Chamber and committees

We have heard people talk about co-design and co-production. They are often used interchangeably, but we know that co-design is actually different from co-production. What is co-design, in terms of shaping the national care service bill?

I will pick up on self-directed support. You came to Dumfries and we spent some time together. I appreciated that because it allowed me to see that some people were really happy with the self-directed support that they had been offered, while other folk had not been offered it or had never even heard of it.

Would a national approach to training ensure that people know that self-directed support exists, what it means and what options there are, and would that support be delivered in a more standardised way by the 32 local authorities?

We have had some interesting evidence sessions with people who assume that the national care service will do things such as taking away local authorities’ assets. Electric vehicles, for example, were mentioned way back at the beginning of the evidence taking. It might help us if you tell us what the national care service is and is not. The issue of transfer of staff and assets that belong to local authorities, for instance, has been brought up. The point about electric cars was interesting to me because I had asked a question about it. How can we dispel some of the myths that have already been created about the national care service?

How will the Government ensure that, as part of the co-design process, national accountability allows for local implementation and flexibility? There is a big difference between developing care to be delivered in the city of Glasgow and doing it for rural Dumfries and Galloway, for instance. I assume that co-design will be on-going rather than having an end point for design of the whole service.

How will we monitor and evaluate the implementation and success—assuming that it is a success—of this framework bill?

On the subject of integrated services, you have highlighted gaps such as, for example, the lack of onward care, which leads to people being held in secure facilities instead of moving on. Do you envisage the national care service bill addressing the issues that you have highlighted in order to ensure a seamless approach? In our evidence-taking sessions, we have heard about the importance of the third and independent sectors in supporting people who have mental health needs but who do not necessarily need an acute stay in a mental health hospital. Do you think that the national care service bill should be able to support a seamless transition?

I have just one more question.

Although the framework bill is pretty short, section 38, which covers three pages, is dedicated to rights to breaks for carers. We have had feedback from various people who have raised questions about what constitutes a break, whether it is a break for everybody and whether it is a break to get out or disengage completely. I am interested in hearing views on what the bill says about breaks for carers—in particular, unpaid carers—and whether it is sufficient to achieve what is required.

Thank you. I might come back to that issue later.

What Elinor Jayne was just saying about stigma is interesting.

I have a question for Kira McDiarmid about mental health and how the bill might support a wider mental health approach. The Feeley report recommended that appropriate care be provided for people with complex issues around their care, such as those involving mental health and alcohol. Do you think the bill is sufficiently clear about how mental health services and support can be provided in the overall framework, and do you have any suggestions about what might need to be added?