Seòmar agus comataidhean

Good morning. Thank you very much, convener, for having Ms Haughey and me here today.

I will give an overview of our approach to the bill, and Ms Haughey will focus on services for children and young people in the context of the national care service. I should say at the outset that no decision has been taken on whether to transfer children’s services or criminal justice services to the national care service.

It is fair to say that the national care service is one of the most ambitious reforms of public services. It will end the postcode lottery of care provision across Scotland, and it will ensure access to consistent high-quality care and support, which will enable people to live a full life.

The bill sets out the framework for the changes that we want to make, and it gives scope for further decisions to be made later through a co-design process. That flexibility will enable the national care service to develop, adapt and respond to specific circumstances over time.

I want to take time to reflect on why change of such scale is necessary. Scotland’s community health and social care system has seen significant incremental change over the past 20 years. Despite that, people with experience of receiving care support, and of providing it, have been clear that there are some significant issues.

We are not changing just to address the challenges of today; we must build a public service that is fit for tomorrow. Today, about one in 25 people receive social care, social work and occupational health support in Scotland. Demand is forecast to grow, and the NCS must be developed to take account of our future needs. We will build a system that is sustainable and future proofed to take account of the changing needs of our population.

The principles of any new system will be person centred. That means that the NCS will be delivered in a way that respects, protects and fulfils the human rights of people who access and deliver care and support.

On Monday, I was in Perth to hear about Turning Point Scotland’s excellent work in supporting people with complex needs. That includes preventative work with school leavers to turn their lives around. Its work highlights the value of focusing on the whole person and collaborating across boundaries.

Our co-design process will ensure that the NCS is built with the people that it serves, and with those who deliver it, at its very heart. We are committed to working with people who have first-hand experience of accessing and delivering community health and social care to ensure that we have a person-centred NCS. We must have a care service that is person centred and that best fits the needs of the people who will use, and work in, its services.

Absolutely. The week before last, I was at the carers parliament and a large amount of the questioning from the floor was about why money that had been allocated to areas was not being spent on carers.

As folk around the table know, the Government has said that it will not ring fence large elements of money that it gives to local authorities. Obviously, local authorities make choices, but there is a real difficulty in some respects for folks who care for people when they cannot access services and they know that the money that is being sent for carers is not going to carers.

Off the top of my head, I think that the Government is now sending £84 million or £85 million per year to ensure that the Carers (Scotland) Act 2016 is lived up to. I have talked to some folk out there, including a man from Shetland who was at the carers parliament. He has requested information on what Shetland is doing through freedom of information legislation, but he canna get it. I am checking up on that, because such an allegation has to be checked up on. We have to ensure that that money is actually going to carers.

Another very important element in the bill for carers is that it will enshrine in law the right to short-term breaks. That is essential.

As I said, some things would be brought forward as business cases. We are working on all aspects of this and gathering as much data as possible, and we will produce business cases for each of the elements.

I recognise that legislation and regulation do not necessarily change cultures. Indeed, we have examples of that in some of the very good legislation that has previously come before the Parliament. Perhaps the best example is self-directed support, in respect of which we put forward—and agreed on a cross-party basis—the ability for folk to have more independence and autonomy over their care, with four different options that they could access to best suit their needs. That approach has worked immensely well in some parts of the country but not in others because, instead of sticking with the spirit of the legislation, some people in some places have looked for and found the flaws in it and have given reasons for certain things not applying to certain folks. That is not good enough, to be honest. Although we are about to publish new guidance on self-directed support that will help with some of the difficulties that people face, there is still an edginess towards the primary legislation.

One of the reasons for embarking on this co-design journey is to ensure that all people—the voices of lived experience and stakeholders—shape how we move forward on this. Beyond that, by putting some of the elements in secondary legislation, we can change things quite quickly if we find any flaws. We have been unable to do that with self-directed support, because it is enshrined in primary legislation. As a result, we will have greater flexibility.

As for the cultural aspect, there are a number of things to highlight. I think that the flexibility that I have mentioned will help to change cultures, but, beyond that, there is also the way in which we are putting the voices of lived experience at the heart of what we are doing. People have asked me, “Who do you see being on care boards?” There are certain folks who obviously have to be there, but I have tried to keep schtum on that question, because that, too, is a matter for the co-design process. However, I am absolutely adamant that the voices of lived experience must be on local care boards and must have votes. I hope—and I imagine—that that, too, will help us to change cultures.

We are going to have a national care service to deal with adult social care.

That was the recommendation from the Feeley review. That is what the voices of lived experience want. That is what many stakeholders want. As we have explained this morning, we will consider whether to include other elements, including children’s services and criminal justice services. If, as part of that co-design, folk say that a certain element might not work, we have to be cognisant of that. We are not going to be dismissive of folk in the sector or of the voices of lived experience.

No matter what is out of or in the national care service, we must ensure that the linkages are there between the NCS and the services that remain outwith the NCS.

Today, the concentration will be on whether something should be out of the NCS. On Thursday last week, folks at the Social Justice and Social Security Committee were saying that housing and homelessness services should perhaps be in it. The—

Not at all.

You are being very naughty, Mr McLennan, because I said that I really do not want to be drawn on my views on who should be around the table. I think that, in the discussion during the co-design phase, many folk will say that the third sector should be there—they will advocate that—but that is a matter for the co-design process.

No, I do not think so, because we have done it in that way for so many other things. The Government has been clear that we will ensure that those who currently require care and support, their carers and the workforce are at the heart of shaping the new service.

When it comes to the voices of lived experience, many folks have gone through lots of other processes that have not worked for them. We need to make sure that we get it right this time. This is a great opportunity for listening, consultation and co-design. If nothing else, one of my big ambitions is to remove as many of those implementation gaps as possible. This is the right way of doing so.

Some people with lived experience—such as those from the social covenant steering group, and others—whom we have talked with and listened to since we began, would argue that the framework is the right way to go, because, if we started the co-design process without the framework, they could put in all that effort then find all of it wasted.

Again, some of the people who are very active in social care—for example, disabled people’s organisations—have been involved in things previously, thinking that that was going to lead to change, but it has not done so. The framework has to be there so that we can do the next part of the work, through co-design.

Others have argued that we could have done it the other way around. I do not think that that would have worked. If we had done it the other way around—without that framework—I do not think that many folk with lived experience would necessarily have had the confidence to participate to the degree that we want.