Seòmar agus comataidhean

I think that we have a long way to go on data. I will have a look at the English, Welsh and Northern Irish situations. There is some data that I would like to get my hands on that is not easy to obtain, and we have to do better on that front. We must also do better in terms of individuals’ data. That is why the national health and care record is important. Depending on the data sharing agreements that are associated with that, we will be able to get much more accurate data about what is going on.

I get your point about the consistency and quality of data. You will know, having seen it at this committee, that, often, data is caveated, sometimes quite heavily, so it does not necessarily give us the true picture. Mr O’Kane talked about comparing apples to oranges; I often feel that that is what we are doing, when we look at comparative data. We absolutely need to get better at that. The national health and care record will go a long way in helping us on that front. Again, even before the NCS, we must continue to refine what data we collect, how we collect it and the impacts of that on people.

I will consider anything, but I again come back to the point that, if we put too much into primary legislation, we might end up in a situation in which it is difficult to change what is there. I do not really like the term “reablement”, so I am glad that you used the term “rehabilitation”. In that regard, we are seeing advances as we move forward. We do not want to set everything in stone, so secondary legislation is probably the right place for that.

Obviously, I want those very good folks, some of whom I know well—including Fanchea Kelly, whom I know from my previous role in housing—to be at the table helping us to shape what is required as we move forward. Blackwood Homes has made immense advances in the technology that it has put in play so that folk can live free and independent lives. Those include a washing machine that irons, which was something that took my eye—Ah hinna got een yet, but I certainly have been considering that over the piece.

We need those folks to be at the heart of the process. I will consider what they have to say. I do not think that that issue necessarily has to be in primary legislation, but their voices have to be heard, and we have to get that right as we move forward.

It does not necessarily need to be mentioned in the bill, but we all have to be cognisant of the need to make sure that, in the co-design, we get everything, including integration, absolutely right.

It has been strange to me that many folk have said that various things should not be in the bill—for example, that criminal justice and children’s services should not be in the NCS. There are numerous arguments about that. The Government has not yet taken any decisions about whether those two areas should be in or out of the national care service.

However, at the Local Government, Housing and Planning Committee the other week, there was a suggestion from a member that housing and homelessness services should be in the bill and in the NCS. Of course, that is not going to be the case. However, we have to ensure that the national care service, no matter what is in or out of it, has linkages with other services across the board, including housing and homelessness services. There are areas that are perhaps not being seen by you folks to be discussed as much as they should be, but those conversations are being had right across the board.

Number 2 on my list was

“realising rights and recognising responsibilities”,

which includes the charter development. The others were: information sharing to improve health and social care support, which we have touched on already; keeping health and social care support local; making sure that voices are heard; and valuing the workforce. As I said, we will write to you on all of those.

We published the new statement of intent yesterday. There are constant meetings between officials and COSLA officials. As you can imagine, I see Paul Kelly, the COSLA health and social care spokesperson, regularly because he is involved in many of the relevant groups, including the ministerial advisory group, which he co-chairs with the Cabinet Secretary for Health and Social Care, to deal with the here and now.

I will give one example of where I want to see improvement, and to see it quickly. As I am sure COSLA officials would agree, I believe that it is scandalous that many women who are working in social care at the moment have no maternity-pay entitlement. That is absolutely scandalous in the 21st century, and it is one of the first things on my list for improvement. I think that the statement of intent will help us to move forward on that front and to get rid of some of the antiquated employment situations that exist.

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.