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What I have been trying to describe is a dynamic process in which we take on board the co-design and then come back to the committee with more information. The business case is iterative, so we will have lots of opportunities for you to scrutinise and examine what is going on. The use of co-design in developing the legislation is fundamental to the type of change that we are delivering. As I say very regularly to people, if we have lived experience at the heart of our policy and legislation, we are much more likely to get them right. The challenge, though, always lies in implementation, so we also have a built-in mechanism for holding our feet to the fire in that respect to ensure that we not only deliver our ambitious policy and legislation but implement them appropriately on the ground.

What I am trying to say is that co-design is a core part of the national care service. I would expect that, once we have delivered it, it will continue to evolve, much like the NHS has. It will not be fixed in stone, just as the NHS was not fixed in stone when it was introduced in 1948. Having co-design at the heart of the development and at the heart of the service itself means that the voice of lived experience will continue to be involved in its evolution, even after we deliver the legislation. However, I agree that the approach makes it more difficult for you to scrutinise costs.

We are working closely together on defining the needs of the country and what we can deliver. I will be candid and say that the cabinet secretary has not set a ceiling. We are looking to deliver a social care system that meets the needs of the population.

Absolutely. I am confident that we can improve the local scrutiny of spend. At the moment, there are times when it is hard to follow the money, and that is sometimes the explanation for challenging situations on the ground. If we empower our local structures and provide them with adequate data and the ability to scrutinise where money is going in the system, we will have a system that operates much more efficiently and that delivers much more effectively for people.

I will give one simple example. Over 10 years ago, the Christie commission told us to spend money early instead of pulling people out of the water and we want to spend money preventatively. If an elderly person is admitted to hospital and gets a care package, that care package will, on exit from hospital, cost twice as much as it would have cost had we managed to catch them before they went in. There will be efficiencies if we do this well. I need to provide you with that assurance.

Yes.

I will be working very closely with the Deputy First Minister to design a social care service that works for the people of Scotland and, as with every area of spend, she will be ensuring that we have sufficient funding to put behind it. However, that is definitely outside my remit.

The rephasing will probably mean less spend, as there will be less of a need for external consultants.

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.

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.

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.