Hansard

I refer members to my entry in the register of members’ interests, which shows that I hold a bank staff nurse contract with NHS Greater Glasgow and Clyde.

I thank the Health, Social Care and Sport Committee clerks for their support during the committee’s inquiry and preparation of our stage 1 report. The committee began its stage 1 scrutiny of the National Care Service (Scotland) Bill in October 2022, having issued a call for evidence during the summer. There was extensive engagement with the initial call for evidence, and I thank everyone who contributed. The committee has listened carefully to all the views that were expressed throughout that process, which were invaluable in informing the committee’s recommendations.

The committee took oral evidence on the bill at nine meetings between October and December 2022. We took further evidence on the bill in May 2023 and at three meetings in October 2023. I am equally grateful to everyone who contributed oral evidence to the committee during that time.

One strong message that we heard throughout our scrutiny concerned the case for reform of social care. Such reform is badly needed to address existing inconsistencies in access, to ensure consistent application of guidance and legislation, to address on-going challenges in the social care workforce, to improve commissioning and procurement of services, and, most importantly, to improve outcomes for people who receive social care and support.

The case for reform motivated Derek Feeley’s independent review of adult social care to recommend the creation of a national care service. In responding to the Feeley report, the Scottish Government has sought to give people with lived experience a stronger voice in shaping the proposals through a co-design process. A witness who gave oral evidence to the committee described that as “a bold approach”.

At the same time, the committee heard many stakeholders raise concerns about an on-going lack of clarity regarding the definition, the precise scope and key areas of focus of co-design or the anticipated outcomes of the co-design process. In a recommendation that was unanimously supported by its members, the committee, in its report, calls on the Scottish Government to

“set out an overarching plan that includes a clear definition of co-design, parameters and intended outcomes of the co-design work and a timetable for its completion.”

We also want the Scottish Government to

“recognise the critical role the Scottish Parliament has to play in undertaking”

on-going scrutiny of the bill’s implementation,

“including in relation to the outcomes of the co-design process.”

During its scrutiny, the committee heard widespread support for the principles that are set out in section 1 of the bill. At the same time, our report highlights several areas in which the majority of committee members believe that those principles could usefully be clarified and strengthened.

Although the committee acknowledges the Scottish Government’s stated commitment to fair work principles, the majority of the committee would like the bill to be strengthened to include a

“clear and comprehensive definition of ‘fair work’”

and provide clarity on how those principles will be consistently applied and enforced.

The committee’s report seeks clarification on the remit of the planned national social work agency. The Scottish Government has said that the agency’s responsibilities will include monitoring and improving service quality, overseeing and supporting education, improving and scaling up good practice, workforce planning, training and development, and work on terms and conditions, including pay. The committee is keen to understand why the agency’s proposed remit is limited to the social work profession when there is an equally pressing need to address such issues for the wider social care workforce.

Furthermore, if the agency is to be set up as a Scottish Government department, how will it be ensured that it has the necessary operational independence to fulfil its role effectively?

I look forward to receiving the minister’s considered response to those concerns.

For a long time, we have been talking about the creation of a single electronic health and social care information record. Completing that work will be fundamental to the success of the proposed national care service and should be treated as an absolute priority. The committee’s report also highlights the importance of monitoring and evaluation. Without that, how can we judge whether a national care service has successfully achieved its objectives?

The committee has unanimously called for appropriate provision to be made in the bill for effective monitoring and evaluation of the proposed national care service. I acknowledge that the committee has been unable to reach a consensus position in many areas, but I am pleased to note that our recommendations on the parts of the bill on creating a right to breaks for carers and on implementing Anne’s law were unanimously supported. I hope that those important measures can be implemented with all due care and speed.

The Scottish Government’s overall approach to the legislation has shifted significantly since the bill was introduced in June 2022.