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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 31 October 2024
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Displaying 593 contributions

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Health, Social Care and Sport Committee

National Care Service (Scotland) Bill (Stage 1 Timetable)

Meeting date: 9 May 2023

Maree Todd

There is a tension there. We need to have clarity on who is responsible and we need to have clear lines of governance. However, we need to capture local delivery as well as providing accountability. We will engage in those conversations over the course of the next few months and beyond. We will be making decisions about the exact composition of care boards a little later.

You can see some of the challenge, but it is one that we are up for and we need to have that conversation about how best to make it work and how best we can reflect those different needs and different communities while still achieving a certain standard of care and a clarity over governance arrangements. Those are the things that we are really keen to do.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill (Stage 1 Timetable)

Meeting date: 9 May 2023

Maree Todd

Anna, are you able to say where that is in the timetable?

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill (Stage 1 Timetable)

Meeting date: 9 May 2023

Maree Todd

Do you want to come in on that, Donna?

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill (Stage 1 Timetable)

Meeting date: 9 May 2023

Maree Todd

Yes, we have taken on board the concerns of Parliament. What we are doing differently is engaging again with stakeholders to see where we can achieve consensus, to see where we can put a little bit more detail into what the way forward is expected to be and to provide reassurance to colleagues within Parliament and stakeholders and partners outside Parliament so that everybody is clear on what is going to happen over the next few years, as we develop and bring into being a national care service.

I am keen that we clearly articulate what the advantages might be because I think that, among all the concerns that have been raised, some of the advantages have been lost. I recognise that it is my job to make sure that I clearly articulate those advantages both to parliamentarians and to the wider citizenship.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill (Stage 1 Timetable)

Meeting date: 9 May 2023

Maree Todd

I am more than happy to work on the detail of that. Within the NHS, general practitioners are private contractors and run profit-making businesses, but they do so in a way that upholds the standards and ethos of the national health service, and they deliver a high-quality service to patients. Most people do not realise that GPs are private businesses.

Private business can work really well in healthcare, and I am sure that they can do so in social care. We need the contract to be absolutely focused on the areas that are important to us, including quality standards, governance and the fair work ethos. There may well be room for building in something about ethical investments and financial regulations, so that people are not using public money to play the stock market.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill (Stage 1 Timetable)

Meeting date: 9 May 2023

Maree Todd

Absolutely. I am always keen to hear the perspective of young carers. You are absolutely right: we need the voices of unpaid carers to be at the core of the development. I say time and again that the voice of lived experience helps us. It is key to the way that we develop policy in Scotland. It helps us to get the policy right in the first place, and then those people hold our feet to the fire with regard to delivery, because they are still involved. It is a really good way of doing things. It is better to get it right first time.

Health, Social Care and Sport Committee

Powers of Attorney Bill

Meeting date: 9 May 2023

Maree Todd

Good morning, and thank you for inviting me to speak about the Powers of Attorney Bill and the associated legislative consent memorandum.

Powers of attorney appointments are incredibly powerful and useful. They allow people to retain control over aspects of their lives in circumstances in which they might not otherwise be able to make decisions or take actions. They ensure that people have the opportunity to make provision for a future in which they might no longer have the mental capacity to understand what is happening to them and therefore to make decisions about the things that they care about.

The Powers of Attorney Bill is intended to modernise the process for making and registering English and Welsh lasting powers of attorney. The bill also adds chartered legal executives to the list of individuals who can certify a copy of a power of attorney.

The bill is a private member’s bill. It was introduced by Stephen Metcalfe MP in the House of Commons on 15 June 2022. The bill passed the committee stage in the House of Commons on 1 March 2023 with broad cross-party support. It has now completed its passage through the House of Commons, and it is awaiting a second reading in the House of Lords.

Clause 1 introduces the schedule, which contains various provisions that will allow for a simpler process for making and registering a lasting power of attorney. That will increase access by allowing lasting powers of attorney to be made and registered electronically in England and Wales.

Most of the provisions of the schedule extend only to England and Wales, but one provision of the schedule extends to Scotland and requires the consent of the Scottish Parliament. That is paragraph 8, which concerns proving the content and registration of an electronically registered lasting power of attorney throughout the United Kingdom.

Clause 2 amends section 3 of the Powers of Attorney Act 1971 to enable chartered legal executives to certify a copy of a power of attorney. That extends throughout the United Kingdom. That provision also requires the consent of the Scottish Parliament. The provision will increase the channels through which consumers can certify a copy of a power of attorney and promote consumer choice. That is why we are asking Parliament to provide its consent to those amendments to Scots law.

It is right that we support a bill that increases the accessibility of powers of attorney. We know from the work that Scottish Mental Health Law Review has undertaken that using powers of attorney can encourage people to think through how they might want their health, welfare and financial affairs to be managed in the future. That means that adults who use powers of attorney are better placed to be as involved as possible in decisions about their lives, even if their circumstances change.

I am pleased to recommend supporting the bill, because it aligns with the key Scottish Government priorities of increasing accessibility of powers of attorney and ensuring that the most vulnerable people in society are protected.

With the prevalence of dementia increasing and our population ageing, power of attorney documents will become ever more important in ensuring that people can continue to live the lives that they want to live. That is why I have recommended that Parliament consent to the relevant provisions of the bill.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill (Stage 1 Timetable)

Meeting date: 9 May 2023

Maree Todd

We will certainly try to do that. As I said, one of the reasons for pausing and re-engaging is that Parliament, as well as all our stakeholders, expressed some concerns.

