Committee
Health, Social Care and Sport Committee 25 October 2022
25 Oct 2022 · S6 · Health, Social Care and Sport Committee
Item of business
National Care Service (Scotland) Bill: Stage 1
Dr Connon
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There is a balance to be struck. There are a lot of lessons to be learned from the Netherlands and Japan, where they set particular standards for qualifying eligibility. Because demand was a lot higher than anticipated, they had to increase the criteria for access to care. That was very much the case in the Netherlands, where increasing the criteria led to long waiting lists as well as gaps in care provision. Similarly, in Japan, demand was higher than expected and they upped the criteria. It is a balancing act. The difficulty with funding only a basic level of care through the system and some people then paying for additional top-up services is that such an approach has been associated with rising inequalities in wellbeing in relation to access to care and to increased health inequalities more broadly. My recommendation is that the eligibility criteria be fairly broad, rather than too strict, so that many people can qualify and lots of services can be provided. That would reduce the reliance on informal care and ensure that there are as few inequalities in accessing care as possible.
In the same item of business
The Convener (Gillian Martin)
SNP
I welcome everyone to the 29th meeting in 2022 of the Health, Social Care and Sport Committee. I have received apologies from Emma Harper. Our colleague Jame...
Dr Irena Connon
Thank you. I am going to talk to the committee about my rapid review that compared international models of social care. The aims of the presentation are to p...
The Convener
SNP
Thank you, Dr Connon. I will let you catch your breath for a moment. You ended by making a point about the ageing population, which is a worldwide concern. ...
Dr Connon
One example would be the Nordic model, particularly as it is used in Sweden; its standards for the accreditation of professionals and service delivery have a...
The Convener
SNP
Before I bring in my colleague, I want to ask a follow-up question. There is accreditation, but you also mentioned remuneration for people working in care. H...
Dr Connon
Yes.
The Convener
SNP
Sandesh Gulhane has some questions on that theme.
Sandesh Gulhane (Glasgow) (Con)
Con
Thank you for the presentation on the work that you have done. I have one question, which is about your methodology. You excluded papers that were published ...
Dr Connon
First, the numbers are detailed in the report, but we did not end up excluding many papers that were not in English. We are talking about academic articles. ...
Sandesh Gulhane
Con
How many were excluded? I could not see that number.
Dr Connon
The report gives the exact number that were excluded—I cannot remember off the top of my head. It was not very many.
Paul O’Kane (West Scotland) (Lab)
Lab
I want to ask about social work. I imagine that it is challenging to make a comparison, because the scope of the bill goes beyond the practical delivery of s...
Dr Connon
Yes, we can see that in New Zealand, Japan, Australia—to a certain extent—and the Nordic countries.
Paul O’Kane
Lab
Do those arrangements involve criminal justice, children and young people’s services or learning disability services, for example, as well as just older peop...
Dr Connon
Absolutely. In New Zealand and Japan, that is particularly the case around disability services. Children’s services come into the arrangements, too, as do cr...
The Convener
SNP
I have a couple of questions on that point. You mentioned the countries where there is an expectation of and a reliance on family care. Do those countries gi...
Dr Connon
There is a variation. In the Japanese model, in particular, there is very much a reliance on informal care—that is the expectation—and social care is used to...
The Convener
SNP
I do not want to presume, but I would say that, in this country, that cultural expectation tends to fall on women. Is that the case in those other countries?
Dr Connon
Very much so, yes. It is very much related to the earner models. In the Nordic countries, Canada and Australia, particular emphasis is placed on the dual-ear...
The Convener
SNP
And that has a knock-on effect on other measures of a wellbeing society, such as the gender pay gap.
Dr Connon
Yes. It is linked to the gender pay gap, a lack of opportunities for women to progress, increasing levels of stress among those who provide informal care and...
The Convener
SNP
I call James Dornan, who is joining us online.
James Dornan (Glasgow Cathcart) (SNP)
SNP
Thank you very much for the very helpful presentation, Dr Connon. I want to ask about eligibility. You seem to suggest that there is a balancing act here: ei...
Dr Connon
There is a balance to be struck. There are a lot of lessons to be learned from the Netherlands and Japan, where they set particular standards for qualifying ...
James Dornan
SNP
That was a good answer, but I still think that such a balance will be quite difficult to achieve in practice.
Dr Connon
Absolutely.
James Dornan
SNP
I have one more question. Under the heading “Findings 3”, you say, pretty clearly: “Increasing integration has had a relatively limited effect on reducing e...
Dr Connon
It is a combination. As far as Scotland is concerned, the system has not been running for long enough; it will take about 15 years to a couple of decades to ...
James Dornan
SNP
Can I ask just one more—small—question, convener?
The Convener
SNP
Yes.