Chamber
Plenary, 07 Mar 2001
07 Mar 2001 · S1 · Plenary
Item of business
Regulation of Care (Scotland) Bill: Stage 1
In the interest of time, I will continue, if I may.
We already intend to regulate home care for children with disabilities. We now propose to extend regulation to agencies that provide care for any children in their own home where the carer is selected or employed by the agency rather than by the parent. That will mean that we will regulate sitter services, where an agency provides home-based care for families who need additional support or respite. Carers such as baby-sitters and nannies who are selected and employed by the parents will not be regulated, as that would be unreasonable and impractical. Those proposals are good news. They will mean that the bill will provide protection for even more children and vulnerable adults.
The question of fees was raised. The Health and Community Care committee has made several comments on the fees that providers will have to pay for regulation. We believe that it is important that the cost of regulation should be explicit and transparent. Everyone—users, purchasers and providers—has an interest in ensuring that the system works effectively and provides value for money. The current fee levels bring in only 17 per cent of the cost of regulating services. It is important to be clear in future about the real cost of regulation.
However, fees for regulation will constitute only a tiny proportion of the cost of providing care services. For example, under our proposals, the regulation fee of £65 per year per bed in a care home will increase to between £120 and £180 by 2004-05. That represents a maximum increase of £115 per bed over four years. That is less than 1 per cent of the overall cost of a care home place.
The Health and Community Care Committee has expressed concern that increased fees might mean that services go to the wall. Let us be clear about the fact that almost all community care services are provided or purchased by local authorities. We are negotiating with the Convention of Scottish Local Authorities to ensure that grant-aided expenditure takes into account the cost to local authorities both of paying fees for their own provision and of meeting the slightly higher cost of commissioning care from others. As central Government grant to the commission is reduced over the coming years, there will be a corresponding increase in GAE. Therefore, there should be no reason why providers should have to bear the increased costs.
We recognise that solutions vary across the different care services that are affected. The GAE proposal would not work for child care, which is generally purchased by parents. We have already said that we will maintain a subsidy for child care so that fees do not have to rise to full cost. We have been pressed to fund everything by a direct grant to the commission, but I see no reason to set up a system whereby an independent clinic, private dentist or large private nursery is not expected to pay a fee for the regulation of its services. I stress, however, that there is nothing in the bill to prevent a subsidy for any service in the future, if needs be.
On the location of the new bodies that are being established, I am pleased to confirm that, as the First Minister announced yesterday, the headquarters of the commission and the council will be in Dundee. That decision is an operational matter and does not relate to any provision in the bill. As we have made clear, the decision is, of course, subject to the Parliament approving the bill's principles. It is good news for Dundee, and the choice of location has been widely welcomed.
I know that the Health and Community Care Committee has questioned the idea of there being five or six regional offices, although it has not said what number it would like to see. Let me make it clear that the commission will consist of no more than 500 staff. To divide its senior people among more than five or six offices would, we believe, work against its national focus and its effective management. We have already said, however, that individual staff will not necessarily be expected to work from the regional offices. Flexible working arrangements and working from local resource centres will be actively encouraged. We want to minimise the amount of time inspectors spend travelling, or on administrative duties, and therefore away from inspecting local providers. We want to build on and maximise their knowledge of particular areas.
Once the commission is established at the end of the summer, the board and the chief executive will be able to make decisions about where the organisation might need to supplement its regional offices with local resource centres. Those decisions do not have to be taken now; it is sensible to make them only when the commission has decided how it plans to inspect.
I will, of course, be interested in any specific proposals that the Health and Community Care Committee wishes to make for the regional structure. However, I stress that we must do enough at this point to ensure that the commission will have buildings to move into in time so that the transition from local authorities and health boards goes smoothly. To wait until after stage 2 for final decisions is not realistic if we are to deliver the new system by 1 April 2002 and thus fulfil our promise to those who use care services.