We need to be able to better articulate the advantages of the national care service and to put more meat on the bones in relation to how it will work and what it will cost, so we will work together with stakeholders in order to reassure them and Parliament. I am keen that we provide sufficient reassurance so that we are able to make progress.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill (Stage 1 Timetable)

Meeting date: 9 May 2023

Maree Todd

That is still the intention. Again, I am keen to hear views on that. There are a couple of things. We have not yet decided on the composition of the care boards. I expect to hear from stakeholders about who they think needs to be represented and I absolutely expect local government to have a say.

A question that has come up very early in my time in this ministerial role is whether geographical representation needs to be even more local. In Highland, for example, there is the question of whether care looks different in the rural west Highlands to how it looks in the city of Inverness, which has an all-singing, all-dancing hospital on the doorstep.

I hear that about Glasgow as well. Glasgow is an enormous local authority and NHS area and, between one side of the city and the other, there are very distinct communities with very distinct needs. Do we somehow need to capture that in the local delivery, in order to ensure that it delivers for the people?

We are open to discussing those issues as things evolve, and all the stakeholders who have an interest will have a say in how it is designed.

09:45  

Health, Social Care and Sport Committee

Subordinate Legislation

Meeting date: 21 March 2023

Maree Todd

The Scottish Government is committed to ensuring that there is appropriate staffing in the national health service and care services to enable the provision of safe and high-quality services and the best outcomes for the people who use them. In 2019, the Parliament passed the Health and Care (Staffing) (Scotland) Bill to provide a statutory basis for the provision of appropriate staffing in both the NHS and care services. That enables a rigorous, evidence-based approach to decision making relating to staffing requirements and supports an open and honest culture that engages staff in those processes. Among other things, the 2019 act inserts new provisions relating to staffing into the National Health Service (Scotland) Act 1978 and the Public Services Reform (Scotland) Act 2010.

12:15  

Implementation of the 2019 act was paused to redeploy personnel and resources to the Covid-19 pandemic response. A new implementation team was convened last year, and the Cabinet Secretary for Health and Social Care announced in June 2022 that all the act’s provisions would come into force by April 2024.

The 2019 act was reviewed as part of the implementation work, and six technical errors were identified. During the bill’s passage through Parliament, numerous amendments were made at stages 2 and 3. On some occasions, to ensure that amendments were properly reflected throughout the bill, cross-references to other provisions in the bill required to be inserted or amended. That was completed in the majority of cases, but in six instances those updates were not made, and the act contains errors. They now require correction to ensure that amendments that Parliament made to the bill are properly integrated. That will ensure that the act can be given full effect and the Scottish Parliament’s intention delivered. The draft regulations that are before the committee make ancillary provision under section 14 of the 2019 act in order to achieve that.

The first amendment will ensure that the obligation on health boards and the Common Services Agency for the Scottish health service—commonly known as NHS National Services Scotland—to raise awareness among staff about procedures for notifying any risks that they identify relating to staffing levels under new section 12IC of the 1978 act will extend to all relevant aspects of that notification procedure.

The second amendment will ensure that the obligation on health boards and NHS National Services Scotland to raise awareness among staff about the procedures that are put in place for the escalation of risks under new section 12ID of the 1978 act will extend to all relevant aspects of those escalation procedures.

The third amendment will ensure that each health board and NHS National Services Scotland must, under new section 12IL of the 1978 act, provide employees with information about how it has identified and taken all reasonable steps to mitigate risks as part of the common staffing method.

The fourth amendment will ensure that the Scottish Ambulance Service board will, under new section 12IM of the 1978 act, be under a duty to report to the Scottish ministers annually on how it has carried out its duties under new sections 12IE, 12IF, 12IH and 12II of the 1978 act. Those are the duties to have arrangements to address severe and recurrent risks, to seek clinical advice on staffing and to ensure that adequate time is given to clinical leaders, and duties relating to the training of staff.

The fifth amendment will ensure that the Scottish Ambulance Service board will have regard to guidance that is issued by the Scottish ministers, under new section 12IN of the 1978 act, about the carrying out of its duties under new sections 12IE, 12IF, 12IH and 12II of the 1978 act.

The two amendments that relate to the Scottish Ambulance Service board will largely bring it into line with other health boards and special health boards that deliver direct patient care in terms of its obligations relating to staffing.

The final amendment relates to the review and redevelopment of existing staffing methods by Social Care and Social Work Improvement Scotland—better known as the Care Inspectorate—under new section 82C of the Public Services Reform (Scotland) Act 2010. The amendment will ensure that the Care Inspectorate may, in a revised staffing method, require persons who provide care services to put and keep in place appropriate risk management procedures, in the same way that it could when developing a new staffing method under section 82A.

Stakeholders including representatives from health boards, relevant special health boards, NHS National Services Scotland, local authorities, integration authorities, Healthcare Improvement Scotland, the Care Inspectorate, professional bodies, trade unions and professional regulatory bodies have all been invited to participate in working groups to prepare the statutory guidance to accompany the 2019 act. As part of that process, the proposed changes that are detailed in the draft regulations were circulated for comment, and no objections were raised.

I fully support the draft regulations as the means of correcting technical errors in the 2019 act. They will ensure that the act can be given full effect and that the Scottish Parliament’s intentions can be delivered. I am happy to answer any questions that members have.