Finance Committee, 13 Jun 2006

Meeting date: Tuesday, June 13, 2006

Official Report 251KB pdf

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Adult Support and Protection (Scotland) Bill: Stage 1

Good morning and welcome to the 17th meeting in 2006 of the Finance Committee. I remind people, as I normally do, to switch off their mobile phones and pagers. We have received apologies from Wendy Alexander and Frank McAveety.

Under agenda item 1, we will take evidence on the financial memorandum to the Adult Support and Protection (Scotland) Bill. Members will recall that we agreed to adopt level 3 scrutiny of the bill, which involves taking written evidence from bodies on which the costs will fall and oral evidence from the Convention of Scottish Local Authorities and then Executive officials.

Representatives from COSLA are with us. I welcome Val de Souza, who is group manager of the planning and services division of West Lothian community health and care partnership, and Alan McKeown, who is team leader of COSLA's health and social care team. Usually, we offer witnesses an opportunity to make a short opening statement before we move to questions. Does anyone wish to make a brief opening statement?

I would like to.

I think that there is widespread, truly multi-agency support for the bill, which will not only lead to our progressing a number of complex cases, but could lead to our looking back at a number of cases that have previously been unexposed. It is probable that the bill will also lead us to look sideways because, as we unearth cases, we will know who perpetrators are and we will need to keep an eye on them. Doing that will require a truly multi-agency approach.

Our view is that the costs fall into three general categories. There are general costs that are covered by the bill, but we think that there are also underestimated costs and unidentified up-front costs. The costs may have been estimated at around £13 million, but—if I may be so bold as to say so—that figure can easily be doubled. Financial memorandums are considered very early in the parliamentary process; we will understand the full costs only when we get the schedules if the bill gets past stage 3.

Val de Souza has worked closely on the bill with the Executive and we will continue to work closely with it. She has also worked closely with her colleagues in West Lothian and throughout the Lothians. She has close contacts with people in the Borders; indeed, we have drawn on examples from the Borders. In our evidence, we hope that we will give concrete and objective examples of where the cost drivers will be and that we will answer members' questions as factually as possible.

Thank you very much.

You said that costs could double. Where are the main risk areas in that respect? Obviously, such an increase would be worrying.

Some increases are difficult to anticipate at this point, but I think that there will be increases across the board.

I put together a paper at the last minute because I did not know that I was coming to the meeting until the end of last week. There will be an impact on staff and staffing levels, and the work that people will do will change greatly, which is a major consideration.

A lot of expense will be incurred if councils set up adult protection units. The bill refers to strategic development officer posts, which will cost a substantial amount of money, although the costs of the adult protection committees will perhaps be less substantial. I suppose that a substantial amount of money will be required to support what the bill proposes. Some of the money that will be required will relate to the impact on staffing and the work that we do to support that, but some of the work and the associated cost will be administrative—it will be about supporting staff to carry out their responsibilities and monitoring and evaluating the work that is being done to ensure that we are getting it right. I can give you more detail if that would be helpful.

It might be useful to get as much quantification as possible of the expenditure that will be necessary. I agree that we find it difficult to deal with financial memoranda at a relatively early stage in the passage of bills because the costs can be affected by the regulations and guidance that are put in place. However, in principle there is no reason why we should not have proper modelling to give us a very firm idea of how things will work in practice before legislation is put into effect. We are keen to get as much definition as we can.

In our submission, we make a general statement about one of our templates or guidelines, which is to examine what has happened in the Scottish Borders area following the inquiry that was held there. Scottish Borders Council has had to invest to develop the delivery of its social work services to respond to the requirements of the social work inspectorate, which were about raising the standard of those services to an acceptable level and implementing robust systems that would support what we are asking of staff and of councils.

The director of social work services in the Borders recently made comments about having to put a substantial amount of money into the learning disability service to set up a specialised unit that would deal with vulnerable adults and cases of learning disability. I think that the cost of that was just under £1 million, to give a ball-park figure. The Executive may want to check that out in more detail. That was not money that was allocated after the event; it was money that had to be found from somewhere else.

If we were to examine the situation in the Scottish Borders partnership area across the board—I am talking about the work not only of the council, but of the health service, the police and the voluntary sector—and to compare it with that in other areas, I think we would find that practice was not great throughout the country and that it needed to be brought up to quite a high standard. I do not think that the Social Work Inspection Agency is asking too much of services. Services have changed and evolved dramatically over the past 10 years. Now that the SWIA is in place, it is setting standards that are putting many cost and staff pressures on councils and other organisations that work in the area of adult protection.

The bill offers us an opportunity to examine the situation closely and to assess how we will shape up and how we can get close to achieving the new standards, which I think will be substantial.

I want to follow the line of questioning that the convener started by going through the different areas of cost that you identify in your submission so that we can obtain an understanding of why they differ from the costs in the Executive's financial memorandum.

