Seòmar agus comataidhean

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.

An average that was based on the forecasts that were available was used when the financial memorandum was written. We understand that more recent Scottish Fiscal Commission forecasts are now available, and estimates will use the updated profile. We have seen a massive change in inflation in a very short period of time, which many of us could never have predicted. As we all know, inflation is very volatile at present and has moved markedly since the estimates in the financial memorandum. Our financial modelling will continue to reflect the most recent inflation rates, and we will update accordingly as we move forward. With that, I will bring in Fiona Bennett.

Let me assure you that we will update the financial memorandum and that, as we move forward with the formulation of the business cases, we will continue to take account of the current financial and economic circumstances, including inflation.

The committee is well aware that the financial memorandum and the business cases are not in themselves budgets. Budgetary decisions on spend will have to take place in the normal way in this Parliament, as you would expect.

I will come in on that. Some of the areas that you have highlighted are outlined in the policy memorandum as ones that require further detailed development, including those costings. We should perhaps have communicated with folk a little bit better around the fact that the documentation that we have produced forms a suite of complementary information to support transparency in all of this. Some stakeholders have picked that up a little better than others. In that suite of documents, we have been open and transparent not only about the work that we have done and the financial memorandum as it pertains to the bill but about the other work that needs to be done and how we go about doing it.