Chamber and committees

Last week, the example of delayed discharges in East Ayrshire, North Ayrshire and South Ayrshire was raised in evidence. There is one health board but three local authorities. One local authority is doing really well in addressing delayed discharges. Is the support of care boards not part of the reform of creating a national care service, so that we can identify why something works really well in one area but not in the other two? That is only one example, but other local authorities struggle with delayed discharges. Is it not part of the reform to look at what is working in one area but not in others?

I will pick up on the reference to having one hour to see the draft amendments. What were the circumstances? In its written submission SOLACE, says that it

“recognises that there are specific areas that would benefit from a national approach”.

Those include

“Leadership and driving improvement ... Standards, assurance, performance, reporting and scrutiny ... Workforce planning, fair work and training ... Ethical commissioning ... Complex and specialist care commissioning ... Improvement and innovation including improving research”,

and more. There is loads that you can agree on. The fact that COSLA has walked away is so significant that I am wondering about those one-hour circumstances. How is it possible that you had just one hour to look at amendments?

Good morning. My initial question is, what are your thoughts on the proposed amendments to the bill?

I have a wee supplementary question. Sweden has a senior alert programme, which includes an assessment for risk and prevention of falls, malnutrition and pressure ulcers. That is done before people even get to the point at which they need care. It is co-ordinated through a national programme that the Swedish Government introduced in 2010—14 years ago. It works; it has been shown to keep people out of hospital. We talk about preventing admission to hospital, but we also want to care for people when they come out of hospital.

In Scotland, we might be seen as a nanny state if we assess people when they turn 65. However, should the national care service aspire to have a programme that supports people to be at their healthiest in their home—or in a care home, which would become their home—for as long as possible, so that prevention runs alongside care?

You talked about direct funding, children and the removal of members from IJBs. In your negotiations with the Scottish Government—in the tripartite agreement that came to be the way to move forward—what additional reform would you like? What fundamental changes need to happen now?

Okay. You are all members of the expert legislative advisory group. I am interested in hearing about how your experience of working together in order to shape potential proposed amendments has been.

I am finding it really difficult to understand that you had one hour to look at amendments but then had June, July, August and September before you walked away. We have marked-up pages of amendments, with lots of additions in blue and strikethroughs in red. I am trying to understand why that one hour is so significant when no decisions were made about the amendments.

What is the impact of COSLA walking away? Has that caused damage?

Good morning—it is still morning.

What are your thoughts on the proposed amendments to the bill? Specifically, our briefing papers include questions about transferring accountability for the proposed national care service to Scottish ministers, as was initially proposed. Is that necessary to deliver the recommendations of Derek Feeley’s review?

I have a final wee question. In the agreement that ministers are working on with COSLA, ministers have the ability to co-design a framework bill—it is a framework bill—then to build on that with further legislation. Would continuation of negotiation support the challenges that you describe on standardising the competency requirements for all staff across Scotland? That is part of it. The bill might not address the shortage of staff, but it looks at how we approach the engagement that is required to have a workforce that could be paid equally, for instance, across the whole of Scotland. That is my understanding of the joined-up co-design approach to creating a national care service that would work across Scotland with the local levels that are required, as Louise Long described.