The first area of cost relates to the introduction of adult protection units. You may correct me if I am wrong, but your main point seems to be that the cost of creating a unit will be determined by whether it is a practice unit or a planning and strategic unit. Is that the distinction that you are making?

I am saying that there needs to be more clarification of what we expect from adult protection committees—I am sorry; did you ask about the units?

Yes. I am referring to paragraphs 11 and 12 of the submission that we received this morning.

In relation to the adult protection units, the main example that we have at the moment is the unit that Scottish Borders Council has set up. I guess that that is the only model that the Executive had to draw on when it was drafting the bill. Under that model, there is one member of staff—an adult protection officer—to work on adult protection issues, supported by administrative staff and training staff. In other words, we are talking about three members of staff.

The adult protection officer has a dual function, one part of which consists of supporting the adult protection committee, which considers strategic issues; training; patterns that emerge in what is not working well; standards; and monitoring and evaluation. Much of the rest of his time is taken up with dealing with practice issues by advising and consulting practitioners; attending or chairing case conferences; giving advice on the legislation that is available—on what can and cannot be used—and the assessment and management of risk; and advising on what is acceptable and what sources practitioners can draw on to keep people safe.

Does such a person exist already in local authorities?

Yes.

You estimate that the national cost of the introduction of the adult protection unit will be £9.5 million. What proportion of that is current local authority expenditure, rather than new money, or a new cost that is being incurred?

I do not know whether I can speak for Scottish Borders Council, which is where close to £1 million was pumped in—I am not sure where that came from. That would be additional expenditure from its point of view. If we were to set up something similar in West Lothian, new expenditure would be involved. Some team leaders' jobs would be vired across, so there would be an element of overlap, but the posts do not exist at the moment.

I was driving at whether the post would be a new function requiring new personnel and new costs or whether similar work is being done just now, although not as comprehensively.

That is right. In preparing for today, I got in touch with quite a few of my colleagues who work in this area. They emphasised the pressure—although it is welcome pressure in a way, because people want to raise standards—that the Borders inquiry report and the recommendations from it have put on practice across the piece, particularly in social work. One of our practitioners in West Lothian estimated that the waiting list for services has increased in the past 18 months because of the pressure of the bureaucracy and the requirements that have come to their team through the standards and requirements that arose from the Scottish Borders inquiry.

The service is being squeezed at the moment. There is a waiting list for cases that do not involve adult protection for those who are at high risk of abuse—the kind of cases that we cannot afford to get wrong. Authorities are putting a huge amount of their limited resources into that area and are finding that the pressure in the teams has become intense. There is little administrative support and they are finding problems with staff turnover. One person said that they reckon they have lost five members of staff in the past 18 months because of the bureaucracy, pressure and waiting lists. The work is new. It is being contained, but not terribly well.

The point is that if the Scottish Borders model is to be the model for all local authorities, there is a journey to be made, which will involve resources.

Yes.

The other major cost difference between the estimates from COSLA and the Executive appears to be set out in paragraphs 15 to 17 of the COSLA submission. There seems to be a pretty sizeable difference, which is driven by the number of cases that an individual case manager would be able to drive. The Government suggests that an estimated case load of 23 is realistic. You suggest a case load of 15. Will you talk us through the reasons for that difference?

It is very difficult to create from nothing a bill that makes a huge amount of sense and is robust in its costs. I seem to be defending the Scottish Executive again, although that is not quite my role.

When I looked in more detail at the cost estimates for case loads towards the end of last week, I drew on my experience of co-ordinating the learning disability audit in West Lothian. One of the conclusions that we drew was that because of the consistent pressure that some social work staff were under, particularly in relation to cases in which risk and abuse were unpredictable, staff behaviour was unpredictable. We are talking about situations in which people's behaviour was on the cusp of being offending behaviour—it was certainly challenging—and there might have been mental health elements, but it was right across the board.

Given what we knew about the cases, we concluded that it would be very difficult for a social worker to hold more than six such cases at any one time. You might think that I am exaggerating and I do not mean to imply that six cases is all that a social worker has to deal with—they have other things to deal with, as well as a further nine cases at a lesser level. I am talking about the kind of cases in which somebody needs 24-hour supervision, whether they live in the community, in a group or whatever. For example, there might be no cover one day a week for some reason or social workers might be trialling less than 24-hour cover. Social workers deal on a daily basis with the unpredictability of not knowing what someone is doing for those two or four hours during which they are not under supervised care and have to deal with people ringing in to ask where somebody is because they have spotted them in various places.

Social workers could not possibly have 23 cases of that nature, let alone 15. To add a sense of proportion, there would not always be 23 cases at that level in West Lothian or in any of the council areas. Those are high-tariff cases, which are given to senior practitioners who are willing to take on cases with a high-risk element.

I hope that I am not going in too technical a direction for members to follow. We are between a rock and a hard place with those cases—we are damned if we do and damned if we don't. Professional judgments are required at every step along the way.

