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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 20 April 2025
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Displaying 986 contributions

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Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Paul O'Kane

What will happen to health and social care partnerships, given the process of integration that has happened in various local authorities?

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Paul O'Kane

I begin by asking more broadly about structures. I hear what the minister says about the need for national standards, and there is a large degree of consensus around that. However, whatever way we look at it, the national care service involves big structural change. Does the minister feel that there is a risk of that structural change becoming an end in itself rather than being a means to a greater end?

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Paul O'Kane

Convener, I wonder whether I can put another quote to the minister. In its report on the financial memorandum, the Finance and Public Administration Committee said:

“The significant gaps highlighted throughout our report in combination with the Scottish Government’s approach to introducing the primary legislation prior to completion of the co-design process has frustrated the parliamentary scrutiny process.”

Given everything that I said in my previous question and the concerns of other parliamentary committees, does the minister recognise that there is an opportunity here to pause, get back round the table, listen to those concerns and try to address them before we move to the next stage of legislation?

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Paul O'Kane

What will the status of health and social care partnerships be in the new approach? Do you envisage them no longer existing in their current form and being redeveloped through the national care service process?

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Paul O'Kane

The minister will hear no complaints from me if he is singing the praises of East Renfrewshire. He makes a fair point about the length of time for which integration has been part of the fabric of certain communities and the importance of trying to learn from that.

I turn briefly to the social work element of that, and the further consultation that the minister intends to undertake on children’s services and criminal justice social work. What are the minister’s intended timescales for that?

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Paul O'Kane

Okay. That might be comparing apples to oranges.

I will move on slightly, and quote some of the evidence that we have heard. The minister said that he feels that he has adopted a logical process, but we heard the following:

“at the moment, it feels as though it is a one-size-fits-all system, and I do not think that that will work”.—[Official Report, Health, Social Care and Sport Committee, 25 October 2022; c 38.]

We heard that

“So much is left to secondary legislation and co-design that we do not feel that we have the detail ... to be able to comment”,

and that

“We are talking about a substantial bill on a national care service that has been introduced without clear detail”.—[Official Report, Health, Social Care and Sport Committee, 1 November 2022; c 2, 23.]

We heard that

“this bill does not deliver the changes that are required”,

and, finally, that

“It is like buying a house without ever having seen it or knowing know how many rooms it has or where it is located.”—[Official Report, Health, Social Care and Sport Committee, 15 November 2022; c 35, 39].

That was a cross-section of the evidence that we heard from legal experts, Common Weal, care providers, local authorities and trade unions. Those are very serious concerns about the way that this has been done. Would the minister like to comment on some of those quotes?

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Paul O'Kane

Does the minister not recognise that there is a principle here around decisions being taken as close to people as possible and the role of local government in doing that? He is right to say that he and I have both served on local authorities as councillors, as have other colleagues on the committee. I am keen to understand why he feels that there will be more accountability by virtue of 129 MSPs and the minister having that control as opposed to local councillors having it. Does he feel that local councillors are not accountable enough now and do not represent their constituents on these issues?

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Paul O'Kane

I appreciate what you have just said. I think that everyone would welcome an enhanced financial memorandum. That would be important, not least because of the significant concerns that have been raised by colleagues on the Finance and Public Administration Committee. Will that enhanced financial memorandum include consideration of the VAT liabilities that are involved in this process?

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Paul O'Kane

If we take as read what you have just said—if we take you at your word—why have you not spelled out in the bill that your intention is that the care boards will be providers of last resort, or that they might put in place specialist provision, which you referred to? Will you expand on that? I presume that you perhaps mean specialist learning disability services or something like that.

Why have you not spelled out in the bill what you have just said, in order to give confidence to people who are clearly very anxious? In evidence, we heard from trade unions, local authorities and front-line staff that there is anxiety, not least about the potential implications of TUPE for pensions and so on. I appreciate that you have written to the committee in that regard, but if we are dispelling people’s anxiety, do you want to take the opportunity to clear up some of those issues?

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 13 December 2022

Paul O'Kane

Good morning, panel. The first section in our briefing paper for the meeting is titled “General hopes and fears”. That is a broad theme, but I am keen to understand the concerns that people might have about how the bill has been structured and came to be.

Over our evidence sessions, we have heard significant concern about the bill being a piece of framework legislation and the detail being co-designed after the bill has been passed. I will quote Tanith Muller, chair of the Neurological Alliance of Scotland, who said:

“Scotland is being offered a new structure for care—but without blueprints, a schedule or a budget. We can’t tell if it will even stand up, much less that it will meet the care needs of people in Scotland. Ministers need to go back to the drawing board and show us all the plans that they have developed with people before they ask MSPs to legislate.”

I know that MND Scotland is a member of the Neurological Alliance, so I ask Susan Webster whether she shares some of those concerns, and to say what could have been done differently.