Hansard

Susan Deacon regrets that she cannot be present today; she is attending a meeting with UK ministers in London to discuss CJD-related issues. I am sure that all members recognise the importance of that.

In the community care debate on 16 November 2000, I said that I looked forward to the Health and Community Care Committee's conclusions. I also said that I was sure that not only would those conclusions contribute to our thinking about policy, but that they would intensify our determination to drive forward change with urgency and focus. I have not been disappointed and I congratulate the committee on its report. I welcome the themes that are highlighted and the direction of travel that is mapped out. I hope that we can go forward together to accelerate the progress that must and will take place.

The report is not just about community care resourcing, standards, organisation and service delivery in general—it has specific reference to older people and to mental health. I am pleased to reaffirm that older people are a top priority for the Executive, and to restate that mental health is one of the top three clinical priorities of the NHS in Scotland. Both matters are certainly at the top of my agenda for the coming months.

The report talks about three aspects of resources: first, the overall amount; secondly, the balance and distribution of resources; and thirdly, the bringing together of resources in a single funding stream.

We agree that, as the report states:

"There is an imbalance in the proportion of funds directed to support people in their own homes as compared to residential or nursing home care."

That is why the heart of the three-year investment package that Susan Deacon announced on 5 October 2000—which will rise to £100 million a year in 2003-04—was a massive expansion of care for people in their own homes, including intensive home care, rapid response teams and more short breaks. That is why she also announced £5 million for this financial year for additional equipment and adaptations, on top of the £19 million extra this financial year to deal with delayed discharges, which the committee highlighted.

The announcement that was made on 5 October meets the demand for above-inflation increases in community care funding and more than meets the concerns of the Convention of Scottish Local Authorities about what it described to the Health and Community Care Committee as a £20 million under-resourcing of community care. However, the extra resources are not the end of the story. On 24 January, Susan Deacon announced that additional resources for long-term care would be a top priority for the Administration.

All those measures require the co-operation of local government. The new resources are being given on the basis of local government's delivery of agreed outputs. I agree with what Margaret Smith said about local government. In the new Scotland, local government cannot turn its back on the clearly stated priorities of the Scottish Parliament.

On the third aspect of resources, to which I referred a moment ago, I welcome the committee's recommendation that

"Mechanisms should be created to ensure that single funding streams and delegated responsibility are put in place in all areas."

Our response makes it clear that

"The Executive will shortly be consulting on legislation which will facilitate single funding streams and will allow us to ensure that all areas adopt this practice. We propose to bring forward this legislation as quickly as possible in the form of a Long Term Care Bill."

Other recommendations about single assessments, joint equipment stores and strategic care management are related to that central proposition. We welcome those recommendations and will ensure that they are acted on.

The care development group will advance some resource and service issues. I am sure that members of the Health and Community Care Committee will welcome the fact that their adviser, Professor Alison Petch, is a member of that group.

Without reading out the care development group's whole remit, I remind members that we shall examine existing service provision to identify gaps, deficiencies and duplication that might need to be addressed. We shall examine the current deployment of resources from all funding streams for the care of older people and make any recommendations for change that are thought to be necessary.

Centrally, we shall draw up proposals for the implementation of free personal care for all, along with an analysis of the costs and implications of doing that. As Margaret Smith's speech made clear, that was a central recommendation of the Health and Community Care Committee's report. I quote the two key sentences from the report:

"Clearly the decision to make personal care available free of charge means money is no longer there to be spent on other aspects of community care. However, the Committee received strong indications that this is an important issue of principle for the people of Scotland."

That encapsulates perfectly that free personal care is right in principle, but that it does have an opportunity cost.