Chamber and committees

There are always challenges in retaining some folk. The Government places great importance on its relationship with senior health and social care leaders. My officials regularly meet integration joint boards’ chief officers, and I have been meeting chief officers almost monthly since I took office. Those meetings cover a wide range of topics, including leadership development and barriers to integration.

Officials recently met the executive group of chief officers to discuss what more support might be required—whether that is more capacity to provide peer support in learning, coaching and mentoring for individuals, or more structured programmes of support. We have also discussed engagement with wider staff groups to encourage participation in local and national strategic activity, with succession planning in mind.

The meetings that we have with chief officers also give them the ability to articulate what they are doing well and where they are having difficulties. There is also peer support, which is extremely important. At some points in the pandemic, folk felt that there was not enough time for that. All those things will be important as we move forward.

My role in all that is to listen to what is being said by chief officers about what barriers exist for them, and to see whether we can get rid of them. It is also to provide a forum to bring folk together for the support that is required.

There is absolutely no doubt that resilience is a part of that. However, much of the focus in discussions has been on how we have all supported one another during what have been very difficult and stressful times for many of us. There have been lots of discussions around the mental wellbeing hub support that we have put in place, for example. Local examples of good practice in mental wellbeing support have been talked about in the national group and folk have implemented them in their areas.

Coming together to talk about such things can be not only good for learning but can be quite cathartic, because at points during the past period, many of us have felt a little bit alone. When we talk to others about what is happening to us, we find that people have been in similar positions. How do we help one another through all that?

As the committee well knows, I do not commit myself or promise anything unless I know that it can be delivered. Timelines are difficult, because we do not know what the coronavirus will do next and trying to second guess all this is not an easy thing to do. As always, I am more than happy to continue to brief the committee on where we are at in all aspects of our workstreams as we move forward.

On the timeline for the bill, we said that we would introduce it by the end of this parliamentary year. That is June, and we are on track to do that. However, I emphasise that it is not all about the bill or the formation of the national care service. We have a lot of work to do to ensure that we get back to some kind of normality—the remobilisation of social care.

The committee will be well aware of the actions that we have already taken. For example, on pay, we have introduced the minimum rate of £10.50 an hour. We are in discussions with the Convention of Scottish Local Authorities about conditions, and I hope that the newly elected members in our local authorities and whoever the new COSLA health spokesperson is will continue to engage with us on that.

I put on record that the previous spokesperson, Stuart Currie, who stood down at the recent election, was extremely co-operative. I think that we are in a good place with our local authority partners, because we all want to achieve the same thing. On that front, we also have to recognise that, at the moment, one of the big difficulties for me and the folks in local authorities is that we are dealing with 1,200 employers, but we will continue to try to make gains in that regard.

As I mentioned in my opening speech, another thing that I would like to see is the demise of eligibility criteria for non-residential services. I know that COSLA shares that ambition, but we have to work our way through that. As we have those discussions and negotiations and, I hope, make progress, we will keep the committee informed. At the heart of all that change are people, of course, and getting it right for people—not only the workforce, but the folks who are being supported and receiving care.

I hope that, with the comfort that we have provided through the procurement policy note that I talked about earlier, we can move to a type of ethical commissioning that has fair work at its heart.

We have drafted procurement rules in Scotland in a way that enables collaboration and discourages competition based on price. The rules enable preliminary market engagement with providers before starting a tender process and prevent a public contract being awarded on the basis of price alone. We want to see high standards; we want fair work to be at the very heart of all that we do. That is vital as we move forward. There are some folks who say that it is difficult to do that under the current procurement rules. Those folks are more than welcome to have conversations with my team or with the procurement team to give them comfort on how they should move forward on that front towards ethical procurement.

We have given a really good outline of what we want to do. You ask about defining benefits. Whose benefits are we defining? There are benefits for the public service itself, and for people using it—the list goes on. We must continue to work on defining what the benefits are. We will continue analysing all of that.

I go back to the report by the Christie commission: the key thing is to look at a joined-up approach and to get rid of the silos that still, unfortunately, exist. No matter what is in, or out, of the national care service, making the transition phases much better for people will be a major benefit. Without doubt, there will be a huge amount that will benefit people and the public sector as a whole. We will continue to work on all of that, and I am sure that Mr O’Kane will continue to scrutinise whether those benefits become a reality. I am hopeful that we will make real change, particularly for the good of folks.

