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Displaying 1051 contributions
Social Justice and Social Security Committee
Meeting date: 17 November 2022
Kevin Stewart
The third sector is a valued part of social care in Scotland, and it will continue to be so as we move forward. The sector is currently delivering quality social care, and sometimes very specialist social care, across Scotland. Third sector organisations are vital in providing advocacy for people and a huge range of other services. I have no doubt that the third sector will continue to be a major player in the delivery of social care, including specialist services, in Scotland. We expect, with a national care service, that there will be a mixture of providers. That is the way that it should be.
Currently, many third sector organisations find that the arrangements for procurement and tendering do not work well for them. The committee has heard from witnesses earlier this morning and previously that it is much easier for third sector organisations to operate in some areas than in others because of the procurement and tendering situations that exist. We have the ability, through ethical procurement, to iron out some of the difficulties that have arisen over the past two or three decades in order to get that right. Again, that will give third sector organisations much greater clarity than, many would say, they currently have.
Social Justice and Social Security Committee
Meeting date: 17 November 2022
Kevin Stewart
In addition, I highlight that a very good example of the co-operation that will be required is the work that Mr Balfour and I did with others, including some previous members, on the inclusion of changing places toilets in the bill that became the Planning (Scotland) Act 2019. That has changed the dynamic not only in planning and building standards, but in how we continue to enhance and improve such provision. That kind of work shows Parliament at its best, and I hope that we can achieve exactly the same thing with all, or most, aspects of this bill.
Social Justice and Social Security Committee
Meeting date: 17 November 2022
Kevin Stewart
This is an all-Scotland programme and we have to get it right for everyone, whether they live in a city such as Edinburgh, in a rural area or on an island. We have to draw a distinction with those folks who live in very remote rural areas. I want everybody to be involved in the process, and we will do what we can to hear as many voices as possible.
On my travels—I am pleased that we can now get out and about a bit more—I recently visited Shetland. In looking at aspects such as care boards and delivery, we might well have to adapt the process for island communities and other more remote communities, and we are open to that. We need those voices to say things like, “That may not be quite good enough for us here because of this.” We will do all that we can to attract those voices.
Moving away from geographical communities, I note that we also have to ensure that we hear the voices of other communities, including minority communities, as it is often much more difficult to get them to come to the table. I am thankful to the Minority Ethnic Carers of People Project in Edinburgh, which in recent weeks gave me the opportunity to talk to Chinese and south Asian carers and their loved ones, and to folks from the Gypsy Traveller community. We are doing our best to bring in all the voices that we can.
Social Justice and Social Security Committee
Meeting date: 17 November 2022
Kevin Stewart
As I said earlier, I have responsibility for policy direction. Some folk probably wonder why the Government would want accountability for some aspects of delivery. When members write to me, I have to reply that it is a matter for the local authority and for the local health and social care partnership. That is frustrating both for me and for members. We need to make the change.
There are a number of aspects around delivery where we need major change, which is why the national high-quality standards that will be in place are so important. However, I cannot put those quality standards in place now, because I do not have the power to do so. The bill and what we are doing at the moment will give us that opportunity.
As you do, Ms Duncan-Glancy, I hear such stories fairly regularly. It is annoying and frustrating for me but even more annoying and frustrating for the folks who have to make those choices.
We have to move away from some of the things that we do now that are not beneficial to anyone. We must move to much more preventative care, and we must ensure that it is person-centred care—that it recognises people’s needs. We talk about person-centred care a lot, now, but it does not happen in certain places.
As you are well aware, there are postcode lotteries whereby people are very well served in some parts of the country but not in others. We cannot have that either. The NCS gives us the opportunity to rid ourselves of those postcode lotteries.
Pay and conditions are important, but so are career pathways, which are lacking. That means that, often, it is difficult to entice young people, in particular, into the care profession. We have to change that, and there are opportunities to do so.
In addition, the NCS gives us the opportunity for national sectoral bargaining. The fact that that has not existed has meant low pay for a long time. Adult social care pay is greater here than in any other part of the United Kingdom, and we will continue to look at all those issues, because fair work has to be at the heart of it as well. It is about not only changing services for people but recognising and valuing a workforce that often feels that it has not been valued.
Finally, that move away from crisis and towards prevention is extremely important. Crisis costs the public purse a huge amount of money. However, there is also a human cost in not getting it right for folk. Making that shift, with those high-quality standards, can make a real difference in savings to the public purse and can stop some of the things that should not happen to folk. We can then put those savings into the system, to continue that work.
Finally—I have said “finally” twice; I hate it when folks do that, so I beg your pardon, convener—another aspect is about freedom and autonomy for front-line staff. There is much better service delivery when front-line staff have that freedom and autonomy. The prime example of that is in my home city of Aberdeen. I am sorry to bore some of the folk who were at the local government committee meeting on Tuesday by repeating this example, but the Granite Care Consortium’s care-at-home staff have the ability to step up or step down care, in consultation with the person who is being cared for, and their family. As folk can imagine, there is more stepping up than stepping down, but giving the staff that ability means that folk are not reaching crisis point. Beyond that, there is the obvious impact of stopping folk requiring additional services or maybe even being hospitalised.
Social Justice and Social Security Committee
Meeting date: 17 November 2022
Kevin Stewart
Good morning. Thank you for having me along to give evidence.
