Chamber and committees

Thank you. I appreciate the sensitivity, and it is good to have that on the record.

In a similar vein, I welcome the survivors forum that has been established to engage with all the applicants in order to gather their feedback. Is there flexibility to ensure that that feedback can be considered quickly enough in order to enable real, practical improvements to be made to the process where that would be helpful?

You have touched on this already this morning, cabinet secretary. Existing targets so often define our priorities and our focus is on what we are measuring. Are you reviewing current targets and considering alternative targets? Can you give a couple of examples of successes?

We know that integration joint boards are sometimes not delivering and that some voices are not being heard on them. Clearly there is some consensus that, when we talk about care boards, it sounds as though we might be recreating a system and just moving people around and, if you like, just sitting them in a different seat.

Can you give us an example of anything that is working like a care board just now? I am thinking, for example, of Granite Care Consortium. It has brought in the health and social care partnership, voices of lived experience and providers with different expertise. Everyone sits down at the same table to collaborate and everyone has a voice. Is that the vision that you have in mind?

Secondly, we have heard from different people the suggestion of a national care board that would play an overarching role with regard to local care boards. Do you have any views or comments on that?

I have three questions. Minister, you have touched already on monitoring, evaluation and outcomes. The bones of it seem to be that we are good at asking people what they want, but we are perhaps not so good at asking, “How was it for you?”, even though that is what matters to people.

It has been suggested that we could adapt the Northern Ireland, England and Wales national survey of bereaved carers. Could you tell us quite precisely how successful we have been with regard to measurement and evaluation, and could you perhaps define what you mean when you talk about consistency and quality?

I want to pick up on that. Housing first was a revelation—we could see it really changing people’s lives with wraparound care and seamless joined-up services. The bigger picture is that public health approach at a population level. There are housing and homelessness services, but there are all those other local services that are closely related to social care, such as those relating to mental health, drugs, alcohol issues and so on. Given that, why is the NCS the way forward in order to get that seamless joined-up care that people are looking for and that really matters to them?

Thank you. I appreciate your committing to looking at that.

I am also interested in your vision for community health services. Will you provide some clarity? In evidence, we have heard that people have concerns around those services. They are central. Will you provide some clarity on where they will sit? People have felt that they are missing from the bill. Clearly, that issue is vital, if social care is to be viewed as an investment rather than a cost.

One of the barriers to that seems to be the idea of incorporating community health primary care services and taking that kind of public health approach. If we are saying that no health staff will be transferred into the national care service, can that really be achieved?

I am grateful to you for allowing me to come back in, convener.

Minister, last week, we had Mark Hazelwood from the Scottish Partnership for Palliative Care, who talked about the fact that not everybody will recover and that one in three hospital beds is used by someone who is in their last year of life. The partnership would like two specific things to be included in the bill. It wants to have something in the bill about people with irreversible health conditions through illness or old age and who are approaching the end of life. Secondly, the partnership wants something about interventions that are about preventing or delaying the development of care needs and reducing care needs and support for those with irreversible health conditions. It feels like end-of-life issues are not included in the bill, even though that is something that we will all face at some point, and the issue is becoming larger proportionately as the demographics change.

Will you consider changes to the principles of the bill to include end-of-life issues?

I have another two, so do not take too long.

On that, the concern seems to be that there is not really any mention of community health services in the bill. Does that need further consideration? Where exactly are you with that?