Meeting of the Parliament 02 November 2022
This Scottish National Party Government is setting out on the most radical reform of Scottish public services in the history of devolution, but ministers cannot deny that they have been warned about the risks around the establishment of a national care service. The Government has been warned by its own MSPs, Michelle Thomson and Kenneth Gibson; by charities, about the risks to continuity of care; by Audit Scotland, about the financial risks; by integration joint boards, about the risks to care across the country; by councils, about the risks to local democratic accountability; by care home providers, about the impact on the independent and third sectors; by rural councils, which warn of the risks of creating a central belt-focused service; by health and social care partnerships, about the risks of proceeding with a framework bill when we know so little detail of the scope of the service; by alcohol and drug charities, about the impact on services for those with dependency issues; by unions, about the risks to workforce planning and development; by labour groups, about the risks to pay and conditions; by social workers, about the impact of detaching social work from local services such as housing and employability; by council chief executives, about the risks of shifting 75,000 council workers to a bloated bureaucracy; by the Scottish Parliamentary Corporate Body, about the risk of a grab on Holyrood’s powers of appointment; and by the legal profession, about the risks of losing cohesive responsibility for the care provided in complex cases. It has even been warned about the legality of pushing through sweeping changes in a framework bill and delegated legislation.
Despite those repeated warnings, the SNP Government continues to sail towards the iceberg. Humza Yousaf is still, apparently, supremely confident that he can captain the national care service, despite sinking Scotland’s national health service. Under the SNP, our NHS and social care systems are in crisis, so it is all the more reckless for this Government to embark on wholesale structural reform when urgent action is needed at the front line.
The minister is ignoring warnings about the crisis that he faces today. He simply dismisses criticisms of that reckless and unaffordable legislation. He ignores the present funding crisis in local government and social care. He dismisses concerns from a workforce that is underpaid, worn down and burned out. He overlooks the acute lack of staff and provision in care at home. He sets aside the skills and workforce crisis in residential social care and ignores the crisis in drug and alcohol services. Instead of taking concrete steps to properly fund social care at the local level, the SNP wants to embark on a massive restructuring, which will divert the millions that are needed to invest in staffing away from the front line and into the pockets of civil servants and administrators.
Why can the minister not see that social care organisations and unions are terrified about that misguided plan? Those bodies include the Convention of Scottish Local Authorities, Unison, Community Integrated Care, NHS Lothian, Scottish Care, Parkinson’s UK, Highland Council, East Lothian IJB, the City of Edinburgh Council, Angus health and social care partnership, the MS Society and the Faculty of Advocates—the list goes on.
The SNP’s members have raised their heads above the parapet to express concerns about how the Government will fund its national care service. After destroying councils’ finances, it is looking to do the same to social care. Audit Scotland is warning that the already eye-watering predicted costs of £1.3 billion are likely to be an underestimate. Even after the framework bill has been published, big questions remain. How is a top-down system consistent with the Christie commission’s view that services must be designed “with and for people”? How will the system eradicate the postcode lottery in care? How will commissioning and collective bargaining work coherently and consistently on a national basis? How will care boards be comprised? Where will the democratic accountability be? What impact will that massive shift have on local authority budgets? If efficiencies are gained in the economy of scale that is achieved through the NCS, will they not be wiped out by the equivalent loss in economies of scale within local government? Where are the calculations on the cost savings that an NCS will achieve? The financial memorandum is very vague. What impact will the NCS have on capital investment in social care today? Councils are pulling back. Is it not the case that that power grab is likely to be an asset grab as well?
The nationalists have learned nothing from the shambolic centralisation of Police Scotland—a move that left the police service plagued by financial problems, a lack of accountability and cuts at the front line. The NHS is in crisis. The SNP has pushed our police service to the brink and is now determined to go the same way with social care.