Chamber and committees

As I said earlier about the local government workforce, I do not envisage there being a huge transfer of staff from local authorities to local care boards. Obviously, there will be discussions about that in the co-design process, but I see no reason for that to happen—unless, of course, a local authority chooses not to deliver care any more, which I cannot see happening. I do not envisage the transfer of a huge number of staff from the third sector to local care boards, either. I want to be very clear about that.

I say to Mr Briggs and others that, as part of my job, I see it as being absolutely at the top of the agenda to listen to the voices of lived experience, but also to speak to front-line staff. I have been open with front-line staff about their ability to speak to me and officials directly, and I have gone out of my way to hear views. At a recent meeting of the cross-party group on social work, for example, I made it clear that social workers should be telling us what they need, what change they want to see and what would make their jobs better. That is the way that we intend to proceed and that is the way that we will continue to operate as we move forward on that front.

Absolutely, Mr Coffey. I have spent a huge chunk of the past 18 months listening to people and what they want to be changed. Some of the stories that I and my officials have heard are particularly galling; we have heard about problems that have reached crisis point because people have not been listened to at the right time, which is wrong. That is my point about the implementation gaps that have developed when changes have taken place previously. If there is one thing that I am absolutely adamant about, it is that we do as much as possible to get rid of those implementation gaps, because we cannot afford the amount of money that we are spending on crisis and we cannot afford the human cost of not getting it right earlier. That is why national high-quality standards are so important in all this.

We will continue to have local accountability, local flexibility and local design of services, but that must match up to national high-quality standards. We cannot afford postcode lotteries. Mr Coffey represents East Ayrshire where care delivery is very good, but I want everyone across the country to be able to expect that level of service and beyond. There are worries in certain quarters that, in all that we are doing, there might be a move backwards in certain places. That will not be the case. We must drive up the quality standard of care delivery right across the board.

The national high-quality standards will go a long way in reaching consistency. Beyond that, we have other pieces of work going on with voices of lived experience and stakeholders around and about the charter of rights and responsibilities. It is some of the earliest co-design work that we are doing; I was involved in discussions on that last week that, for me, were very exciting.

We must ensure that we get the right design and that we monitor as we build on the principles of the bill, ensuring that we get the secondary legislation right and removing the implementation gaps that have existed before.

Most important in all this is that, in order to change the culture that exists in certain places, we have to continue to listen to the voices of lived experience and to listen to and trust front-line staff, because a lot of what has gone on over recent years has eroded the autonomy, independence and flexibility that front-line staff have in certain places. When front-line staff have greater freedom, autonomy and flexibility, there is usually better service delivery for people. People have to be at the very heart of all this. Even once the bill is passed and the secondary legislation and regulations are in place after co-design, we must continue to listen all the way through so that we continuously improve.

Thank you, convener, and good morning to the committee. Thank you for having me along to give evidence and take questions on the National Care Service (Scotland) Bill and its financial memorandum.

The National Care Service (Scotland) Bill is an enabling bill that sets out a number of provisions. The national care service, as proposed in the bill, will bring together social work, social care and community health to strengthen health and social care integration for adult services. By the end of this parliamentary session, accountability for adult social work and care support will transfer from local government to the Scottish ministers. The Government is establishing a programme of evidence gathering and research to inform future decisions on children’s services and justice social work and on whether it would be appropriate for them to become part of the national care service, too.

The aim of the NCS is to improve the already high quality and consistency of care across Scotland and to reduce variation to ensure that everyone, no matter where they live in Scotland, is provided with the best possible care. The bill sets out that the functions at a national level will focus on consistency through national oversight, while services will continue to be designed and delivered locally. That is the right approach to support delivery with and for our communities and the people whom they serve. The purpose of the NCS is not to nationalise services.

The principles of any new system will be person centred, with human rights at the very heart of all that we do. That means that the NCS will be delivered in a way that respects, protects and fulfils the human rights of people who access care support and their carers.

The bill sets out a framework for change, but the key details will be developed as part of a co-design approach. Co-design is all about engaging and working with people—people with lived experience of and people who deliver community health and care support. Those are the people who understand the challenges best and are therefore best placed to help drive forward the improvements that we all want. It represents a new approach to drafting the detail of the bill, with the intention of working more collaboratively to reduce the gap between the legal and the policy intent and its delivery, following the difficulties faced in realising the changes identified in previous service reviews.

Integrated health and social care has long been the joint ambition of local and national Government, but the people who access and deliver care have told us that it is not delivering the quality of services that is needed consistently. Combining national oversight with local expertise will ensure that the right balance can be struck to ensure consistent and fair quality of service provision across Scotland, allow for better sharing of good practice and innovation and remove unwarranted duplication of functions in order to make the best use of public funds.

The financial memorandum sets out the estimated costs for establishing and running the national care service and the proposed local care boards. It does not cover any proposed changes to wider policy, such as those set out in the independent review. It includes significant assumptions about required investments in pay and terms and conditions for front-line local government care staff if they transfer to the NCS.

