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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 21 April 2025
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Displaying 757 contributions

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Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 8 November 2022

Daniel Johnson

The point that I took from the Feeley report about commissioning—even just reading the executive summary—is that it needs to be more personalised. You are saying that there are likely to be fewer boards in the care service. To my mind, that means that things will be done further away from the person. Considering all the different points that were made in the Feeley report, which covers commissioning and standards, why have you pursued a model that involves creating national bodies that will oversee commissioning? To my mind, the Feeley report alludes to the possibility of reforming the inspection and quality regimes. Was that option explored, and was a financial comparison made of what the difference might be in pursuing that model, which would provide you with national accountability for standards? I am interested in what options were examined.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 8 November 2022

Daniel Johnson

I believe that you did, minister. We will consult the Official Report but, if I misunderstood or misheard that, I offer many apologies. I was simply making an inference based on what I thought that you had said.

I imagine that a computer system will be pretty key to the delivery of the bill. Such systems are key to the delivery of any public service. Recently, Social Security Scotland’s computer system was estimated to cost around £250 million. Police Scotland did not get the funding for the new information technology records system that it needs, but it was estimated to cost £300 million. Disclosure Scotland’s IT system, which was delivered a few years ago, cost £80 million.

Although we do not know the precise detail of the IT requirements, it is fair to say that, in broad terms—in terms of range—we must be looking at a sum in the hundreds of millions of pounds, even in the lower range. Are those examples fair comparators when we think about the sorts of costs that might be incurred by the creation of an IT system for the national care service?

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 8 November 2022

Daniel Johnson

That is not what I asked. I asked whether, in broad terms, the money that is used to set up the NCS will be recouped through savings or whether it will simply be additional cost. As we sit here this morning—unless you correct me, minister—even as regards the current scope of the bill, which covers the setting up of the national apparatus, what you are saying is that the financial memorandum does not include the full costs of that, because it does not include things such as the cost of the IT, which, as you have recognised, is an important element of public service delivery. We do not know what the cost of that will be.

The convener set out the costs that the Fraser of Allander Institute said are missing, which include the costs of the national care boards; the cost of transition; the cost of the impact of VAT, which you have acknowledged that we do not have; the cost of the impact of any change to the pension schemes; the cost of potential changes to capital investment in maintenance costs, the extent of which we do not know; and the cost of the health and social care information scheme. Some of those things are about service delivery, but many of them are about the national apparatus itself.

Likewise, NHS Scotland has said that we do not know what the cost of the phasing of the functions will be and has pointed out that we do not know what the size of the wider savings and benefits will be. We do not know whether the transfer will include children’s and criminal justice social care as well as adult social care, we do not have a list of the health functions that will be transferred and we do not have clarity about future demand.

There are quite a lot of unanswered questions about the specifics of running the national apparatus and about whether—even just in broad terms—having the NCS is likely to make service delivery more or less expensive. Am I wrong?

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 8 November 2022

Daniel Johnson

Minister, you have been at pains to point out that, in essence, the detail of service delivery will be subject to the co-design phase. Fine—let us park that for a moment.

Can I raise some points of clarification? You said at the beginning that the point and purpose of the bill was standardisation and accountability. For clarity’s sake, it is not just about those two elements, is it? It is also about commissioning, rather importantly. The purpose of the bill is to set up the national apparatus to make possible, and to nationalise, centralised commissioning. Is that correct?

Secondly, you are saying that, notwithstanding the points around what costs may arise from service delivery or additional services, the costs for setting up that national apparatus are all contained in the financial memorandum.

Are those points correct?

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 8 November 2022

Daniel Johnson

Okay—correct me.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 8 November 2022

Daniel Johnson

I am sorry if people thought that I was putting words in the minister’s mouth. I believe that the words that the minister used were that he “could not conceive of a situation where there would be more care boards than IJBs.” I was merely making the inference that—

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 8 November 2022

Daniel Johnson

I was not getting at cost overruns. Without plucking numbers out of the air, I was just giving what I thought were fair and recent comparators.

Coming up a layer, will IT be an important element and is it likely to be a substantial cost component of what is finally delivered?

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 8 November 2022

Daniel Johnson

Looking at the overall business case, we are talking about a set-up cost for the national apparatus of £500 million-plus. At the moment, that does not include IT or a number of other items. Will that cost be recouped in benefits? Currently, £7 billion is spent on social care and £8.9 billion on community health. Will this drive benefits and efficiency on the current footprint, excluding improvements or increases in the standards of care? In terms of the as-is—the baseline business case—will that cost be recouped, or will it be additional? Do you expect costs to go up or down on the basis of the planned investment?

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 8 November 2022

Daniel Johnson

Why not?

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 8 November 2022

Daniel Johnson

In the interests of time, I was really just asking for brief confirmations of my assumptions. I understand the different words, but I do not think that I was suggesting anything different. If it is not about centralised commissioning, can you conceive of a situation in which there will be more commissioning boards than the current number of IJBs, or are you clear that there will be fewer?