profit – entailing smaller and smaller returns per £1 of investment for most capitalists – the bourgeoisie is faced with a need to intensify labour to secure their existing investments. They do not need the labour of disabled people (whose unemployment in Scotland is more than double the national average), but they do need that of those who provide informal support. Nationalising and standardising services, as an organisational innovation, is attractive because it maximises the time a worker remains at work and provides more certainty about workers’ family obligations across the country (allowing investment to move more easily). Paying for it, however, is not so attractive. Increasing taxation on firms to improve services would constitute a further drain on surplus value, entrenching the accumulation crisis further. As nationalising social care means minimising the money that councils currently claw back from service users through arbitrary means testing, the NCS is impossible to realise without more resources. This circle is impossible to square.
But it is not the economic elite who make disability policy – although, in the final analysis, at least a plurality of them must accept it. Nor is it the executives of national governments (which Marx and Engels described as simply the committee for managing the bourgeoisie’s common affairs). As by-products of capitalist production processes, the lives of disabled people are of no interest to the ruling class and are handed over to the tender mercies of those charities, small ‘care’ businesses, local agencies, local governments, and so on, which are more willing to deal with them via state-managed markets.
The managers of such enterprises assume an uncomfortable class position. They by turns exploit and rent-seek to make the most of the hand they are dealt; but they are ultimately entirely dependent on the largesse of the state for survival. In a zero-growth market, they compete fiercely for the right to administer disabled people’s lives, allowing the ruling class to maintain their blissful ignorance. They support radical innovation when it strengthens them against their competitors, and oppose the mildest reforms when these might weaken their ability to extract value or maintain their market position. The difference between the shared accountability which council leaders insisted on, and the sweeping central government powers the NCS Bill eventually offered, is best explained by this dynamic. If the NCS were simply a mechanism for embroiling national government in local problems, councils and their community partners’ leverage would be massively increased. Underfunded services in West Dumbartonshire, say, would become a matter of confidence in the national government. If it became a transfer of power to the centre, much of the leverage they have would be lost.
Taking the Struggle Forward
Care services are governed by unresolvable economic contradictions and devolved to a bickering and grubby professional caste. But disabled people’s responses to this dysfunctional picture are not passive. When organised together, disabled Scots have attempted to exploit the contradictions between the state and the fractured disability industry. The NCS proposal adroitly identified that the existing system was intolerable to the ruling and political classes, and that the existing ‘care’ markets were incapable of offering solutions. Turning this strategic insight into a winning campaign, however, requires the power to force those other actors to act against their interests. Power is not something which is dropped into movements’ laps; it must be consciously and patiently built.
There is no single way to build power; and I have no desire to pre-empt Scottish DPOs’ next steps. As a disabled activist in England, I am painfully aware that Scottish comrades have built their movement in a way that puts us to shame, and they need no lectures from me. It is worth emphasising, however, that there is no path to our freedom and dignity that does not go through conflict with the state and the third-sector industrial complex built around disability. We must be thinking about how we exact costs from our opponents (and our history of direct action offers lessons in this regard), but also how our broader activities might build our strength.
Charities, care companies, and local government have power because they dominate how services are run. At a local level, we can contest this. The idea of disabled people running equipment and support services is often thought simply to be a better, more humanising, version of the mess that others have made. The point, however, is that it brings more provision under our direct control. Our campaigning aims to put disabled people in charge of all the services they use, and to use the constant failures of service markets as an opportunity to expand this control. When we do this, not only do we create better services, and more humane and joyful social relationships; we prevent our opponents from deepening their control over our lives. A national reconstruction of disability services may be off the table for now, but the fight for who owns them and who benefits must continue.
Luke Beesley teaches Political Science at the University of Manchester and is a PhD Candidate at the University of Brighton. He is active in various Disabled People’s Organisations in England. The views expressed here are solely his.