Meeting of the Parliament 29 February 2024
I agree that people have waited a great deal of time for this change, but let me assure the member and the public that change is coming. Over the past 10 years and more, we have established that primary legislation and structural change are required. There are parties in the Parliament that still oppose that idea. I absolutely agree with Pam Duncan-Glancy on the need for change—I am unequivocal about that. We will deliver change, and I am keen to work with everyone across the Parliament to deliver the change that Scotland needs and deserves.
The bill as introduced sets out the principles of a national care service. It commits to a national care service charter, it sets out a national approach to managing complaints, it sets out provisions relating to data sharing and care records, it includes provision for breaks for carers and it includes provision to enact Anne’s law so that people in care homes have the right to be visited by their families. The engagement that we have carried out over the past year reconfirms that all those provisions are essential to improving social care in Scotland, and they remain central to the Government’s planned approach.
As I have set out in some detail to the committees and in the information that I have shared with all members this week, I intend to make three significant changes to the bill at stage 2, should the Parliament agree to its general principles today. They respond to evidence that was taken at stage 1, they follow engagement with the Convention of Scottish Local Authorities and the national health service, and they respond to on-going feedback from stakeholders.
These are the main changes that I want to make to the bill at stage 2: a national care service board will be established to oversee delivery across Scotland; we will not create new local care boards, as originally planned, but will, instead, reform existing integration authorities; and local authorities will retain responsibility for current functions and the delivery of social work and social care services, with no transfer of staff or assets.
That change in approach reflects the challenges of a new fiscal environment, in which it is more important than ever that we demonstrate value for money. The changes will substantively reduce the cost of the bill by removing the need to set up care boards and to transfer staff and assets. As I set out to the Finance and Public Administration Committee, that means that the cost of setting up the national care service will be up to £345 million over 10 years, whereas the proposals that were set out in the bill as introduced would have cost £1.6 billion over the same period. Collectively, we spend more than £5 billion a year on social care provision. The costs of change will be less than 1 per cent of current spend. We can make meaningful and lasting change for that relatively modest amount.
The national care service will bring change to children’s social care, social work and community health services. We have a real opportunity to improve the outcomes for children and families. An NCS will help to simplify the currently complex landscape for children and will lay the foundations to deliver much-needed improvements.
I will set out the difference that I believe the national care service board will make. The board will include, as a minimum, an independent chair, the Scottish Government, local government, the NHS and people who have lived experience of receiving and delivering community health and social care. The board will have an overview of the planning and delivery of community health and social care provision across Scotland. It will look at what is spent, what care is provided, who receives it and the outcomes for those people. The board will have a support and improvement framework that will drive improvement and innovation and will help local areas when monitoring indicates that standards and needs are not being met, and it will intervene if necessary.
The national board will give us a level of transparency that is not possible in the current system. It will let us understand where there are inconsistencies in people’s experiences across Scotland, build on good practice and tackle challenges. It will reflect the approach that we have taken to building the national care service by ensuring that we listen to the voices of the experts—