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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 27 April 2025
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Displaying 1225 contributions

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Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Kevin Stewart

Absolutely. The Care Inspectorate should be their first port of call. Actually, the care home should be their first port of call. They should ask why a change to access has been made and why they are being denied access. If they do not get the right answer or they do not get access, they should go to the Care Inspectorate. The number of complaints has gone down dramatically, but we will provide you with information for your reassurance.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Kevin Stewart

That would be the case if there was service failure. Let me give you an example of a provider of last resort scenario.

It might well be that a care home in a particular place collapses because the company goes out of business. In some circumstances, the local authority might, as the provider of last resort, move in and take the home over to ensure continuity of care for people. Unfortunately, such things happen fairly regularly—not only with care homes, but with care-at-home provision and so on.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Kevin Stewart

Ms Callaghan is, I think, enticing me to be naughty, which I am not going to be. I am not going to name things that are necessarily good or things that are necessarily bad.

It is clear that areas where there is increased delegation to IJBs and to health and social care partnerships, and where there are budget flexibilities, tend to perform better.

However, there are other aspects to consider, such as the scrutiny agenda. I do not know how many members around the table are as anorakish as I am, but at times I have gone out of my way to dig a little bit deeper, which I am always prone to doing. When I look at some IJB agendas and minutes, I can see quite clearly that they are taking their scrutiny responsibilities very seriously and are making key decisions.

Frustratingly, however, the other side of the coin is that in some IJBs, often agenda items that are pretty serious are for noting only, and it disna look like there is the level of scrutiny or decision making that there should be. Members do not need to take my word for that—they can go and look at the documents themselves. We need to get to a position in which local care boards are scrutinising and taking decisions, and being accountable to the populace as a whole for those decisions.

I have heard the suggestion about a national care board, but I am not entirely convinced. It might just become another bureaucratic layer, and I am not one for bureaucracy, as the committee well knows. Nevertheless, my ears are still open on that one.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Kevin Stewart

For transparency, in the letter that I write to the committee, I will give full details of everything that I have outlined already, and I will also outline how we are running public workshops on co-design—information on that is available on the Scottish Government website. There are two registers promoting this heavily, as I have outlined already. All registrants will have detailed training around co-design.

I am more than willing to be as open and transparent as possible. I know that co-design is new for many folk. Some folk see it as being very brave; I see it as being necessary in terms of our getting it right. In our letter to the committee, we will outline all that we are doing.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Kevin Stewart

No financial commitments are being directly made through the financial memorandum. The process of co-design will continue, and detailed work on the preferred options will be done through our business case process before spend is committed to.

Again, a number of things have been said about the financial memorandum that are not quite correct. For example, it is clear in the financial memorandum that more than 40 per cent of the projected costs relate to improved pay and terms and conditions for front-line social care workers, and not to bureaucracy costs. The estimated costs in the financial memorandum largely represent investments in service improvements and terms and conditions for front-line staff. Any suggestions that the figures relate exclusively to administration or bureaucracy costs are totally false.

Additionally, investment in areas such as support services will directly improve areas such as data analysis, planning and reporting, which will allow us to better understand outcomes and tailor future investment in order to have the biggest impact on our citizens.

The Scottish Government has said that we will increase social care spend by 25 per cent—some £840 million—by the end of this parliamentary session. That is in our manifesto, and we shall do it.

However, I recognise that there have been criticisms of the financial memorandum, which was produced before the current financial and economic crisis. We will consider what has been put to us and come back with an enhanced financial memorandum. However, not all social care spend that is going on now and will continue to go on is covered by the financial memorandum, which covers bill aspects only.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Kevin Stewart

We have had a fair amount of discussion already this morning about implementation gaps and the postcode lottery, as well as about the fact that folk often feel that their complaints and concerns are not properly addressed. There are three things to take from that. We want to ensure that the implementation gaps are plugged and that we end postcode lotteries. It is galling for some folks to see people who live not far from them getting better services for their condition. The national high-quality standards will be important in ensuring that we end the postcode lottery. We also need to garner knowledge from people to help us to fill implementation gaps.

Preventative approaches must be at the heart of all that we do. We talk a lot about person-centred care; lots of folk get person-centred care, but we need it to apply to everyone. That is why getting it right for everyone is also at the heart of all this. Crisis costs a lot of money, so it would be much better for the public purse, and in terms of the human cost when we get it wrong, to move to there being more prevention, rather than dealing with crises.

Ethical procurement and fair work are important to delivery. We need to ensure that we improve recruitment and retention, which we know are problems. More than that, as I said in an earlier answer, we need to attract new folk to the profession; we need to attract young people into this vital work. To do that, we must show folks that they are valued—not just in terms of pay and conditions, but in terms of career progression. At the moment, we have 1,200 employers; it is often difficult to deal with that many. However, ethical procurement and fair work being at the heart of every single contract will mean that we can do much better.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Kevin Stewart

There might be other reasons why staff transfer to a care board. For example, it might well be that a care board puts in some specialist provision in relation to the flexibilities that it is allowed in its area, and it might want to transfer staff to fill those positions. Of course, that would still have to come with the agreement of all in that regard.

I come back to the question of why we would transfer huge swathes of staff if the current employer is a good one and is delivering good high-quality social care. I have made no bones about that point during the course of these discussions. There are folk out there who continue to say that I want to grab and transfer 74,000 people to the national care service as part of a bit of empire building. That is not the case. I hope that local authorities across the country will continue to be good prime delivery partners that serve people in their communities. That is the ambition.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Kevin Stewart

As I have said at other committees, alongside the draft bill, there is a suite of documents, which includes the policy memorandum. Paragraph 48 of the policy memorandum spells all of that out. I direct the committee to that paragraph and suggest that it looks at it in depth. I also ask others to look not only at the draft bill but at the policy memorandum and the rest of the suite of documents that we have published.

Beyond that, in respect of all of those issues, I continue to, and will always, listen to what folks have to say. I want to allay fears and concerns. I want to ensure that people are enthused by what we are trying to achieve here. The key thing for me—I declare an interest as a trade unionist and a member of Unison—is that I want to ensure that we have a workforce that is bolstered by fair work and that has ethical procurement guarding its back in terms of fair work and pay and conditions.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Kevin Stewart

What do you mean?

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Kevin Stewart

That is the big question. We talk about legislative and regulatory changes as well as planning changes, but often such talk does not lead to real change. However, as we have been discussing this morning, if we can replicate what is happening in certain parts of Scotland elsewhere through ethical procurement and fair work, we will get that cultural change. I know that we keep picking on the situation in Aberdeen, but the committee has been there, as have I, so it is one that we all know. If we can give staff that sort of freedom, flexibility and independence on the front line, cultures can change dramatically.

That is the case not just for social care but for social work, too. Indeed, I am due to visit Fife; in a couple of areas, social workers have basically been given a clean sheet about what they can do, and some very positive outcomes already seem to be emerging. That freedom for social workers was embedded in the Social Work (Scotland) Act 1968, but we have moved away from it, and many of the social workers to whom I have talked feel that they are not empowered to take the right decisions at the right time for people, because they feel that the eligibility criteria and the budgets get in the way.

We have to move away from that. Again, that will mean a massive culture shift, which can be achieved. Legislation and regulation are fine, but in order to get that culture shift, we have to empower the front line again, and we can do that through ethical procurement and fair work. We need to be trusting of a workforce that should be trusted.