Meeting of the Parliament 29 February 2024
Here we are again, debating another iteration of what was, in essence, a line in the SNP’s manifesto in 2021. The election was three years ago, and we are here again, with another amorphous form looking for a function. I will come back to that.
Yesterday, in the debate on Jackie Baillie’s motion to refer the bill back to the lead committee, the focus from the Government evoked the establishment of the national health service. I am gratified that that has not happened so far today—although I dare say that it might—but the rhetoric would suggest that we are on the threshold of some great reform, and that the names of Beveridge and Nye Bevan are soon to be joined in the annals of our national story by the likes of Kevin Stewart and Maree Todd. However, we are not on the edge of a great reform. This is an amorphous and ever-changing structure that is looking for a role in our society. All that we have heard from Opposition members such as Jackie Baillie and Sandesh Gulhane—and rightly so—is that it is still to find that role in our society.
I have heard the minister suggest that the Liberal Democrats, in their staunch opposition to the bill and the establishment of a national care service, would also have opposed the national health service, were we all transported back to 1948. However, you will recall, Presiding Officer, that although the vision for the NHS was executed by a Labour parliamentarian, it was the brainchild of a Liberal parliamentarian, William Beveridge. When William Beveridge wrote the Beveridge report, he identified five great evils in our society: ignorance, idleness, squalor, want and disease. It was the final one that he felt was most important in establishing a basis on which we had equal access to healthcare that was free at the point of delivery and readily available in every community of this country.
In relation to the national care service, the nomenclature is where the similarities end. We know that this is a form looking for a function. No lives will be saved in its creation. Nobody who did not get free care yesterday will get it on the implementation and royal assent of the bill. No care workers will be paid any more as a result of it, but we will be paying the cost of it through the taxpayer purse. There are significant concerns about the bill among stakeholders and, indeed, members of the Health, Social Care and Sport Committee. We have heard some of that today. The committee report on the bill has been damning. The word “concerns” features 28 times in the summary alone.
Around 238,000 people receive social care support in Scotland. Many of them will be known to those of us in the chamber and many of them will be related to us. That is 4 per cent of our population. Social care is a vital and important part of our society. Those who work in it and manage the sector are clear that it needs to be better funded and, of course, that it needs reform, but they are not talking about the ministerial power grab of centralisation that lines the pages of the bill. Do not take my word for it. Listen to COSLA, which just this week said:
“the reality is that national funding decisions ... will further squeeze local care and social work services which are already under incredible pressure.”
COSLA put out a briefing this afternoon saying that, despite the agreement that it has come to with the Government, it still harbours significant reservations, particularly about the nature of the funding settlement that it has been met with this week. Instead of providing support, the Government has delivered a hammer blow to local authorities in its budget.
It is hard to imagine a worse plan for social care than the one that is before us or a worse time for its execution than now. It is a bureaucratic exercise that will cost large sums of money and consume vast amounts of time. Right from the start, there have been serious concerns about its skyrocketing costs, which could reach more than £2 billion, and about the design process. Each and every iteration of the bill has proved to be outrageously expensive and completely unworkable. That is why we keep having to go back to the drawing board, and why the Government has deferred it and deferred it again.
Care organisations, unions and local authorities have united to condemn the bill. Even SNP Finance and Public Administration Committee members have suggested that the sums do not add up, and there are still hesitations and concerns among the members of that committee. It is no wonder that the bill has been pushed back three times. I put it to you, Presiding Officer, that we are only here now because the SNP is running out of parliamentary time to deliver on its flagship manifesto commitment before we rise for the next Scottish parliamentary elections. That is why we are here today.
Just when the sector needs clarity and support, the Government has embarked on a grand bureaucratic crusade that is characterised by confusion and chaos. It is form looking for function.
Scottish Liberal Democrats have always rejected plans for a ministerial takeover of social care, and we always will. We firmly believe that local authorities, care providers and those on the front lines are best placed to make decisions about how to implement and structure care services in their communities. We believe that power works best when it is as close as possible to the people whom it is there to serve.
However, there is yet more confusion around just what powers ministers would be given as part of the plans, with the committee report saying:
“It remains unclear to what extent Scottish Ministers will have similarly extensive powers with respect to the proposed National Care Service Board.”
The Government is all over the place on that.
Right from the start, things have not been done properly. The committee says that one of its challenges with the bill is
“the lack of available detail at the start of”
its scrutiny. Only this morning, the minister circulated a target operating model for the national care service, which we have been waiting for for a long time. On the day that we are expected to vote on the bill’s general principles, we are given that. It is simply not the way that we should do things.
We are now forced to waste our time voting on a hollowed-out nothingburger of a bill that does zero to address the very real issues in social care—a bill that no one on the front lines wanted in the first place. It will not make care free at the point of delivery; it will not make care a profession of choice; and it will not relieve the interruption in flow that is currently causing a crisis in our NHS, because people cannot be released from hospital because there is no adequate provision in our communities to receive them.
Free up the funds of this billion-pound bureaucracy. Scrap the bill today and use the money to improve the pay and working conditions of our social care staff, whose selfless, quiet and heroic efforts often go unnoticed and unrewarded.