Chamber and committees

Okay—thank you. Tracey Brown, you wanted to come back in. Could you be brief?

As we look back over the Covid period, what are the key lessons for Government? What should or could Government do better?

Secondly, in comparing communication in Scotland with that in the rest of the UK, I think that, in Scotland, the First Minister had a press conference near enough every day, and she was communicating a message. Generally, that was well received. That was less so for the UK Government, but the press-release briefs of the UK Government were much more informative. Dr Whitty and Jonathan Van-Tam had never been heard of before, but they are now household names—and they are very informative.

What could Government do better? How did it perform, and what are the lessons?

I will begin with Dr Dawn Holford. In your submission, you say:

“There is considerable collective and diverse expertise among researchers that could support Government in communicating science and public health messages based on evidence-informed principles. However, there is a lack of infrastructure to help with rapid consolidation of this expertise”

to enable that to happen. Could you expand on what you mean by “a lack of infrastructure”, please?

Okay—thank you. I will move on from that specific issue related to health and social care and care homes to talk about the general state of health and social care in Scotland. We have major challenges and problems. I have been quite clear that that has been the case over a number of years, under successive Governments, so I am not pointing a finger at anyone. However, there were reports this week about care homes from the Care Inspectorate and the reality is that some of them are just not fit for purpose.

We have a social care sector in which care homes are in difficulty, and we have a home care service that has massive problems with recruitment and retention. It seems to me that the Government’s answer to all the issues—which are impacting on people right now—is to say that it is setting up a national care service. That is umpteen years away, but we have major issues now, and older people in Scotland are being let down badly. How can we start to get on top of the issues that are impacting on people right now, rather than simply saying that a national care service will magically fix all that in two or three years’ time? It will not.

I understand that the High Court decision in England is for England and Wales, but I think that it would be fair to accept that practices in Scotland were like for like or certainly similar to those in England. Do you agree that it is crucial that the public have confidence in any public inquiry or reviews that take place?

Although I accept that the public inquiry is independent of politicians, I was concerned this morning to read one lawyer for bereaved families of those who died in care homes say that the families do not feel that they are getting a say in the inquiry. I think that I read that families had met Lady Poole and were not satisfied with the outcome of that meeting. Do you accept that it is important that the Government plays a role and ensures that families’ voices are heard, and, equally, that their questions and concerns are heard in the process?

Just quickly—

I would come back on that by saying to you that, in the medium term, Scotland could and should have its own immigration policy to tackle some of those issues—there is not a lot of disagreement there.

However, I am old enough to remember the Griffiths report that came out under Margaret Thatcher, which was the starting point for community care. Indeed, I remember writing an essay on that report and concluding at the time that, although the proposal sounded wonderful, it could not be about providing care on the cheap.

The reality is that we have seen a move away from the majority of home care in Scotland being delivered in-house by the public service and through local authorities to a shift into private provision. Indeed, in many authorities—including Fife, where I come from—the split is, I think, less than 40 per cent in-house delivery and more than 60 per cent external delivery. That has happened only because it is cheaper for councils to put that work out, and it is cheaper only because those staff are paid more poorly and their terms and conditions are horrendous compared with those in the public sector. That, for me, is the major factor in the current recruitment and retention crisis, but every time that I raise the matter with Government, the answer that I always get is about a national care service that is coming at some point two or three years down the road.

I do not believe that we have two or three years. If we do not tackle the issue now, it will just get worse, and older people up and down Scotland will pay the price. Will you agree at least to look at the issue of terms and conditions, and to start to put in place a timetable for addressing the issues that need to be addressed now?

With regard to people on lower incomes, the data that I have looked at shows a stark reduction in vaccination take-up in the under-40 age group. I have to say that the situation is not unique to Scotland—it goes across the UK—but there has definitely been a stark reduction in take-up of the third dose. Likewise, when the Office for National Statistics compared vaccination take-up and free school meals data, it found a clear correlation between lower socioeconomic status, deprivation and poverty and vaccination uptake, particularly with regard to the third dose. That was in England, but there is no reason why the same should not apply to Scotland. Have you found that to be the case? Does the Scottish Government need to consider further action to encourage vaccination uptake, particularly in those areas and amongst those groups where it is lowest?

On the basis of the evidence that we have taken so far, I would say that there is general support for many of the measures and proposals in the bill. To oppose many of them would be to do so for the sake of it, because they make sense—I get that. One area that is clearly causing problems, however, is the Henry VIII clause, as it is called. As I understand it, it is basically

“a statutory power given by the legislature to the executive to alter or repeal primary legislation, without reference to the ordinary parliamentary processes of scrutiny and amendment required for Bills. While powers of this kind have been used by the UK government to adapt the statute book to the United Kingdom’s departure from the European Union, Henry VIII powers are rightly controversial, as they infringe upon the separation of powers, give legislative functions to the executive, and can be imposed with modest opportunities for parliamentary scrutiny, particularly in circumstances when they are used on an emergency basis.”

You can see that there is genuine and sincere concern. Along with your partners, the Greens, you have a majority in the Parliament, so there is no doubt that you could ram the legislation through regardless. Given that there are genuine and serious concerns, particularly about that part of the bill, among those of us who believe that most of the bill makes sense, are you willing to sit down with other parties, have a discussion and reconsider the genuine concerns that are being expressed?

Good morning, and best wishes, cabinet secretary.

How do the public health powers in the Coronavirus (Recovery and Reform) (Scotland) Bill compare with the equivalent powers in England and Wales?