Discussions are on-going with regard to the potential transfer of staff or assets from local authorities. That is a key area for co-design and one that, given its importance, will not be rushed. Work is on-going, and all financial considerations are under constant review as new information becomes available. I want to make it clear that we are not waiting for the NCS to start improving social care; we are already taking steps to improve the outcomes for people who access care and support, and our priority will be to continue to maximise front-line spending.

The Scottish Government’s commitment to fair work and support for fair pay and conditions are long-standing policies that will be embedded in the values of the new national care service. By rewarding and valuing the workforce to deliver the best possible service for the people of Scotland, we will make the sector fit for the future and more attractive to people who come into the profession.

They might argue that, but we have been at this for a very long time. It is not just a matter of the consultation itself; there was all the work that went into the independent review and all that Mr Feeley has done in that regard. Again, voices were listened to there. In fact, from what I have heard from the voices of lived experience, people think that all of this has been too slow. If you were to ask them whether the consultation was too short, the answer from most would, I think, be a resounding no.

A lot of people, organisations and stakeholders engaged with the consultation. I have spoken with and, most important, listened to thousands of people since I came into post. Officials have been engaging with people across the board. If the committee was to bring forward some folk from the likes of the social covenant steering group, they would say that things have taken too long, that the consultation was the right thing to do at the right time and that we need to move forward.

I make the point to the committee that, just because the consultation is over, that does not mean that engagement discontinues. It will continue throughout the process. A huge amount of my time and that of officials is spent talking to stakeholders and hearing the voices of those with lived experience so that we get this right. We want such folk to be fully engaged in the co-design process as we move forward.

We know that there are financial challenges. You mentioned the emergency budget review; it would be better for us all if there was some more clarity from the United Kingdom Treasury about public spending as we move forward.

We know that, in the system that we have, huge sums of money are spent on dealing with crisis. We need to change that and ensure that, for the future, we invest in more preventative care. That will free up the resources that are currently spent on crisis, which also has a huge human cost attached to it.

As I am sure that the committee is well aware, the Government has also said that we will increase our social care spend by some £840 million by the end of the parliamentary session. We all know that we will have to get things right for the future, particularly if there continues to be restraint on the public purse. That is why we cannot stand still.

What we are proposing is not change for change’s sake. We are setting up a social care system that is fit for the future to deliver for the people of Scotland.

My door is open to local government. I will listen to what it has to say on many of these issues, and we will act accordingly. As I have said, much local authority care provision is of high quality and we would not want to see that go.

I disagree with SOLACE on that point. I have seen estimates of possible costs from others, with the Convention of Scottish Local Authorities itself estimating that the costs will be in excess of £1.5 billion, which it says outstrips the pledge of £840 million of investment. I am not sure where COSLA and others have got these estimates from. I am more than happy to go through those estimates with them in depth, but we have not had sight of them and I would be happy to take an overview in that respect.

The other aspect that I should highlight is that the recommendations in the independent review are pretty wide ranging and include not only the national care service but changes to other policies that are not necessary covered in the NCS. For example, the review has a great deal to say about charging policies and other supports for carers. I reiterate that each individual recommendation in the review has been and will continue to be subject to further policy work and financial assessment as well as economic appraisal, which I know the committee will be interested in, too.

The numbers in the financial memorandum are not compatible with COSLA’s calculations, but I am more than willing for COSLA to explain its workings to me. Equally, we will explain our workings to it and see where we can come to an agreement on some of these issues.

No, I do not necessarily agree with that. One of the things that the Government and, I am sure, the committee have spoken about on numerous occasions—Parliament has certainly discussed this at length over time—is shared services, co-operation and collaboration as a means of doing our best in delivering for the public, which is, ultimately, what we are all about.

I recognise—I have heard first hand—that certain quarters have concerns about the aspects that you have described. The other week, Ms Bell and I were in Shetland for a huge conversation on the national care service and the impact on Shetland. We will continue to listen and we will we do all that we can to ensure that there is no detriment.

You are right to point out the challenges. The scenario that you raise could lead to a huge number of opportunities for shared services and ensure that we are doing our level best to deliver for the public of Scotland.

Convener, I have said to many committees before that I am a man who does not like unintended consequences, and that is why we will dig deep into all of this.

I have great respect for the alliance and its views. However, I am unable at the moment to quantify how much it costs to collect data, which is often quite disparate and can be very difficult in some regards. We need to get better at that, and one of our ambitions is to streamline data collection and make it better.

In all this, in order to support data improvement and to benefit from data, one of our main planks in the bill is investment in the workforce so that we get this right as we move on. Again, I am more than happy to speak to the alliance where it thinks there might be difficulties but, equally, we would have to go back and say that some of the cumbersome processes that have grown probably take a lot more time than a streamlined system of data collection would.