Hansard

I am pleased to be opening a stage 3 debate for the first time. We may celebrate the new parliamentary procedures that have been working so well throughout the bill's stages as well, more importantly, as celebrating the very substantial advances that are embodied in this piece of proposed legislation. Political comment usually focuses on disagreements, so it may be that the joint purpose and common ground that we have witnessed at the various stages of the bill will not get the recognition that they deserve.

I thank the Health and Community Care Committee for all its work on the bill over the past three months. I also thank the Local Government Committee, the Equal Opportunities Committee and the Subordinate Legislation Committee for their work, comment and reports. All have contributed to a parliamentary process that has been effective in improving and refining the bill. Many of the changes that were suggested by the Health and Community Care Committee at stage 1 were taken on board at stage 2. We have a better bill as a result.

That process has continued today. I assure Janis Hughes, who has worked so tirelessly for carers throughout the bill's progress and before, that we shall drive forward action on information for carers and the identification of carers. The work of the Princess Royal Trust for Carers has been mentioned, as has general practitioner practice accreditation in relation to the identification of carers and the carers focus of the Clinical Standards Board for Scotland. Mary Mulligan, Hugh Henry and I undertake to monitor all that work and to ensure that the concerns of the Parliament about the identification of carers and information for carers are translated into action.

Turning to the contents of the bill, it will be a significant achievement of our Parliament in helping to improve community care services throughout Scotland. It will enable us to deliver real benefits for thousands of people who need those services. It will enable us to deliver fairer charging; more support and recognition for carers; greater choice and independence for people who need care; higher-quality care services through greater joint working; and free personal and nursing care.

Through the bill, we will ensure that nursing care is free for all who need it, regardless of the context—free at home, free in hospital and, for the first time, free in nursing homes. In the same way we will ensure that personal care is free for all Scotland's older people—the dementia sufferer and the stroke victim, those at home as well as those in care homes.

Today the Subordinate Legislation Committee reported on the powers to make orders and regulations in relation to that part of the bill. I am pleased that the committee welcomed the changes noted above and I am grateful for its careful consideration of the matter and for making its report available so quickly to enable Parliament to have the benefit of its members' views. However, I disagree with their comment that the power to qualify the requirement for free care can be used to

"undermine the purposes of the Bill."

A power to qualify is not a power to remove the requirement for free care.

The Health and Community Care Committee accepted in its stage 1 report the Executive's view that some flexibility is required. That is because we will need to be able to update the provisions in response to future changes in the way that care is delivered. We also need to allow for clarification where necessary to ensure that free care is applied consistently throughout Scotland. We have been clear and consistent about the need for those powers and how we intend to use them to provide free care. I remind the Parliament that we have amended the bill to ensure that such regulations are made by affirmative procedure so that they can become law only if the Parliament votes for them.

Debate on the bill has often focused on free nursing and personal care. Those provisions are a major step forward in improving fairness in care charging throughout Scotland, but they should not overshadow the other important changes that the bill will introduce. The bill will extend choice for people in need of care. The measures to extend direct payments will put real power into the hands of those needing care at home to choose the best care package to suit their needs. Instead of people being provided with services chosen by local authorities, direct payments give them the power to buy in their own services.

The bill will ensure that direct payments are available throughout Scotland and will make them available to all care client groups. In practice, that could mean that whereas a person's care needs are met currently by half a dozen different care staff, in the future that person could choose to employ one or two personal assistants to meet their needs in the way that suits them best.

The bill will also extend choice for people who need to go into care homes. Deferred payment of care home fees will mean that people will no longer have to sell their homes to fund their care during their lifetime. Leaving home to live in a care home will always be a stressful time, but deferred payments will mean that people are spared the additional worry of selling their homes. Of course the overall number of people involved will be greatly reduced by free personal and nursing care in any case.

Part 2 of the bill will allow new closer ways of joint working between NHS Scotland and local authorities, enabling them to develop more effective seamless services to suit local circumstances. It will give them real flexibility in how they manage and resource services jointly. We want local partners to come together to provide the best services for users, carers and patients. The bill lets them do just that.

Part 3 of the bill provides measures to improve health services. It will extend the medical list system so that it applies to all general practitioners, rather than just those who run practices. That is an important improvement in the coverage of our existing quality and discipline procedures. It will mean that patients can be confident that every GP will be subject to similar disciplinary procedures and standards.

Significant though it is, the bill cannot and should not be seen in isolation. Effective change does not come about just because of some words on a piece of paper. That is why we are already engaging with local partners and why the bill links to many other crucial initiatives.

First, there is the work of the carers legislation working group. I pay tribute to everybody who was involved with that group. Secondly, there is the work of the implementation steering group in preparing for the implementation of free personal and nursing care. Thirdly, there is the work of Direct Payments Scotland in laying the foundations for the expansion of direct payments. Fourthly, there is the work of the integrated human resources working group, under the chairmanship of Peter Bates, on the staffing issues that arise from our joint working agenda. Hugh Henry and I were pleased to meet Peter Bates on Friday.

I take this opportunity to thank the members of those working groups and to pay tribute to all who have been involved in the bill's development over many months. Some of those were mentioned earlier. I also thank Susan Deacon, who developed many of the policies that underpin the bill and who introduced it to Parliament. I thank Henry McLeish, who was particularly identified with the central policy of the bill, as well as all the officials who were associated with developing the policies of the bill and with its detailed drafting.

The bill is also better because of the various consultations that took place on its different provisions. The extent to which we carry out consultation is a new and very positive feature of this Parliament. I thank the hundreds of individuals and organisations that took the time to contribute their views and insights at public meetings, in focus groups and through written consultation.

Finally, I must mention some of those who have been instrumental in laying the foundations for the measures that the bill will put on to the statute book. I am grateful to my fellow members of the care development group, as well as to the carers legislation working group and to the joint future group before that.

The completion of the bill's progress through Parliament is far from the end of the process. We will continue to face challenges. We will continue to work with key agencies to ensure that progress is made in other ways on areas for action where legislation is not needed. I repeat what I said concerning the identification of carers. I have already mentioned some of the implementation work that is under way. We now need to turn our attention to regulations and guidance, to provide some of the detail that is needed beneath the provisions of the bill. We will continue to work in partnership with stakeholders on implementation and the development of regulations. I welcome the Parliament's input to the process.

The bill is a major step forward in improving care for the thousands of people in Scotland who need it and for their carers. I am pleased that there is such widespread support for the bill and am proud to see it nearing the end of its time in Parliament after months—indeed years—of planning. Although much remains to be done, the bill represents a major milestone in improving care.

I move,

That the Parliament agrees that the Community Care and Health (Scotland) Bill be passed.