Other Key Activities

Other Key Activities

Work with Scottish Government on Transport to Health and Social Care

This area of work remains a high priority of the committee and whilst there has been a level of frustration at the distinct lack of progress on this, MACS have, this year had promising and productive meetings with Government officials one of which included Humza Yousaf, the then-Cabinet Secretary for Health and Social Care.

The background on this goes all the way back to MACS Report into Transport for Health and Social Care from December 2019 and the follow-up Report in March 2020 that made a number of recommendations as well as a workshop in 2021 organised by the Scottish Government Health Directorate. This event was based on the end of the phase one work and culminated in 9 recommendations.

Following discussions between MACS and Ministers in 2020 it was agreed that the Scottish Government Health Directorate would lead on how best to take forward and implement these recommendations with the formation of a Task Force/Advisory Group being established. This was then explored further with the Cabinet Secretary for Health and Social Care the meeting in 2023.

The first Recommendation of the MACS Report in Dec 2019 was that the Scottish Government should review the operation of patient transport services to promote consistency, quality, and affordability, while ensuring that disabled and older people are not being unfairly excluded from accessing healthcare. This should align with the 4 priorities of the National Transport Strategy and in particular priority areas 1 and 4 (Promotes Equality/Reduces Inequality and Improves Our Health and Wellbeing).

The overarching recommendation of all this work is that Transport should be built in as an integral part of the care pathway. The goals are ensuring access to health and social care by better joined up transport and care planning, which needs to include joint working with NHS Boards, Local Authorities, the Scottish Ambulance Service and with the Community Transport Association as key partners planning and care pathway.

The following themes were identified as needing specific focus for future work.

  • Accessibility
  • Booking Information
  • Availability (current procedure and availability of resources)
  • Community Transport
  • Affordability.

MACS will continue with the work on Transport to Health and Social Care as a priority.

We have, had follow up meetings with officials, including one with the Cabinet Secretary for Health and Social Care, which we have been assured that this work will be taken forward, and as such, we look forward to feeding into and helping shape the workplan for driving much needed change, particularly as the NHS remobilised and recovers.

Fair Fares Review

The Fair Fares Review aligns very much with one of MACS' key principles, that transport should be Available, Accessible and Affordable.

From conversations with various Ministers (Minister for Transport, Minister for Active Travel, Cabinet Secretary for Social Justice, Housing and Local Government, Minister for Equalities and Older People) and officials, the Fair Fares review has been cited as the vehicle to deliver affordable transport, to assist with keeping people connected (reducing social isolation and loneliness, improving health and wellbeing) and enabling the modal shift from private car to public transport.

This approach also supports various government policies (Child Poverty Delivery Plan, A Fairer Scotland, National Transport Strategy 2, Low Traffic and 20 minute neighbourhoods, the Sustainable Transport Hierarchy, 20% reduction in car kms by 2030, tackling the climate emergency etcetera).

MACS' position is that to enable the delivery of the commitments and ambitions from these policies and strategies the "Review" needs to keep in scope actions that are bold and break down the financial inequalities between urban, rural and island areas, the cost variance between modes of public transport and assist with making transport more available, accessible and affordable for all. In particular, there should be a focus on delivering affordable public transport options for those who rely on and currently struggle the most to use public transport (disabled people, older people, people on low incomes, island and rural communities).

Of course, the review can also make a vital contribution to tackling the cost crisis, the over riding theme of the recently published PfG.

We recognise that the national bus concession scheme for older people and disabled people is a huge benefit for people in Scotland. It is simple, free and has few limitations in time of travel or geographical limitations (dependent on the availability of bus services). People who require companions to travel can also travel free.

In contrast, concessions for most other modes of travel e.g. rail, taxis (including private hire cars), tram/subway, community transport, ferry, and domestic air, are either a postcode lottery or are largely absent. Moreover, information on what is available is extremely difficult to find in one place.

We appreciate that this is because most concessions applying to such modes are the responsibility of local authorities rather than national scheme although there are of course exceptions; for example blind people travel free by rail nationally (although whether the companion can travel for free too depends on the local authority area).

However, one of our chief hopes for the Fair Fares review is to see a coherent, consistent, and logical set of concessions for all modes in place across Scotland, to remove the 'postcode lottery' and to provide a simple set of concessions, which apply everywhere.

We would also want all concessionary schemes to take a consistent approach to discounts or free travel for carers/assistants as a matter of course. We appreciate that this would be easier to introduce for some modes of travel than for others.

Concessionary travel schemes are of course only one tool to aid affordability of travel. Commercial transport providers have always structured fares to provide a range of discounts and incentives including discounts for:

  • return fares,
  • child fares,
  • family tickets,
  • season tickets,
  • a range of rail cards (including of course, for disabled people), etcetera.

More recently, the widespread use of smart ticketing has enabled daily fare 'capping' to become common. For example, Lothian Buses' 'tap tap cap' system has a daily cap of £4.40 and a weekly cap of £20.00. Some of these fare arrangements can offer significant savings but may not help some people who are least able to afford them. For example, people who cannot afford to pay the upfront cost of season tickets, or people who use cash, rather than smartcards. This may be similar to the well known problem with energy costs where people who have the lowest incomes may rely on prepayment meters, which exclude them from cheaper tariffs. The distribution of these kind of fare benefits of such commercial schemes is something which Fair Fares Review needs to explore.

We appreciate that the viability of many public transport services, especially but not exclusively in rural areas, is fragile. While we accept this is outwith the scope of Fair Fares Review, it is vital that other measures to boost public transport ridership should be encouraged, which will enhance our aspirations for 'available' as well as 'affordable'.

Most obviously this would involve effective plans to stop buses getting caught in traffic congestion, for example through new Bus Partnership arrangements, which extend and better enforce bus lanes.

No doubt the Fair Fares review will encompass opportunities presented by smart and integrated ticketing, which has the potential to especially benefit many disabled people by allowing seamless ticketed travel, whether this is simply changing from one mode to another or a more fully developed 'Mobility as a Service' (MaaS) type system.

The Fair Fares Review will no doubt take full account of the distinctive needs of rural and island communities, but a full Island Inequality Impact Assessment (as well as Equality Impact Assessment) should form a core part of the Review. This will need to take account of ferry and domestic air fares for both passengers and vehicles and consider the place of Road Equivalent Tariffs (RET).

Finally, we note some ambitious national schemes to promote free or discounted public transport, for example in Luxembourg, Germany and Spain. We hope that Scotland will match such ambitions, and be alert to opportunities for learning from elsewhere, while being bold in its approach.

MACS look forward to hearing more about Fair Fares Review soon.

Monitoring and Evaluation through improved data collection

To assist with monitoring the progress of NTS2 and the ATF, the Planning and Strategy Workstream, had a further meeting with Transport Scotland Analytical Services team.

MACS has collaborated with them previously to determine what data was missing/needed to be collected as a baseline to monitor disabled people's travel behaviours and to track progress of several transport policies (NTS2, ATF, STPR2, 20% reduction strategy). This built on the initial work to produce the TS Report, 'Disability and Transport' in 2021.

The chief conclusion from the meeting was an explicit request that Transport Scotland publishes a separate version of 'Disability and Transport' every year, to aid longitudinal monitoring of trends, especially on 'closing the Mobility Gap'. MACS also followed up with a letter outlining all the specific suggestions for data improvement we have made.

Moving forward, it is intended to form a small subgroup to continue monitoring evidence, developing MACS' research asks, and to aid continuing liaison and dialogue with Analytical Services.

 

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