We already intend to regulate home care for children with disabilities. We now propose to extend regulation to agencies that provide care for any children in their own home where the carer is selected or employed by the agency rather than by the parent. That will mean that we will regulate sitter services, where an agency provides home-based care for families who need additional support or respite. Carers such as baby-sitters and nannies who are selected and employed by the parents will not be regulated, as that would be unreasonable and impractical. Those proposals are good news. They will mean that the bill will provide protection for even more children and vulnerable adults.
The question of fees was raised. The Health and Community Care committee has made several comments on the fees that providers will have to pay for regulation. We believe that it is important that the cost of regulation should be explicit and transparent. Everyone—users, purchasers and providers—has an interest in ensuring that the system works effectively and provides value for money. The current fee levels bring in only 17 per cent of the cost of regulating services. It is important to be clear in future about the real cost of regulation.
However, fees for regulation will constitute only a tiny proportion of the cost of providing care services. For example, under our proposals, the regulation fee of £65 per year per bed in a care home will increase to between £120 and £180 by 2004-05. That represents a maximum increase of £115 per bed over four years. That is less than 1 per cent of the overall cost of a care home place.
The Health and Community Care Committee has expressed concern that increased fees might mean that services go to the wall. Let us be clear about the fact that almost all community care services are provided or purchased by local authorities. We are negotiating with the Convention of Scottish Local Authorities to ensure that grant-aided expenditure takes into account the cost to local authorities both of paying fees for their own provision and of meeting the slightly higher cost of commissioning care from others. As central Government grant to the commission is reduced over the coming years, there will be a corresponding increase in GAE. Therefore, there should be no reason why providers should have to bear the increased costs.
We recognise that solutions vary across the different care services that are affected. The GAE proposal would not work for child care, which is generally purchased by parents. We have already said that we will maintain a subsidy for child care so that fees do not have to rise to full cost. We have been pressed to fund everything by a direct grant to the commission, but I see no reason to set up a system whereby an independent clinic, private dentist or large private nursery is not expected to pay a fee for the regulation of its services. I stress, however, that there is nothing in the bill to prevent a subsidy for any service in the future, if needs be.
On the location of the new bodies that are being established, I am pleased to confirm that, as the First Minister announced yesterday, the headquarters of the commission and the council will be in Dundee. That decision is an operational matter and does not relate to any provision in the bill. As we have made clear, the decision is, of course, subject to the Parliament approving the bill's principles. It is good news for Dundee, and the choice of location has been widely welcomed.
I know that the Health and Community Care Committee has questioned the idea of there being five or six regional offices, although it has not said what number it would like to see. Let me make it clear that the commission will consist of no more than 500 staff. To divide its senior people among more than five or six offices would, we believe, work against its national focus and its effective management. We have already said, however, that individual staff will not necessarily be expected to work from the regional offices. Flexible working arrangements and working from local resource centres will be actively encouraged. We want to minimise the amount of time inspectors spend travelling, or on administrative duties, and therefore away from inspecting local providers. We want to build on and maximise their knowledge of particular areas.
Once the commission is established at the end of the summer, the board and the chief executive will be able to make decisions about where the organisation might need to supplement its regional offices with local resource centres. Those decisions do not have to be taken now; it is sensible to make them only when the commission has decided how it plans to inspect.
I will, of course, be interested in any specific proposals that the Health and Community Care Committee wishes to make for the regional structure. However, I stress that we must do enough at this point to ensure that the commission will have buildings to move into in time so that the transition from local authorities and health boards goes smoothly. To wait until after stage 2 for final decisions is not realistic if we are to deliver the new system by 1 April 2002 and thus fulfil our promise to those who use care services.
In the same item of business
The Presiding Officer (Sir David Steel):
NPA
Our main item of business is a debate on motion S1M-1523, in the name of Susan Deacon, on the general principles of the Regulation of Care (Scotland) Bill, w...
