Health, Social Care and Sport Committee [Draft]

Meeting date: Tuesday, February 6, 2024

Official Report 767KB pdf

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Subordinate Legislation

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Community Care (Personal Care and Nursing Care) (Scotland) Amendment Regulations 2024 [Draft]

Our second agenda item is consideration of the draft Community Care (Personal Care and Nursing Care) (Scotland) Amendment Regulations 2024, which is an affirmative instrument. The purpose of the instrument is to increase the value of payments for free personal care and nursing care by 6.68 per cent.

The policy note states that payment rates are being increased in line with inflation using the gross domestic product deflator, with rates increasing from £233.10 to £248.70 for personal care and from £104.90 to £111.90 for nursing care.

The Delegated Powers and Law Reform Committee considered the instrument at its meeting on 23 January 2024 and made no recommendations in relation to it.

We will have an evidence session on the instrument with the Minister for Social Care, Mental Wellbeing and Sport and supporting officials from the Scottish Government. Once all our questions have been answered, we will proceed to a formal debate on the motion.

I welcome to the meeting the minister, Maree Todd; Marianne Barker, who is the unit head in adult social care charging and support from home; and Clare Thomas, who is a policy manager in adult social care charging and support from home.

I invite the minister to make a brief opening statement.

Thank you very much for the opportunity to speak to the committee about a proposed amendment to the Community Care (Personal Care and Nursing Care) (Scotland) Regulations 2002.

The draft regulations that are before the committee will make routine annual increases to the rates for free personal and nursing care. Those payments help to cover the cost of those services for self-funding adults in residential care.

This year, I am happy to propose an uplift based on the GDP deflator that will result in a 6.68 per cent increase in the current rates. The GDP deflator has been used historically as the inflationary measure to increase those rates. That will mean that the weekly payment rates for personal care for self-funders will rise from £233.10 to £248.70 and the nursing care component will rise from £104.90 to £111.90. It is estimated that that will cost around £11.5 million in the next financial year. That will be fully funded by the Scottish Government with additional investment in the local government settlement, as outlined in the recent 2024-25 Scottish budget.

The most recent official statistics show that more than 10,000 self-funders receive free personal and nursing care payments. All of them should benefit from the changes.

I am happy to take any questions from the committee.

Thank you very much, minister. We will move to questions.

Thank you for your opening statement, minister.

In increasing the rates above inflation for the past three years, the Scottish Government has effectively admitted that in-line-with-inflation uplifts are simply not enough to meet the rising costs of providing care. However, the statutory instrument puts the rate in line with inflation for the coming financial year. Who does the minister see meeting the gap between rising costs and the capacity to pay for them? What is covered in the local government settlement? Is it for the councils, which are already under significant financial pressures in the forthcoming budget settlement, to find that extra financial capacity rather than central Government?

Given the challenging financial context that we face, I am happy that we have been able to increase the rates by 6.68 per cent. An additional £11.5 million is being invested through the local government settlement to do that. It is for local authorities to make decisions on how they spend their funding at the local level.

Does the minister accept that over 80 per cent of local government finance is determined by central Government grants and that that constrains local government’s capacity to meet the other side of the equation?

Traditionally, since 2010, the payments have increased in line with inflation. In the first few years of their existence—up to 2007, when the Scottish National Party Government came into power—they were not increased at all. From 2007 to 2010, we and local authorities negotiated the payment rates, and from 2010 to 2020, they were increased using the GDP deflator.

As you said, there have been above-inflation rises in the past three years. Unfortunately, the financial context this year means that that cannot occur again. However, in the financial context that we are experiencing, I am pleased to be able to increase the payments in line with the GDP deflator, as stated.

On the GDP deflator, what assessment has the Government made of the impact of the rate on the delivery of personal care? Can you guarantee that people will still be able to access the care that they need and that it will remain free at the point of use?

We have not done an impact assessment because it is not a new policy; an existing policy is being continued. We have not done a full impact assessment, but we expect this to support everyone who is self-funding in the system, which we think is around 10,000 people.

I want to follow up on the points that have been made about an impact assessment. You were concerned that the costs increased more in previous years. Do you have concerns that that will be the case again this year and that local authorities will need to meet the costs that are not in the agreed settlement?

In the past three years, our ambition has certainly been to give above-inflation settlements. Unfortunately, the financial context that we find ourselves in this year does not enable us to do that. Local authorities will make their own decisions on their local priorities, as they are democratically elected to do.

I want to be clear. I suppose that, in your modelling, you anticipate that local government will need to make some contribution to costs because you think that there will be an increase in costs, as in the previous three years.

I ask my official Clare Thomas to respond to that line of questioning.

The free personal and nursing care rates are set out in the legislation. They are set rates. There should not need to be a contribution from local authorities. The contracts and the rates that self-funders pay are private arrangements between individuals and the provider.

I want to pick up on what Paul Sweeney and Carol Mochan have asked about. On the £11.5 million cost, is that £11.5 million what central Government is putting into a budget that will allow local authorities to make their own choices? Is that an extra £11.5 million that central Government is putting in, or will local government have to find that £11.5 million?

The £11.5 million is additional funding to fully fund the uplift.

As I have not had any indications that any other members wish to ask questions, we will move on to agenda item 3, which is the formal debate on the instrument on which we have just taken evidence. I ask the minister to speak to and move motion S6M-11853.

I move,

That the Health, Social Care and Sport Committee recommends that the Community Care (Personal Care and Nursing Care) (Scotland) Amendment Regulations 2024 [draft] be approved.

Thank you, minister. Members should not put questions to the minister during the formal debate, and officials may not speak in the debate.

I have concerns about the statutory instrument being recommended to Parliament because the Scottish Government has set the rates above inflation for the past three financial years to help to redress the costs of providing personal and nursing care, which have increased significantly, and payments have not kept pace with that. By its own admission, the rate increase in line with inflation is insufficient to meet the rising real costs of delivering personal care.

The Scottish Government expects members to trust in its vision—which we have not yet seen—for a national care service that, in its own words, delivers “consistent and high standards”, but the statutory instrument demonstrates an inability to adequately resource a basic tenet of social care. I will not vote against the statutory instrument, but I have concerns about recommending to Parliament the rate, which falls short of what local government needs to provide personal care.

I have had no indications that any other members wish to speak. Minister, will you sum up and respond to the debate, please?

As stated during questioning, the uprating is fully funded by the Scottish Government, and local authorities have additional income in their budget in order to ensure that it is paid. I am happy to put the matter to a vote with the committee.

Thank you very much, minister.

The question is, that motion S6M-11853 be agreed to. Are we agreed?

Motion agreed to.

That concludes consideration of the instrument. I briefly suspend the meeting to allow a changeover of witnesses for our next item.

09:10 Meeting suspended.  

09:12 On resuming—