Absolutely. A lot of the questions in the consultation came from suggestions and views from the voices of lived experience. We ask some difficult questions; that is how consultations work. The question about the GP contract came directly from the recommendation from Derek Feeley’s independent review. If we had not asked that question, people would have said that we had ignored a Feeley recommendation.

We hear a lot of different stories about where self-directed support does and does not work for individuals or their families. We have to look at some of the flexibilities that were in play during the pandemic to see whether they should be embedded as we move forward. I have heard stories of transformational change for individuals and families with self-directed support, but there are other cases in which the support has not gone far enough to meet the needs of the person who requires it.

One of the great things about my job is the ability to talk face to face—not often yet, unfortunately—or online with people about what does and does not work. It is quite amazing when I hear about cases in which SDS has made a difference for not only the individual who is being supported but the family as a whole. Such stories are the ones that we should be aspiring to as we move forward rather than having the current situation, which is still a bit of a postcode lottery, to say the least, when it comes to the delivery of support and services.

One of the key principles of the national care service is to raise those standards and to look at national pay bargaining as we move forward. I am a great believer in fair work and the Government is committed to fair work principles, which will be embedded in the national care service. One of the reasons why so many of the employers who deliver social care are having difficulties with recruitment and retention at the moment is that they are not providing their workers with fair work. I am sure that many of you will have seen, as I have, that there is a lot of movement within the social care workforce. In many cases, that is the movement of folks who want permanent contracts, higher pay and better conditions—and who can blame them?

At the moment, the good employers out there—and there are some, without doubt—are gaining the benefits from the pay and conditions that they offer, and some of the employers who are not living up to the principles of fair work are losing employees. A lot of that is people fishing from the same pool, which is a difficult situation. It may resolve a tension in one area but cause one in another area. I hope that we can iron out that scenario as we move forward with fair work and national pay bargaining.

The other issue is attracting young people, in particular, to social care and social work. We have to show young folk how they can progress in their careers in those areas, which is not so easy at the moment. However, we have had discussions with the likes of NHS Education Scotland, the Open University and others to look at how we can provide better training, qualifications and education to make progression easier. We know that, during the course of their careers, some folk will want to flip jobs. It may well be that they want to go from social care to the health service or social work, or vice versa. Sometimes, that is not so easy to do, and we need to make it easier. In order to grow the workforce for the future, we have to make it much more attractive, particularly for young people. Career progression and career pathways are immensely important.

It has made matters for many very, very difficult. Some of you will have heard me mention before that, in conversation with one employer, I heard that they lost 40 per cent of their workforce in one of their facilities after Brexit. Folks chose to return home because of what happened and because of the feeling that there was a hostile environment. That has had an impact on service delivery. Some folk have said that we overegg the pudding when it comes to talking about Brexit, but that is a prime example of the impact that Brexit had on service delivery. Although I am not saying that every service lost 40 per cent of its staff, there are tales from right across Scotland about the impact of people returning to their home countries because they did not feel welcome in the UK any more.

I know that we have done our level best to try to reassure folk that they are welcome here in Scotland, but we lost a lot of good people who were delivering for our most vulnerable people.

There are many different views on the national care service consultation, and I think that it would be fair to say that I have heard them all. Some folk thought that the consultation was too long, some thought it was too short, others felt that some of the questions that they wanted to see were not there. The list goes on.

The NCS consultation is not the end of the engagement on the service. I have made it very clear, right from the beginning, that, as we move forward, we must continue to talk to, listen to and consult with stakeholders, and in particular the voices of lived experience, in order for us to get this absolutely right.

That is why the work will continue throughout. It will go on as the bill progresses, and beyond the bill as we shape the NCS. It is not just about the legislation or the regulation; it is also about the cultural change that is required. There will continue to be engagement on the NCS all the way through.

As I have said to the committee time and again, and will probably continue to say as we move forward, I am very keen to hear the voices of lived experience. We need to hear those voices as we shape social care for the future.