Seòmar agus comataidhean

When the bill was introduced, a number of committees in the Parliament, Opposition parties and stakeholders raised concerns about it. That is why we paused and refined it. We worked hard to strike an agreement with the Convention of Scottish Local Authorities and the national health service on the tripartite shared accountability arrangements, which we did last June. From last June, we have worked together on that point.

The amendments that I sent to the committee in June were draft amendments that were intended to bring that agreement to life in legislation.

Good morning. I thank the committee for its consideration of the bill. It remains critical that we get this right. Strong social care and community health support are the bedrock of a thriving, compassionate civil society. Given the many areas that we agree on, I appeal to members across the political spectrum to engage collaboratively on this endeavour.

I also thank the many organisations and individuals who responded to the committee’s call for evidence. The overwhelming majority of respondents recognised that the status quo cannot continue and that fundamental change is required. That echoes the thousands of conversations that my officials and I have had with people across Scotland who use social care and community health services, and with people who have caring responsibilities.

In those discussions, people have told us that three key issues require urgent action, the first of which is shifting society’s attitude to ensure that social care is properly valued. Secondly, there needs to be access to consistent high-quality support and services that are targeted at where and when they are most needed, with clear information on availability. There is an unacceptable variation across local authorities.

Thirdly, there must be oversight of planning and delivery. Indeed, the committee’s post-legislative scrutiny of the Social Care (Self-directed Support) (Scotland) Act 2013 highlighted the importance of that, and it is on that issue that we have the furthest to go to reassure people with lived experience. They have been heard and we are taking action. The bill is intended to address all three issues with structural reform that further empowers the role of people with lived experience.

The bill and the draft amendments that I sent in June represent how best to achieve this reform. As you will be aware, although some draft amendments garnered broad support, we encountered opposition to other proposals. I can answer questions about the Government’s policy intention behind those proposed amendments, if that will be helpful, as they are part of the consensus that we are working on. I need to consider what approach will secure sufficient support to make progress.

For those reasons, on 13 November, I wrote to the committee saying that I wanted to take the time to fully reflect the views expressed in our approach, and that I was not seeking to start stage 2 today. That was a necessary step to ensure that we get this right.

We need to come together, agree the way forward and deliver for people who need it most—those who use or work in social care and community health services and those with caring responsibilities. It is vital that the needs and voices of people with lived experience are put first, and we must work together to develop a social care system that we can be proud of.

Yes.

Yes.

I do not think so, no. It is well established that there is a great deal that we agree on in the bill. I need to hear from Opposition parties and stakeholders which parts of the bill they agree with and which parts need to be refined. I am in the process of listening, reflecting on what I am hearing and making decisions on how to move forward.

You will have heard in the evidence to the committee from people who access social care and whose loved ones depend on social care that it is very clear that the status quo is not acceptable. Many people are telling us that the social care system in Scotland is broken and that there needs to be fundamental and systemic change to deliver better social care. I will be keen to hear from all political parties in the Parliament on how we proceed.

I might ask my officials to chip in, but, fundamentally, aspects of the National Care Service (Scotland) Bill would amend those pieces of legislation to deliver the changes that people have told us, through the Feeley review, they want to see.

That looks like an attractive option—I can understand why that looks like an approach that could be pursued. However, the reason why we chose to have the National Care Service (Scotland) Bill was that we think that fundamental structural reform is needed, and we think that it is wise to bring all of those things together into one piece of legislation that the Parliament can scrutinise in one go.

There are some things that we can do only with primary legislation. For example, a crucial part of the national care service, as proposed—and one that everybody supports—is the information-sharing aspect, which requires primary legislation.

You could perhaps pursue each of the goals of the Feeley review on an individual basis, and you could probably, by regulation, achieve some of them, but there are some things that you just cannot do without primary legislation.

We are working on accurate data. It is not as simple as saying that we should put in extra money. If it were that simple, we probably would just throw money at it, but most people would recognise that a change in approach is required as well as extra money. There are challenges in following the money across the system and in seeing where the money goes within social care. It is quite complex to follow it.

There is a general acknowledgement that we are not getting in early enough. If we go back to data, one of the problems with data is that we focus very much on the things that are easy to count, such as delayed discharges—what we call the back door of the hospital. It is less straightforward to measure unmet need in the community. If we could get that fixed, that would help us with early intervention and prevention and mean that money was spent more efficiently. Some of the calculations on early intervention and prevention suggest that we could probably help twice as many people if we were able to get in earlier, rather than waiting until somebody reaches crisis and is admitted to hospital. A frail elderly person being discharged from hospital is likely to need twice the package of care than they would have needed if we had got to them earlier.

It is not an easy thing to do, but morally, ethically and economically, we have to get in earlier, higher upstream, and we have to have more grip and assurance across our system. We have to understand what is going on and make sure not just that money goes into the system, but that it goes to the right place. I think that there is general agreement in that regard. People have concerns about the national care service and about the Government’s delivery of social care, but very few people are arguing for the status quo and more money to do things the way that we do things now.

The Government encourages all local authorities to approach SDS in the same way so that people understand their options and are offered the full range of choices through SDS. I am aware that the support that is available is inconsistent across the country.

In April, the Scottish Government relaunched the support in the right direction programme and has committed £9.2 million to fund the programme for the next three years. I have to say that I was absolutely delighted to see the multiyear funding for that programme, because it is important that it is embedded and that it continues. It will ensure that people who require social care support will have access to independent information, advice and advocacy in line with the Scottish Government’s vision for self-directed support.

Inspiring Scotland is the fund manager for the support in the right direction—SIRD—programme, which is delivered through partnership arrangements with third sector organisations and local authorities right across Scotland. The Scottish Government funds 33 organisations across the country through the programme, which covers all 32 local authority areas. That is one really significant piece of work that is being done in order to ensure that people have the right information, options and support in order to make the right decisions.

We are keen to identify any barriers to the implementation of full integration across the board. We will look at any barriers that this post-legislative scrutiny identifies. We will then make improvements to the system and take action to ensure that it operates as intended.

I do not know whether Rachael McGruer wants to say a bit more about the evidence that has been gathered so far in this inquiry.