Chamber and committees

I cannot remember seeing the letter from Lauren McNamara. We will have a look at that and respond accordingly.

I have a lot of comments on that. I know that some folk out there are not even getting 45p a mile. I declare an interest, convener, because I have two nieces who work in social care, one of whom works in rural Aberdeenshire, so I know how hard those mileage costs have hit.

That is why I have written to the UK Government, not once but on several occasions, to ask it to change the rates that it sets in order that we can do better for folk out there. I have also urged the UK Government to find additional resource to deal with increased fuel costs; the UK Government is taking in much more money in fuel duty and VAT because of the increased prices, so let us use some of that money to pay better mileage rates to social care and other vital workers across the UK. Unfortunately, I have yet to hear from the UK Government on that issue. I wish that it would take cognisance of the elements that I have laid out, for the good of social care workers and other vital workers, not only here in Scotland, but right across our islands.

Ethical procurement and fair pay and conditions are at the heart of the bill. Do we aspire to do better in all of that? Absolutely, we do. We need to do this for the simple reason that if we do not, we will be unable to grow the social care profession, which has taken a huge hit in recent times. We have lost lots of people because of Brexit, and we need to replenish that staffing core. In order to attract young people to the social care profession, we will have to do much better with regard to pay and conditions and in providing career pathways, so that they see the profession as being the right one for them. That is the only way that we will make the workforce sustainable for the future.

I have no desire to take folks’ electric cars off them, to be honest with you.

There are some myths about assets and staff transfer. The bill gives the Scottish ministers powers to transfer staff from local authorities to care boards or the Government as part of the NCS, but there is no desire for wholesale transfers of staff. Many local authorities are delivering good social care services and we see local authorities as being essential delivery partners, as we move forward. However, because care boards will be the providers of last resort, the bill has to include the ability to transfer staff if a care board becomes that provider of last resort.

It is by no means a foregone conclusion that local authority staff will have to transfer their employment. The Scottish Government’s position remains that the new local care boards will work collaboratively and in partnership with local authorities, NHS boards and the third and independent sectors locally and nationally. Our intention is that local staffing decisions will be taken by local care boards as they are established.

That is where we are. I have heard rumours about 74,000 staff being transferred. That is not on our agenda.

Let me take the example that Ms Callaghan gave in relation to drugs and mental health. At points, it seems as though Angela Constance and I are joined at the hip in respect of getting it right for folks who have more than one difficulty. I have to be honest and say that services in many parts of the country are not what they should be when it comes to dual diagnosis. That is why we are already changing standards and there are several pilot projects aimed at getting that right. Those things should become the norm. That is why we need national high quality standards in order to get it right for everyone. We cannot have a situation where we are pushing folk from pillar to post. That is one of many reasons why we need to have a completely joined-up approach.

Where folk have substance use and mental health difficulties, on many occasions, we have managed to overcome those barriers for those folks through housing first. We should—and need to—do that right across the board for everyone who has that kind of situation in their lives.

It can be achieved. We are seeing changes in certain areas now in the way in which we are dealing with folk, so it can be done.

Convener, Ms Kynaston has just pointed something out to me, and if I do not say it, she will give me trouble. Again, I refer the committee to the policy memorandum, where paragraph 38 has a commitment to

“Improve outcomes through prevention and early intervention”.

I think that that fits in here, and the issue is also referred to in part 1 of the bill.

Whatever we invest in the national care service is for the good of people, but we know that there is work to do in the here and now. It is not all about the formulation of the national care service. That is why we are also acting in the here and now, which will also be for the good of the establishment of the NCS.

I am very pleased that the Convention of Scottish Local Authorities has now agreed, through our joint statement of intent, to support additional actions that we will jointly take over the next 12 to 18 months to bring about improvements in delivery of social care.

We have heard repeatedly from people with lived experience that the current adult social care system must change in order to drive up standards to a consistent level across our country. We need to tackle the postcode lottery of care, so a different approach is needed. We must have a system in which high-quality community health and social care support helps to create thriving communities across Scotland. That is why we have introduced the National Care Service (Scotland) Bill, which is a framework bill to support collaborative design and address the historical implementation gap that has been mentioned. The implementation gap between policy, legislative intent and service delivery must be closed. That is top of the agenda for people.

The NCS is important, but the work that is being done here and now is absolutely important, too. That is why we will work with the Convention of Scottish Local Authorities to ensure that we cover the additional actions in our newly published statement of intent.

I said at the finance committee that there also would have been detractors if we had done it the other way round. The approach that we are taking allows for the scrutiny of the principles of the bill before the co-design starts, which provides reassurance for people in the co-design process that their contributions matter.

That is a good question. I will not dodge Ms Mackay’s question, but I will start off with something that I should perhaps have said in my response to Ms Harper. Some folks have asked what co-design is. One key element is that we have a job of work to do on the introduction to co-design sessions, many of which are now complete. Those sessions demystify the process for people, and more than 200 folk have taken part in them so far. That has given them a fair grounding in the task that they are going to embark on.

Ms Mackay is right that we want to ensure that we have all the voices that we can possibly have at the co-design table, and we have gone out of our way to attract folk with various conditions from various parts of the country. We also have to take cognisance of the fact that some folks require help and support, which may mean financial support, in order to take part in the process. We will continue to listen to people and provide what support we can.

We have to ensure that we continue that listening process along the way and continue to encourage people to come forward. We also have to look at the activities around co-design, which will vary. A number of activities will be suitable to meet the needs of individuals, including one-to-one sessions, surveys and group sessions. Recruitment for the lived experience panels, for which we now have more than 400 folk, will continue throughout the development of the national care service. I said “more than 400 folk”, but I should probably say 450, because that is the latest number.

That is a very good question. Sometimes there is confusion. Co-design means working with people in an equal and reciprocal partnership on design of services, policies, frameworks and interventions. Involvement starts from understanding the present to decide what the future should look like and how we will all get there.

There are three clear phases to the national care service collaborative design. The first is understanding; that is, building on the shared understanding of the current challenges that I mentioned. The second phase is sense making—what we can deliver and how in order to make the improvements that we all want. The third phase is agreement. Do the proposed changes address the issues that have been raised by people?

The initial co-design themes were launched at the national care service forum in October, and they focus specifically on the information that will be needed to develop policy that is directly associated with the passage of the bill. They are:

“information sharing to improve health and social care support”,

which includes measures such as data sharing;

“realising rights and recognising responsibilities”,

which is the human rights work and the charter development;

“keeping health and social care support local”,

which will consider care boards, geography and board representation, for example;

“making ... my voice ... heard”,

which will consider advocacy and complaints; and

“valuing the workforce”,

which will consider issues such as ethical commissioning.

I hope that that helps Ms Harper and the committee.