Hansard

I start by welcoming the Health and Community Care Committee's report. As someone who joined the committee at a very late stage of this piece of work, I pay tribute to all the members of the committee, including my colleagues Kay Ullrich and Duncan Hamilton, who are both so committed to the report that they have come out of health retirement to speak in today's debate. It is also appropriate to thank the committee's support staff—the clerks, the advisers and the research staff—without whom no work of this nature would be possible. It is important that the Parliament recognises their work.

The Health and Community Care Committee has placed a comprehensive report before the Parliament. It is a report that has been tremendously well received by a range of groups and individuals across Scotland, and it is generally recognised that the report's recommendations, if implemented, will greatly improve the delivery of community care in Scotland, guarantee the dignity of people in their later years and vastly improve the experience of service users and their carers.

It is also appropriate to acknowledge that the world has moved on quite significantly since the report was published. That is because the Executive has already moved to implement a great deal of what it contains. Statements on 5 October 2000 and 24 January 2001 and the Executive's response to the report of the joint future group have all acted to move those issues forward. The Executive deserves credit for the fact that so much of what we are discussing today is already work in progress.

I do not have time to talk in detail about all the report's recommendations. The convener of the Health and Community Care Committee has already touched on many of those recommendations, including those relating to resources and financial planning, work force planning and training for staff. I associate myself with Margaret Smith's comments on all those areas. They are all extremely important recommendations, which I hope will be fully implemented by the Executive.

In the relatively short time available, I would like to highlight and make special mention of just a couple of the report's recommendations. First, I want to comment on the recommendations that relate to joint working and joint resourcing. Although I joined the committee at a very late stage of the report, I have read carefully through the evidence presented to the committee. What strikes me about that evidence, among other things, is that time and again the committee heard how the fragmentation of service delivery and budgets at local level, the lack of co-ordination and the disputes between health boards and local authorities detracted from the quality of care provided to individuals and, too often, led to situations in which vulnerable individuals fell through gaps in the system. I know that the Executive has already committed itself to taking action on that area, but it is important to emphasise that action is urgently required. I was glad to hear Malcolm Chisholm assuring us again that the long-term care bill will be introduced as soon as possible.

The second area that I want to touch is the quality of care provided to older people. I make particular reference to the report's recommendation that calls for the commission for the regulation of care to be funded adequately to do its job properly. If there was ever any doubt—and I do not think that there was—about the importance of establishing a commission for the regulation of care to regulate and inspect the quality of care that people receive, it would surely have been dispelled by reports in last weekend's press that a fifth of elderly people in care are not being fed properly. That revelation certainly horrified me and I am sure that it horrified everyone else in the Parliament.

The funding of the proposed commission for the regulation of care is an issue that is exercising the Health and Community Care Committee in its consideration of the Regulation of Care (Scotland) Bill. The proposal to make the commission self-funding by 2004-05, which would inevitably lead to an increase in registration fees for service providers and users, is causing a great deal of worry. I hope that the Executive will give further consideration to that issue—the minister may want to touch on that in his summing-up.

I turn now to the Executive's amendment, which causes me some considerable concern. I understand that the Executive's rationale in lodging the amendment is that committee motions are normally take-note motions while Margaret Smith's motion on behalf of the Health and Community Care Committee goes further. Let me make two preliminary points on that argument. First, it should be for committees to determine the terms of their own motions. Secondly, it sets a bad precedent in the Parliament that committees should never call upon the Executive to act on the recommendations that are contained in committee reports.

However, what really concerns me is that the Executive amendment appears to go much further than simply seeking to turn the motion into a take-note motion. Instead, the amendment seems to take us back headlong into the debate on personal care that dominated all our thinking only two weeks ago. The minister talked about issues such as training. The fact is that the terms of his amendment single out the personal care recommendation. He cannot get away from that fact.

If the Executive is committed—as Henry McLeish says and as Malcolm Chisholm has repeated in the chamber today—to the provision of free personal care for all, why is there so much reluctance to allow the parliamentary majority in favour of that to be expressed in a vote on an unambiguous motion? Why not vote for a motion that calls on the Executive to do what the First Minister says it is committed to doing anyway: providing personal care free to all on the basis of assessed need?

The Executive must accept that in lodging the amendment, it raises the suspicion that there is a difference between the committee's recommendation—free personal care for all as proposed by Sutherland—and the Executive's position. If we add to that the fact that Susan Deacon has, yet again, passed up an opportunity to state for the record that she is committed in principle to the implementation in full of Sutherland, we can all be forgiven for having some doubts in our minds today.

The amendment leaves open the possibility that the Executive will bring forward proposals on free personal care—which, let us remember, is all that the statement on 25 January committed it to doing—but that those proposals will in some way fall short of the full implementation of Sutherland, for example, by changing the Sutherland definition of personal care. That may not be what the First Minister envisages but, reading the amendment, it seems to be the intention of Susan Deacon and Malcolm Chisholm to leave themselves a get-out in respect of fully implementing the Sutherland report.