Seòmar agus comataidhean

Thank you very much, convener, and good morning to the committee. Thank you for having me along today to give evidence.

You will be aware that I have given evidence on the bill to several committees already, so it is good to come to the lead committee, although I have another two to come. 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 in Scotland and it will ensure that people who need it have access to consistent and 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 will enable the national care service to develop and adapt, and to respond to specific circumstances over time.

I will take time this morning to reflect on why a 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 some significant issues remain.

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

The principles of the new system will be person centred, with human rights being at the very heart 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 are accessing care support, and those of their carers.

Improved carer support is one of the core objectives of establishing the NCS. As part of the human rights based and outcomes-focused approach, carers and people with care needs will be able to access support that is preventative and is 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 people’s needs.

The NCS will bring changes that will benefit the workforce, too. The importance of staff in the social care sector has never been clearer, so we are fully committed to improving their experience through recognising and valuing 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 whom it serves and those who deliver the service. They have to be at the very heart of all this.

I have noticed that the committee has been out and about, hearing from people with lived experience of social care across Scotland. You have also heard from organisations that represent them. I was delighted to see that, because it is vital that we listen to those people as we establish the national care service. 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 national care service that best fits the needs of the people who will use and work in its services, with human rights being at the very centre.

Thank you very much, convener.

Community health is a foundation of the national care service that we need to get right. Through early engagement with stakeholders, we have learned that it is imperative that we continue to engage people who have experience in that.

As things currently stand, community health—those services that are based in the community and provide the first point of contact, diagnosis and treatment—comprises more than 90 per cent of all interactions in health, and many problems are identified, managed or resolved within the community. That makes it one of the largest and most crucial areas of healthcare.

Community health, community social work and social care services are the front line. They are accessed in a variety of ways: through many of our health and care sites; in people’s homes; or remotely, supported by technology. Again, we need to look at best practice in that when it comes to getting it right for the NCS.

For clarity, community health staff will remain in the NHS. The commissioning and planning of community health will be the responsibility of the national care service. That will build on the current integration arrangements that are in place under integration joint boards.

One of the key barriers is that, as I said, there are 1,200 disparate employers that are working to contracts that the Government has no control over.

I say again that the two wage rises, which I and everybody here wanted in order to put money into people’s pockets and purses as quickly as possible, were not the easiest things to achieve. We do our level best here, but there are things that we rely on others doing, which often makes things not as easy as they might seem.

Absolutely. This is not about moving the deck chairs—I am not into that kind of game. We need to take cognisance of the views that we have heard from those who are in receipt of care and support, from their carers and from front-line staff about the improvements that are required.

I return to a point that I made in my opening statement: we canna just tinker about at the edges, here. We have a changing demography in Scotland and we need to expand the social care workforce, as I also said earlier. We need to make a real change and, of course, people have to be at the very heart of our doing that.

As always, I am more than happy to work with anyone to ensure that we get things right, as we move forward. That is not to say—let us be honest—that I will support every amendment. However, if we can work in partnership to get the most out of all this, I am more than happy to do so. I think that Ms Mackay knows that ethical procurement is one of the top things on my agenda. I want to make sure that we do our level best to get all this right and to embed fair work principles as much as we can.

However, I highlight to the committee that, as you are all well aware, this Parliament does not hold powers over employment law, so we will have to do that, as always, with great care. It has been achieved previously in other bills—including in relation to forestry, if I remember rightly—and we need to do that again. If that means co-operating and collaborating with members to get it right, I will be more than happy to do so.

Folk in the consultation said that they wanted Scottish ministers to have control and accountability over this.

I am sorry that I did not quite get it.

The financial memorandum will cover all aspects that pertain to the bill. As the committee knows, we are working at this moment to ensure that we cover all bases when it comes to any liabilities, including VAT. The best option would be for the Treasury to rule that there would be no VAT liabilities. We will continue to push and prod the Treasury on that front.

We have to have a framework before we can move to co-design. We had to show the people who we want to help us co-design the bill with us that there is a framework to blanket that co-design around.

We came to that decision because that is the logical way to do it, and because we looked at what has happened previously. I remind the committee that the formation of the national health service was based on a framework bill, and I think that the national health service has been a wee bit of a success, has it not?

What do you mean?