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Chamber and committees

Official Report: search what was said in Parliament

The Official Report is a written record of public meetings of the Parliament and committees.  

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Dates of parliamentary sessions
  1. Session 1: 12 May 1999 to 31 March 2003
  2. Session 2: 7 May 2003 to 2 April 2007
  3. Session 3: 9 May 2007 to 22 March 2011
  4. Session 4: 11 May 2011 to 23 March 2016
  5. Session 5: 12 May 2016 to 5 May 2021
  6. Current session: 12 May 2021 to 24 November 2024
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Displaying 938 contributions

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Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Kevin Stewart

As I have said at other committees, alongside the draft bill, there is a suite of documents, which includes the policy memorandum. Paragraph 48 of the policy memorandum spells all of that out. I direct the committee to that paragraph and suggest that it looks at it in depth. I also ask others to look not only at the draft bill but at the policy memorandum and the rest of the suite of documents that we have published.

Beyond that, in respect of all of those issues, I continue to, and will always, listen to what folks have to say. I want to allay fears and concerns. I want to ensure that people are enthused by what we are trying to achieve here. The key thing for me—I declare an interest as a trade unionist and a member of Unison—is that I want to ensure that we have a workforce that is bolstered by fair work and that has ethical procurement guarding its back in terms of fair work and pay and conditions.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Kevin Stewart

What do you mean?

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Kevin Stewart

That is the big question. We talk about legislative and regulatory changes as well as planning changes, but often such talk does not lead to real change. However, as we have been discussing this morning, if we can replicate what is happening in certain parts of Scotland elsewhere through ethical procurement and fair work, we will get that cultural change. I know that we keep picking on the situation in Aberdeen, but the committee has been there, as have I, so it is one that we all know. If we can give staff that sort of freedom, flexibility and independence on the front line, cultures can change dramatically.

That is the case not just for social care but for social work, too. Indeed, I am due to visit Fife; in a couple of areas, social workers have basically been given a clean sheet about what they can do, and some very positive outcomes already seem to be emerging. That freedom for social workers was embedded in the Social Work (Scotland) Act 1968, but we have moved away from it, and many of the social workers to whom I have talked feel that they are not empowered to take the right decisions at the right time for people, because they feel that the eligibility criteria and the budgets get in the way.

We have to move away from that. Again, that will mean a massive culture shift, which can be achieved. Legislation and regulation are fine, but in order to get that culture shift, we have to empower the front line again, and we can do that through ethical procurement and fair work. We need to be trusting of a workforce that should be trusted.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Kevin Stewart

I could also provide quotes from people with lived experience who want to be at the heart of shaping the national care service, which is, after all, delivering for them. I recognise that some people are worried about the change; I get that. Change is often of concern, but I have said, and I will continue to say, that we will continue to be open and transparent on this journey and to listen to people and allow the opportunity for scrutiny.

I will use the example of secondary legislation. Many people out there, and in here, always feel that everything has to be in primary legislation, but that does not allow for the flexibility that we often need for change.

Self-directed support, which I mentioned earlier, is mostly in primary legislation, and we know that people are using the loopholes in that to avoid the spirit of that act. To close loopholes such as those, we have to go back to primary legislation, but it would be so much easier if things were in secondary legislation because, if we found loopholes or an implementation gap, we would have the ability to change that pretty quickly to get it right for people. I recognise that some folk do not like that, and if we were to make change we would, of course, consult people and listen to them. However, using secondary legislation is a major way to ensure that we have the flexibility to get all this right in the future.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Kevin Stewart

On picking the best that is out there, as I have said to the committee in previous appearances, I make no bones about the fact that it is absolutely vital that we pluck out the best work and export it across the board. In informing the national high quality standards, we must look for the best of the best. That is our aspiration.

However, as we continue on our journey, we will not wait for the NCS for some of that. We are already trying to ensure that we export best practice across the board. At the moment, we do not have the power in relation to national high quality standards to ensure that that becomes a given across the board.

10:15  

On plugging the implementation gaps, the reason why we should have more confidence on this occasion than on other parts of our integration journey is because we will be listening to the voices of lived experience—they know where the gaps are, where the difficulties lie and the barriers that are preventing them from getting the care and support that they need. They will be key in plugging those implementation gaps.

