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Absolutely. I am absolutely determined to improve the situation, particularly because of where I live. The geography where I live is very challenging for social care. We do not have a care home in the village that I live in. If someone is unable to manage independently in their home in my village, they have to move away from their community and family to access care, probably on the other coast. That is the reality for people in the Highlands.

One of the reasons for our focus in the national care service on shifting care upstream and getting into that early intervention and prevention end of things, to support people to live independently and healthily at home for as long as possible before care is needed, is about enabling people to grow old and frail, and potentially die in their own communities. We are determined to deliver that. I will hand over to Donna Bell to give a bit more detail on palliative care.

I do not have the numbers in front of me at the moment, but it is significantly less than was predicted because the pace of delivery is slower. The slowing of the pace, the pausing and the phasing of the introduction of the national care service mean that it is costing less.

Donna Bell might have the table in front of her.

I am really sorry, but I did not hear that figure. Could you repeat that figure, please?

No, we do not recognise that figure.

I did not say that the Conservatives slowed the delivery of the bill. The Conservatives were one group that was opposed to the bill as introduced, but there was significant opposition to the bill as introduced. I think that it is reasonable in the face of significant opposition that the Government pauses and works on the direction of travel with the people who are concerned about the direction of travel, and that is what we have done.

The bill will be delivered. We will finish stage 1 by the end of January next year. Of course, it will be down to Parliament how fast the legislation progresses, but I would expect there to be significant progress in the next few months.

We are still in the thick of discussing local governance arrangements. I might ask officials to come in on that, in case I have missed anything in answers that I have given. However, I envisage that the structures that already exist will be strengthened.

At the moment, we have quite a disparate pattern of integration, which is one of the reasons why we have a postcode lottery. There is more integration in some parts of the country than there is in others, which is probably not serving us particularly well. There will be a move towards more integration all over the country, and the structure of integration joint boards and health and social care partnerships will evolve and probably strengthen in order that they can oversee local delivery of social care.

Donna Bell can probably give more detail.

I have not been asked very much about palliative care. However, the reality is that the vast majority of people who go into a care home do so at the end of their lives and they pass away within an 18-month period. It is there, but it is not up front. I will let Donna Bell talk a little bit more about that.

You are absolutely right. It is crucial that carers have a life alongside caring. I mentioned that I meet regularly with many people who are involved in social care. People who are caring for members of their family are often at the end of their tether, which is one reason why I am absolutely passionate about shifting care higher upstream towards early intervention and prevention, so that people do not get to crisis point before help is available to them.

It is absolutely crucial that carers have their own life alongside caring and that they can sustain their own health and wellbeing. As you are well aware, we are doing a lot of work through the bill to enshrine the right to breaks. However, we are acting now to expand easy access to short breaks support ahead of the legislation—we are not waiting for the legislation to make that change. We increased the voluntary sector short breaks fund by £5 million to £8 million, and we have maintained that fund at £8 million for 2023-24.

That is in addition to the Carers (Scotland) Act 2016 funding—the £88.4 million that goes through the local government block grant. We are trying hard to support carers before we create their right to a break by putting it in the bill.

Thank you very much for inviting me to provide an update on the National Care Service (Scotland) Bill.

During the summer, we used the time to respond to stakeholder concerns. We have agreed proposed changes to the overarching structure of the NCS, which will help to achieve our ambition of improving the quality and consistency of social services. We have also carried out extensive co-design engagement across Scotland to understand how to achieve the change that is needed.

After being out and about over the summer speaking with people, I know more than ever that the status quo is not an option. We must act decisively so that people can have the improvements that they need as quickly as possible, and we must make wise decisions in a new fiscal environment in which resources are under pressure. That is not an easy task, but we are absolutely committed to getting it right by listening to the voices of experience. I want to outline how we propose to go forward, having listened carefully to those voices.

In my recent letter to the committee, I described our extensive summer programme of local co-design activity. We held regional events across Scotland and online. Hundreds of people participated and shared valuable and diverse feedback on the NCS. I attended several events in person, and I whole-heartedly thank everyone for sharing their experiences and knowledge. We have now published our analysis of those events. They will shape our thinking going forward and they will shape the second NCS national forum, on 30 October.

Our other major discussions over the summer were with the Convention of Scottish Local Authorities, the national health service and trade unions. We reached initial consensus on a partnership approach with COSLA in July. That will provide shared legal accountability for integrated health and social care services. Those discussions are still continuing, and more detail is being developed that will inform our proposed amendments to the bill.

It is important that we have effective national oversight and governance to drive consistency and improved outcomes for people who access support. The proposed NCS national board will provide that.

At the local level, local government and NHS boards will retain statutory delivery functions and the staff and assets to deliver services. We are considering how local integration structures can be reformed and strengthened as part of the NCS.

Additionally, we regularly discuss the bill and current challenges in social care with trade unions. Although we are limited in legislating on employment, we are committed to promoting fair work as far as possible through ethical commissioning and procurement. We will provide funding to increase the pay of social care workers and to improve workforce planning, practice and culture, and we will take into account trade union views on issues such as workforce representation in designing the national board and local delivery.

In summary, I say that the summer was very busy, with many productive discussions and positive developments.

I hope that that is a useful overview before our discussion.

I hear that criticism loud and clear. I hear it very directly because we are engaging so closely with people who have lived experience of accessing care. Undoubtedly, there are many people for whom the situation with access has been traumatic and disappointing. They are absolutely clear that change is required, as am I. As I said, the shared accountability that we foresee will, I think, give ministers control over the system, while ensuring that local delivery is still done by the local democratically elected body. That is probably the best combination.

It is really important that the board has the power to take action when there is system delivery failure, so I am determined to reassure people that it will have sufficient power to take action when it needs to. We are envisaging something similar to the arrangements that are currently in place for health boards, where there can be intervention, if there are challenges, and escalation of interventions. We envisage something similar for the national care service, in that its board will have the power to intervene.

You are absolutely right: the trade unions will be crucial to the development of the national care service. I spent a lot of time working with them over the summer, and I would expect that work to continue.

I have said a number of times that one of the reasons why the social care workforce is so disadvantaged is that it is largely female and barely unionised. It is 83 per cent female and there is less than 19 per cent unionisation. I would like there to be a stronger role for unionisation within the workforce, in addition to me working with the unions to develop the national care service.

In terms of the shared agreement, I have mentioned the national care board. The board will be broader than just ministers, local authority representatives and NHS representatives. I would expect the voice of employees—the voice of people who work in social care—to be at that table as well. I would envisage an on-going space at the table for dialogue with them.

We envisage that the national social work agency, which will not be a union but a professional organisation, will be a strong voice for social workers in the national care service. Social workers are key to effective delivery of the ambition that we have set out. There will be a strong role for people who work in the sector, not just in the development of the national care service but in the on-going delivery and the national governance of that delivery.

As I said, I cannot commit to those things yet, because we are still discussing it. Today, I am laying out how I envisage that taking shape.