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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 23 December 2024
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Displaying 654 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

Absolutely. Donna Bell will probably want to say a bit more about this, but we are very keen to hear from people who are employed in the care system about what works for them and what does not work for them. Over the past few years, the Scottish Government has done a lot of work on ensuring that everyone working in social care is in a regulated profession. Everybody is registered with the Scottish Social Services Council and there are continuous professional development requirements, but we could do more to support individuals to fulfil their potential in their role and more to make it clear what career paths are available for people to progress to other roles in the national care service, which is a really important aspect of it.

As someone who worked as a health professional in the national health service, I know that the level of variation across the country in the social work profession—in terms of the postgraduate qualifications that are required to do different roles, and the different types of training—definitely raises concerns about governance, quality and standards, and the lack of clarity for the people who are pursuing those professions. People might become qualified in a certain area in one local authority but find that those skills are not transferable to others and that they do not have the right qualifications to work in the next-door local authority. We need to maximise the opportunities for people and reward them for the extra efforts that they are putting into postgraduate qualifications, and we need to make sure that things are clear in terms of governance and what standards we expect everybody to meet across the country. That is something that we can definitely do, nationally.

We are keen to hear from people who are working in social care because we know that, although there is an awful lot of political focus on pay and conditions—rightly so; that is a really high priority—there is also concern about the differences in what is expected in terms of training, what the minimum standards of training are and what potential there is for people to do extra all over the country. It would be good to give some clarity around that.

Health, Social Care and Sport Committee

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

Meeting date: 9 May 2023

Maree Todd

They certainly raised concerns, yes. This is how we develop legislation in this country, is it not?

Health, Social Care and Sport Committee

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

Meeting date: 9 May 2023

Maree Todd

Pausing and re-engaging is part of the process of addressing COSLA’s concerns. We hear those concerns loud and clear, and we are keen to work with COSLA to see where we can achieve consensus and agreement.

I understand the point about the national health service having variation. However, the NHS has been trying to tackle the question of unnecessary variation for many years. I think that I have said already to the committee that there are times when variation is necessary, perhaps because of geography, the estate or what is available in the local area, but there are other times when variation is simply down to historical practice. Such variation can present a barrier to people trying to access care.

One example that is often cited to me is that of younger people who have a social care package and who want to move around the country. Perhaps the person lives in Ullapool in the north-west Highlands, where I live, and they want to go to university in Edinburgh. The systems are so completely different that it is almost impossible for them to move—they are almost limited to remaining in their own geography because the systems are so difficult to navigate. I think that we can improve on that.

That is not what it is like in the NHS. There are not those barriers. There are some barriers, but it is not quite such an impossible task and, for the user, it does not feel as though they have to learn to navigate an entirely new system. There is enough commonality between the ways in which healthcare is delivered in each area for the system to appear navigable and coherent to the people who are trying to access the care.

There are things that we can improve on. The people who access social care are very clear that things need to change and improve. We hear them, and I am sure that COSLA hears them, too. We will find a way to work together to ensure that those improvements happen.

Health, Social Care and Sport Committee

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

Meeting date: 9 May 2023

Maree Todd

Operational delivery will undoubtedly be by local organisations. Health and social care partnerships and local care boards will be involved in designing and delivering local services. However, currently, there is a perception among the general population and within politics that ministers have responsibility. Ministers do not have direct responsibility for all sorts of things. I am asked questions in Parliament all the time that are the responsibility of local health and social care partnerships. There needs to be clarity about who is responsible. I think that there is a general wish for ministers to be held responsible for decisions but, if we are going to be held responsible, we need to have the powers to make a difference. That is the challenge.

09:30  

I am keen to hear from local government over the summer about how it thinks partnership should work. I have no interest in Edinburgh designing in operational detail the minuscule micromanagement of services in every local area, but clear lines of governance are needed. Even for national workforce planning, central Government needs to have a better grasp and understanding of what the national workforce picture looks like. We do not have that because we do not have the responsibility for it.

Health, Social Care and Sport Committee

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

Meeting date: 9 May 2023

Maree Todd

Okay; so you know that I said that there was a great deal of consensus over parts 2 and 3 of the bill. The debate is largely around part 1 of the bill, and that is where we need to achieve consensus over the next few months.

Health, Social Care and Sport Committee

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

Meeting date: 9 May 2023

Maree Todd

My aim over the next few months is to achieve consensus. There will need to be compromise on both sides about what we come up with, but I will not proceed without an alignment with close partners.

In any area where we are developing legislation, we are not a Government that imposes our view on the country. We work with the country to develop legislation that aligns with the problem that we are trying to solve. That is how we proceed. Generally, we build things carefully.

Even if there had not been a change in Government, there would have been a pause because so many concerns were raised during stage 1 evidence—including by a couple of committees in the Parliament, not just COSLA. Any Government would have to reflect, take on board such concerns and find a way forward that is in agreement with the Parliament; otherwise, we would never get the bill through the Parliament.

Health, Social Care and Sport Committee

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

Meeting date: 9 May 2023

Maree Todd

Absolutely. Routinely, in this country, for all legislation, we put forward a proposal; we consult on a general idea for a bill; we put forward a bill and consult on its actual detail; we take evidence; and we amend. That legislation evolves as it passes through the Parliament, which has its role in scrutinising and amending it.

One of the fundamental differences with this bill is the process of co-design, which involves working with people who access care or who work in care to ensure that they are absolutely integral to the development of the legislation. That is, possibly, slightly different to the way in which we have developed other legislation.

Health, Social Care and Sport Committee

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

Meeting date: 9 May 2023

Maree Todd

Absolutely.

Health, Social Care and Sport Committee

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

Meeting date: 9 May 2023

Maree Todd

Islands have particular challenges in delivering social care. There is an ageing demographic, particularly in the Western Isles, and a lack of young people to work in the national care service, which provides a particularly challenging set of circumstances for our island communities.

I am absolutely clear that one size does not fit all. We cannot have exactly the same system working all over Scotland, because that is not possible. In some areas, there are not enough people to work in the way that it is possible for care to be delivered in urban areas.

We need to make sure that we there are no unintended consequences that make things tougher for our island areas. I know that some of our island local authorities had real concerns when we introduced self-directed support. We are keen to work with them to ensure that we get the balance right between empowerment of the individual who is accessing care, while having their wish to have their needs and choices respected, and the possibility of there being a more limited range of options in rural and island communities.

Health, Social Care and Sport Committee

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

Meeting date: 9 May 2023

Maree Todd

The Finance and Public Administration Committee has written to ask for an updated memorandum; I will respond to it very soon. We would usually update the financial memorandum after stage 1 and before stage 2. I do not want to have to give multiple updates of the financial memorandum between now and the usual time when you would get an update. If there is going to be a period of pause, engagement and possibly further changes made to the bill, it makes sense to wait until those changes are woven in before we update the financial memorandum.