The Minister for Health and Community Care (Susan Deacon):
Lab
I am conscious that, as we gather here this afternoon, certain events south of the border may have distracted some politicians and members of the public from...
Nicola Sturgeon (Glasgow) (SNP):
SNP
On consultation, the minister will be aware that concern has been expressed by, I think, everybody who has given evidence to the Health and Community Care Co...
Susan Deacon:
Lab
That is one of the issues that has arisen during early consideration of the bill. I will say more about it later in my speech, but I stress now that, at stag...
Mr Keith Raffan (Mid Scotland and Fife) (LD):
LD
Will the minister give way?
Susan Deacon:
Lab
In the interest of time, I will continue, if I may.We already intend to regulate home care for children with disabilities. We now propose to extend regulatio...
Nicola Sturgeon:
SNP
Will the minister give way?
Susan Deacon:
Lab
I regret that, in the interest of time, I am unable to give way. The deputy minister will respond at the end of the debate and will pick up on points that ha...
The Presiding Officer:
NPA
I call Mary Scanlon to speak to and move the amendment.
Iain Smith (North-East Fife) (LD):
LD
On a point of order, Presiding Officer. Will you clarify for me the reasoning behind accepting the amendment? According to rule 9.6.4 of the standing orders,...
The Presiding Officer:
NPA
I commend to Iain Smith and to all members the guidance that I issued on this subject only a week or two ago. The amendment falls completely within the terms...
Mary Scanlon (Highlands and Islands) (Con):
Con
Although we have lodged amendment S1M-1523.1, the Scottish Conservatives welcome the broad principles of the Regulation of Care (Scotland) Bill. We particula...
Iain Smith:
LD
Will the member give way?
Mary Scanlon:
Con
I think that Mr Smith has said enough for today and I would rather keep my contribution positive.
Mrs Margaret Smith (Edinburgh West) (LD) rose—
LD
Karen Gillon (Clydesdale) (Lab) rose—
Lab
Mary Scanlon:
Con
Alzheimer Scotland does not pay registration fees—Interruption.
The Presiding Officer:
NPA
Order. Three members are asking whether Mrs Scanlon will give way, but it is up to her to decide whether to do so.
Mary Scanlon:
Con
I will give way to Mrs Smith.
Mrs Smith:
LD
The SCRO check payments have been set aside. All parties in the chamber supported that and the Executive has listened.
Mary Scanlon:
Con
I am aware that, between the submission of evidence and today, there has been quite a bit of movement. That is why I say that the points that have been made ...
Shona Robison (North-East Scotland) (SNP):
SNP
On behalf of the Scottish National Party, I welcome the Regulation of Care (Scotland) Bill. I also welcome the fact that the headquarters of the new Scottish...
Mrs Margaret Smith (Edinburgh West) (LD):
LD
I begin by thanking the members of the Health and Community Care Committee for their work on the bill. I thank the members of all the other committees that h...
Trish Godman (West Renfrewshire) (Lab):
Lab
The Regulation of Care (Scotland) Bill is part of our modernising programme for government—and rightly so.I say to the Tories that to suggest, even as a joke...
Ben Wallace (North-East Scotland) (Con):
Con
Will Trish Godman give way?
Trish Godman:
Lab
No. I have just started my speech.No one in any political party would disagree that we should safeguard vulnerable people. That means vulnerable people of al...
Irene McGugan (North-East Scotland) (SNP):
SNP
I want to raise several children's issues that have been identified by the Education, Culture and Sport Committee and by the cross-party group in the Scottis...
Margaret Jamieson (Kilmarnock and Loudoun) (Lab):
Lab
I declare an interest in the matter, as a member of Unison and the mother of a student nursery nurse. I do not want anything to come back to haunt me later.T...
Mary Scanlon:
Con
Will the member give way?
Margaret Jamieson:
Lab
No, I am winding up.In particular, I draw members' attention to section 2(2) of the bill, in which reference is made to somebody "being of a young age". At n...