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 ensure that the people who need it have access to consistent, high-quality care and support to enable them to live a full life wherever they are.
The NCS bill sets out a framework for the changes that we want to make and allows scope for further decisions to be made. That flexibility enables the NCS to develop, adapt and respond to specific circumstances over time. I will reflect on why change of that 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 remain some significant issues.
We are not making changes to address only the challenges of today. We must ensure that we build a public service that is fit for tomorrow. About one person in 25 receives 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 sustainable and future-proofed system to take account of the changing needs of our population. The principles of any new system will be person centred, with human rights at the centre of social care. 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.
Improved carer support is one of the core objectives of establishing the NCS. As part of the human rights-based, outcome-focused approach, carers and people with care needs will be able to access support that is preventative and consistent across Scotland.
Nationally and locally, the NCS will work with specialist charity and third sector providers of social care as well as other third sector organisations in the field of social care to meet the needs of people.
The NCS will bring changes that will benefit the workforce, too. The importance of staff in the social care sector has never been clearer and we are fully committed to improving their experience, as we recognise and value the work that they do. The NCS will ensure enhanced pay and conditions for workers and will act as an exemplar in its approach to fair work.
Our co-design process will ensure that the NCS is built with the people that it serves, and those that deliver it, at its heart. We are committed to working with people with first-hand experience of accessing and delivering community health and social care to ensure that we have a person-centred national care service that best fits the needs of the people who will use and work in its services. Human rights will be at its heart.
Social Justice and Social Security Committee
Meeting date: 17 November 2022
Kevin Stewart
Mr Briggs and others around the table know the role that I had previously and the changes that we made to homelessness legislation and regulation, as well as changes to culture. I certainly want to ensure that all of that hard work continues to bear fruit. Without doubt, that means that there has to be an interconnection of services. I recognise, as we all do, how valuable the interfaces between the national care service and housing and homelessness services will be.
We are working closely with stakeholders through the development of the national care service to make sure that all of those links are in place. We have already held our first round-table meeting with the homelessness prevention and strategy group, which I used to chair, and we will continue to engage regularly and meaningfully with the sector. I have met people, as you would expect. No matter what is in or out of the national care service, we have to make sure that those linkages with all services are there. I do not want any difficulties with transition phases such as we have seen before.
In my work with colleagues across Government, we are clear that we have to get all those linkages absolutely right; that is why there is a lot of work going on in the background. Some may argue that that involves diverting resource to deal with the NCS rather than the here and now, but a huge amount of that work needs to be done anyway in order to improve linkages and prevent difficult transitions. I am well aware of where there could be blips, and we are doing everything possible to ensure that those connections are there.
Social Justice and Social Security Committee
Meeting date: 17 November 2022
Kevin Stewart
We can easily do that. We can keep the committee and Parliament up to date about how we are getting on.
There have been 400 registrations for the lived experience experts panel so far. I want that number to be much higher and we will do all that we can to boost that. There is also the stakeholder register that I mentioned already. I want as many people as possible to play a role.
Beyond the lived experience panel and stakeholder groups, I will continue doing what I have always done, which is to go out and about and listen. That is the essential element in all of this. Sometimes, when you go out, you find that folk have come up with a simple solution that has never been tried before or that happens in one place but not in another. We must export the best practice that exists. This is quite a small country, but we have sometimes not done that particularly well. The NCS gives us an opportunity to do that better, but that does not mean that we should not be doing that in the here and now.
Social Justice and Social Security Committee
Meeting date: 17 November 2022
Kevin Stewart
The purpose of the charter is to ensure that everyone knows and understands their rights and responsibilities and what to expect from the future national care service. In addition, the charter will provide information on the process for upholding those rights.
The forthcoming Scottish human rights bill will underpin in statute human rights in Scotland, and we are working across Government to ensure that the co-design work which is taking place will reflect the contents of that future bill. The intention is to include information on the NCS complaints and redress system, which will provide the necessary recourse if the rights in the charter are breached. That will provide a clear pathway to empower people to claim their care-specific rights, through raising awareness of those rights and informing people about how to bring a complaint should those rights not be met.
Social Justice and Social Security Committee
Meeting date: 17 November 2022
Kevin Stewart
As we move forward with incremental change, we have to continue to listen to organisations. I am pleased that you have already had a number of organisations here this morning, so that you could hear at first hand some of the things that they want to see. Their voices are required for that co-design. I have talked about the expertise of those with lived experience, but there is also the expertise of those folks who work on the third sector’s front line for many groups, including those disabled persons organisations that I mentioned earlier. We pledge to listen as we go along.
Let us be honest about the fact that co-design will have to be done within parameters. However, people understand that and they also understand that certain things might not be achievable. I have faith in people bringing their views to the table and helping us to make the right decisions as we move forward.
Social Justice and Social Security Committee
Meeting date: 17 November 2022
Kevin Stewart
This may sound a bit flippant—perhaps Dr Jim Elder-Woodward will have a pop at me later—but I have no option whatsoever but to listen to Jim, and I will always consider whatever he puts forward. As the committee may or may not be aware, Dr Elder-Woodward serves on the social covenant steering group, and he has been a very strong voice for disabled people’s rights for a very long time. I give the commitment to Ms Duncan-Glancy that we will consider whatever Jim puts forward—I do not have the option not to.