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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: 25 January 2024

Maree Todd

The local delivery plan being overseen and scrutinised by the national care board will help to ensure that the outcomes that are outlined in the local delivery plan are achieved. At the moment, there is not that level of external scrutiny of whether what local areas say will happen happens, or that strategic thinking about commissioning—it works well in some areas and less well in other areas. The oversight from the national care board and its ability to step in and support if there is service delivery failure will improve the situation.

You asked about the money getting to where it should be. Everybody agrees with this: the local authorities and the NHS have agreed to share accountability, much of which is, at the moment, entirely in local authorities’ hands. They have agreed to shared accountability in order to improve the situation and that will go some way towards doing so.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 25 January 2024

Maree Todd

The evidence for early intervention and prevention is relatively strong. More than 10 years ago, the Christie commission made a strong case for early spend—in other words, for preventing people from falling into the river rather than having to pick them out of the river.

There is robust detail about the economic benefit of early intervention and prevention—we have fairly robust calculations on that. I am not sure where the 1 per cent assumption that you have talked about came from, but the fact is that we are running a very costly system. Social care costs Scotland enormous sums of money every year, and everyone accepts that what we are delivering is not of the standard that we want.

The national care service provides an opportunity for us to improve social care delivery. I absolutely agree that there might well be costs. Feeley calculated that, as the business case says, social care would be beneficial for 36,000 people in Scotland who do not currently have access to it. I agree that there might be costs that we are uncertain about, but I am certain that, if we can deliver better care—which we will do through the national care service—we will save money and bring money back into the public purse.

We can calculate the wellbeing impact on the 36,000 people. If just 10 per cent of them—3,600 people—experienced a 0.1 point improvement in their wellbeing on the life satisfaction scale, the annual benefit could be worth about £5 million.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 25 January 2024

Maree Todd

We are still working hard to establish the costs of carers’ breaks. As you will see in the revised financial information, there remains quite a level of variance on that. We are seeing improvements in carers’ rights to have a break: we are putting funding into that, without the legislation having to make that change. We will consider very carefully the costs and how quickly we can implement carers’ breaks after the bill is passed.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 25 January 2024

Maree Todd

I would need to read the letter and get back to Social Work Scotland on the detail of it. Unfortunately, I have not seen the letter. Lee Flannigan saw it last night, but it was not addressed to us.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 25 January 2024

Maree Todd

Donna Bell wants to come in on that. I suppose that the thing to emphasise is the cost of the national care service relative to the cost of social care spend. The cost of the national care service, from 2031-32, would represent between 0.54 and 0.82 per cent—less than 1 per cent—of spend on social care. It represents between 0.2 and 0.31 per cent of the entire spend on health and social care, so the cost of the bill is relatively small compared with the enormous amount that is being spent on social care. It is important that everyone understands that.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 25 January 2024

Maree Todd

There will be some costs earlier than the first three years. The three years is to do with setting up the local care boards. We will begin to set up the national care board as soon as possible after the bill is passed. We are working to deliver things such as the national social work agency now, so some of those things will start sooner.

The implementation costs of Anne’s law are likely to be small. Much of that work has been done, but there will be an education piece that is associated with that. Some costs will start from day 1, and some will come a little further down the line compared with the bill as introduced.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 25 January 2024

Maree Todd

I think that we have already given full information. Not every bill that comes through this Parliament has an accompanying business case. Members do not get that level of detail about economic impact or the value of the investment with every bill that comes through Parliament.

I am happy to furnish the committee with more detail. I want to have robust, quantifiable figures, but the reality is that much care work is female work and is unseen and unaccounted for in our society. That is one of the challenges that we are facing and one of the reasons why we are determined to improve the delivery of social care. There are no accurate numbers about how many unpaid carers are out there. From looking at that population, we have some idea of how many there are and we know that care is a gender issue and that far more women than men are impacted by unpaid care. We also know that, for working age carers, that impacts their ability to work. Unfortunately, we live in a society in which women’s work is unaccounted for and invisible, so it is tricky to get robust evidence. I am determined to work to improve the quality of the evidence that you have.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 25 January 2024

Maree Todd

The powers of the national care board are clear. We have agreed what the board will do, but the detail about its composition, and about who will sit on it and will have voting rights is still being negotiated and designed.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 25 January 2024

Maree Todd

The national care board will be interested in service delivery, and it will certainly have powers to intervene, particularly where there is service delivery failure. That is somewhat similar to what happens in the NHS at the moment, where there is an escalation framework of support to ensure that local NHS boards are helped to deliver as required. On the ability to direct budgeting and so on, I think that the system that we are introducing will enable far better financial scrutiny. Local authorities and the NHS are signed up to that. They are inviting that level of scrutiny and shared accountability so that we can do a better job together.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 25 January 2024

Maree Todd

There would definitely be room for variation on operational delivery. There has to be. As I have said time and again, I live in the rural west Highlands, and the way that care is delivered in the village where I live is very different from the way that care is delivered in Inverness, which is within the same local authority and NHS board. Necessary variation is not what we are worried about.