Meeting of the Parliament 14 November 2018
In this role, I have the privilege of meeting people who benefit from social care and people who provide it. Although those who I have met and heard from have been resoundingly positive about many aspects of the service that they receive, or the work that they do, that experience is not universal.
I welcome the opportunity to have this debate and to hear what members say and I am grateful to Mr Rowley for lodging the motion. I know that we need to continue making improvements. I also know that that task does not sit with Government alone. We must use the partnerships that we have and nurture with local authorities, the NHS and integration joint boards to harness our collective experience and efforts and to make improvements where they are needed.
In the health and social care financial framework that I brought before the chamber in October, we recognised that services needed to change, particularly as we enjoy longer lives with more complex needs. A key component of that change is the delivery of integration in health and social care. Integration is the most significant reform to health and social care services since the NHS was created in 1948. However, integration is not an end in and of itself. It is a tool—a means—through which we collectively deliver better services for people. People do not and should not have to care about whose budget the service or the support that they need comes from. They want our collective focus and work to be driven by their needs as a whole person. They want the support that they need to be safe and effective, and they want the right support in the right place at the right time.
Integration brings together almost £9 billion that was previously managed separately in health boards and councils. This year’s funding includes more than £550 million of NHS front-line investment to support integration and social care.
That whole-systems approach needs to be focused on safe, effective and, crucially, person-centred services. It also needs whole-systems thinking. In that regard, I am at one with Mr Rowley in emphasising the importance of our looking at and thinking about the system as a whole. That is radically different, and it is challenging.
To deliver the significant shift that we need in thinking and delivery as fully as it is needed will, of course, take time. However, we will do that together. With COSLA, we are reviewing how far we have come, identifying where we are getting it right, working out what we need to do to scale up the good practice that exists and, crucially, considering what more we need to do to learn and apply the lessons and to continue to build the momentum of improvement.
With COSLA, we are committed to the delivery and upcoming expansion of free personal care. Scotland continues to be the only country in the United Kingdom that provides free personal care. We provide 76,000 over-65s with free personal care. From April next year, that will be extended to those under 65.
The social care workforce provides care to people the length and breadth of our country. We want to help those workers to develop, so we have provided funding for all adult social care workers to be paid the real living wage. That has benefited up to 40,000 care workers. Like Mr Rowley, I have heard and have correspondence from individuals in organisations who are adult social care workers, who have yet to benefit from the funding that the Government provided.
That is a shared problem between COSLA and the Scottish Government. With COSLA, we need to look at why those funds are not being passed on to deliver that commitment, which, I am sure, is shared across the chamber. Fixing that does not lie at the hands of Government alone. I am sure that members would be quick to criticise the Government if we got into the business of instructing local authorities what to do.