In the future, once the care service is up and running, if we find that there are gaps and there is practice that is not working out for everyone, we will have the ability to change the standards in order to ensure that those issues are fixed.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Kevin Stewart

No, this is not a power grab. We are responding to what we have heard from people right across the country. They want to see ministerial responsibility for social care. It has come as a shock to many people that while, as a minister, I can help to legislate and bring about policy, I have no direct influence over service delivery. It comes as a shock to many members of the Parliament, who write to me all the time, asking me to intervene in situations, which I cannot do, because I am not responsible for the delivery of community health and social care. As I say, we are responding to people who believe that ministers should have accountability for the delivery of social care. We are also responding to people’s view that that accountability should be enhanced at a local level—which I agree with. This is not a power grab; it is a response to people.

On the work that we have done around staff transfers and pensions, the bill only gives ministers powers to transfer staff from local authorities to care boards. However, as I said earlier in response to Ms Harper, it is by no means a foregone conclusion that there will be wholesale transfer of staff.

The Government is, as always, well aware of the repercussions of transfers. That is why we have worked on all of that to ensure that we get it right—and will continue to do so. If there are transfers, we will engage and consult with trade unions on that transfer of staff.

If it is agreed that any staff will transfer to the national care service, following discussions with local authorities, TUPE regulations would apply, as set out in section 31(4) of the bill. The Government would engage with the recognised trade unions in line with TUPE regulations and the Cabinet Office statement of practice. TUPE and COSOP place requirements on both sides to consult with trade unions in good time. We would ensure that such consultation takes place. We would intend to avoid any detriment to staff, including in relation to pensions.

However, I reiterate the point that I made to Ms Harper: there is no intention to make a wholesale transfer of staff.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Kevin Stewart

It is not just about the bill; the key issue is implementation. We need to ensure that the implementation gaps that we have talked about often today are plugged.

I have been honest about this previously and will be honest again. It is often very difficult for us to gather data on what is going on. That is one of the reasons why data will be so important, as we move forward. There has been a lot of to-ing and fro-ing around certain aspects of social care delivery, costs and so on, and it very difficult for me, as minister, to gather some of that information. We need to change that.

10:00  

We also need to consider outcomes a lot more—what is working for people and what is not. Although we have a fair amount of information, it is still not enough. As we move forward, we must become more adept at garnering data in order that we are able to monitor the situation properly. Beyond that, we need to continue to listen to the voices of lived experience, as we continue on the journey.

I have not talked much about the make-up of local care boards, but I am adamant that the voices of lived experience should be at the table at local care boards, and that they should have voting rights. When it comes to monitoring what is going on and plugging the implementation gaps, they are the experts.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Kevin Stewart

Mr O’Kane has been an elected member in a local authority, as I have. Local authorities do not carry out just the functions that they are statutorily obliged to; they do other things that are for the good of the people of the area that they represent.

As I said earlier, we want to ensure that local authorities remain prime partners for the delivery of high-quality social care in their communities. That is for the good of the people who they represent. Whether or not they are accountable for it by a law, I am sure that the altruists who serve on local authorities will see the huge advantage of ensuring that their people are cared for properly, appropriately and to the highest standard of quality. Beyond that, as I have pointed out, local authority members will play a part in local care boards, as they do with IJBs at this time.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Kevin Stewart

I refer to the policy memorandum again. At the end of the day, the national care service will be there to

“Provide leadership, oversight, and accountability for community health and social care, including by providing strategic direction and planning at the national and regional levels, and performance management and monitoring of the care boards to ensure national standards and expectations are achieved, albeit in a way that suits local circumstances”.

However, I have pointed out again and again this morning that local accountability needs to be strengthened, too. That is a purpose of the bill. That is what we have heard from people.

None of what the care service will do stops local decision making. None of it stops local flexibility and innovation. None of it stops flexibilities around delivery of services in particular areas. However, those national high-quality standards must be met. That will end the postcode lottery of care, which, again, folk want to see, but it does not stop flexibility.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Kevin Stewart

We cannot afford to pause—we need to change the system. We have to do it carefully and incrementally, and we have to ensure that, as we move forward, we get everything right. That is the dilemma for me. I know that many folks including Derek Feeley want things to move at pace; many folk want change to have happened yesterday. Let us be honest: activists have been campaigning for social care change for decades. They have seen some changes, which we have spoken about, but that does not go far enough for them.

We have a job to do in getting this right: we have to take people with us and we have to have people at the heart of co-design of the service. That will take a bit of time. We also have a situation in which Parliament rightly wants to scrutinise what we are doing. That, too, will take a bit of time. We have to build the confidence of everyone as we move forward, and sometimes that takes a bit of time.

I very much understand why Derek Feeley wants change to happen at pace, and I understand the activists who want change to have happened yesterday, but I, the Government, the committee and the Parliament have to recognise that there is work to be done, and that that work will take a little time.

Basically, I am saying that there is a fine balance to be struck.