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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 1 November 2024
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Displaying 593 contributions

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Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 26 September 2023

Maree Todd

The final details are still being decided, but there is an agreement involving ourselves in the Scottish Government, the Convention of Scottish Local Authorities and the national health service that there will be shared accountability. I would envisage a board involving others, including, for example, those with lived experience, staff-side representation and the national social work agency, and it would oversee and scrutinise the national care service and what it delivered. An important point is that I would expect the board to be built with some teeth so that it could take action in the event of service delivery failure and ensure the success of that delivery.

We have not quite finalised the negotiations on the national care board, but I think that it will be an absolutely crucial part of oversight. I find it frustrating that, at the moment, I am regularly held to account for the delivery of social care across the country, even though I have no legal responsibility for it and the matter sits entirely with local government; I have no powers to change what goes on. As a result, the proposal aligns with Derek Feeley’s vision in his independent review of adult social care and with what the country told us in our consultation, which was that people want national Government to have some say in and oversight of social care.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 26 September 2023

Maree Todd

There is a lot of engagement with the profession, but there is no proposal to transfer employment. With the agreement between us and COSLA, that will no longer be necessary for any staff.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 26 September 2023

Maree Todd

You are absolutely right—you have picked out one of the real tensions in the bill and in the idea of national oversight of the social care system. You are preaching to the converted on that. I come from the rural west Highlands and I represent the northernmost and biggest mainland constituency in Scotland, and I absolutely recognise that care cannot be delivered in exactly the same way in every part of Scotland. NHS Highland, which is the health board in the area where I live, has its own model of integration—we have the lead agency model and the rest of the country has a different model. In Ullapool, where I live, accessing care is a very different experience from accessing care in Inverness, which is a city and is much more like Edinburgh.

There are fundamental differences throughout the country, but we are focused on the unnecessary variation. The thresholds of need should not vary quite as much throughout the country, and there should not be a variation in quality throughout the country. It is not acceptable that people in one part of the country have to accept a lower quality of care. We want the standards to be high everywhere. There are variations in pay and conditions, which are really challenging and threaten service delivery in parts of the country. For example, the social work profession, unlike nursing or teaching colleagues, do not have a standardised approach to their pay and conditions. Working through the national social work agency, we will be able to improve that.

I will use Shetland as an example, because I really enjoyed visiting there as I had not been back for a number of years—since pre-pandemic—and it was a pleasure to go back to an area that I used to represent. Shetland has integrated health and social care very well, so was fairly healthily sceptical that the national care service would offer it anything. It is doing things pretty well as things stand, but we were quickly able to identify certain areas in which a national approach could support local delivery, including support with social work training and legislative changes to information sharing, which will vastly improve the experience for people on the ground. I agree that there is tension and that it needs to be done very carefully, but it is possible to raise standards generally and to reduce unnecessary variation without impacting too much on the way that people do things locally.

It might be down to the part of the country that I represent, but another very important thing to consider is that young people with disabilities who access care packages can find it impossible to move freely around the country because their care package does not follow them. We need to improve the system to make it more straightforward for them. I want young people in the Highlands to be able to go to university, and that almost inevitably means going away. I want them to be able to access education and to be able to choose employment that suits them. They need to be able to move around to do that. The national care service could definitely improve the situation with transition across the boundaries that we currently have, which are impossible for young people to navigate.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 26 September 2023

Maree Todd

Absolutely.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 26 September 2023

Maree Todd

There will be a decision on that point towards the end of the year.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 26 September 2023

Maree Todd

No.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 26 September 2023

Maree Todd

There are always discussions in Government about how to generate revenue for public spend, particularly at a time of constraint as we have at the moment. I would expect discussions to be on-going in that respect. You will be aware of the public statements that have been made on care and the balance that needs to be struck in that respect, but that is absolutely outside my portfolio.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 26 September 2023

Maree Todd

As I have said, we will bring forward a revised financial memorandum—

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 26 September 2023

Maree Todd

Yes. That figure is reasonably close to the lower end of the range, given that, with the initial financial memorandum, we were expecting the bill to go forward and complete its passage by summer, with the work ramping up and being phased in a completely different way. A lot of work would have been going on in that financial year, but that is now not needed as a result of the extension of the bill timetable and things being spread over a much longer time. The process with regard to expenditure is still being worked out.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 26 September 2023

Maree Todd

Yes. The pace has also changed.