We looked at case load configuration in scrutinising some of those cases in West Lothian. We looked at who took on the tough cases and why they were weighted for some individuals and not others. We concluded that there should be about six cases per case load. The figure of 23 cases that the Executive came up with drew heavily on existing complex care management information and policy. That is a fairly solid place from which to take the information, but the level of unpredictability, risk and abuse brings the tariff up for me. It is unrealistic for somebody's case load to be at that level.

From a cost point of view, cases do not drop out of the system—the total is cumulative. It is not one in, one out as it might be in other services, so not only is the cost cumulative but the pressure of the case load becomes cumulative.

I will broaden out the question slightly from the cost to local authorities. We have had a number of submissions from health authorities; we received one particularly comprehensive submission from NHS Lothian, with which I suspect you are familiar given that you are from West Lothian. NHS Lothian highlights a number of costs that will arise from the fact that the bill is an interagency bill. Therefore, costs to local authorities will not be compartmentalised. What information can you share with us about the discussion that has taken place among partners—either the health authorities or the police authorities—on the relevance of the costs identified by the Executive and whether additional costs have been missed out?

Health and police colleagues—health colleagues in particular—are a bit surprised that the Executive is saying that the cost to them will be limited. Do you want me to speak from their point of view?

Yes. I want you to comment on any issues that are relevant from their point of view.

There are two ways of answering the question, the first of which is to consider separately health, police, the voluntary sector, housing, education and other areas. The second way is to identify a responsibility to fund an interagency response, so that the responsibility moves away from local authorities as a whole.

Colleagues in the health sector were surprised that the financial memorandum suggested that there would be little cost to them. The COSLA submission makes the point that the current input from our general practitioners is in a sense quite minimal. GPs are in a crucial position because of the information that they get from a host of people about how they live their lives and the risks that exist in some families, but they find it difficult to get away from the work that they are doing and to free themselves up to attend an adult protection committee or adult protection case conferences. The situation is mirrored in child protection. GPs do their best, but there is frustration among the professions that are involved in interagency work that they are not visible in those discussions, because we think that they are crucial to the process. I am not necessarily laying the responsibility only on GPs—perhaps other health professionals could bring such information to the table. GPs say that the cost of covering their attendance at a case conference would be about £300. We have to ask where that money would come from, given that we see GPs as crucial in the sharing of information and the overall and continuous protection of some very vulnerable people.

We have conducted interagency training throughout the Lothian and Scottish Borders area on the implementation of our guidelines, which were launched in 2003. However, we found it exceedingly difficult to get GPs to come along to the training. The issue is their time and the way that their days—and their priorities—are structured. It comes down to whether such training can be treated as part of GPs' continuous professional development schedule and whether they can get locum cover, which would cost about £300, or more for a full-day session. That is only one of the issues on the health side.

The way in which my health colleagues and I would see their involvement in the Adult Support and Protection (Scotland) Bill is that health visitors, district nurses and practice nurses are out in the community. Like our home helps and domiciliary care workers, they go in and out of people's houses daily. The rest of us may go to someone's house once a week, once a fortnight or once a month. We get a snapshot, but those people are in people's houses daily and can see what is happening.

The biggest record of adult abuse is of physical or financial abuse, because we can see the evidence. We can see bruises or tell that people cannot pay for things, so the abuse comes to our attention. However, a huge amount of other types of abuse takes place. Emotional abuse, psychological abuse and sexual abuse can be largely hidden. Staff who visit households daily can see what people's lifestyle is like, what the risks are and what forms of abuse might take place. They often get a gut feeling and when they come back they might say that something is not right. They can build up a picture.

We rely on those people to refer situations to us. The local authority has clearly been given the lead in investigating such situations, but we depend on people's awareness having been raised through training. Their role in referring is crucial and they must know to whom they should refer the matter. Referrals take time. Sometimes, health professionals will phone on Friday and say, "Something occurred to me on Tuesday." It is something of a joke in social work circles about child protection and adult protection—they tell us on Friday because they are a bit worried about thinking about it over the weekend. It is just one of those things, but why did they not tell us on Tuesday when it occurred to them?

When they are challenged, people will say, "We don't have time. We have to go on to the next case. We have 30 people to see in a day, and we're doing dressings and this, that and the next thing. It's been on my mind but I haven't had the time." We need to look at that. It is one thing to say that a bill will be introduced and that we will try to improve standards and have robust systems, but we should be talking about a transformation. We have to change people's minds and hearts. They have to know that it is their duty to report anything suspicious or anything out of the ordinary that does not fit. For that, we will depend particularly on health professionals and some of our own staff.

I am struck by the uncertainty of figures for the case load. At the beginning of your submission, you say that research suggests that one in eight older people experiences elder abuse. Based on that ratio, my back-of-the-envelope calculation is that between 150,000 and 200,000 people in Scotland come into that category. However, the Executive figure is of 4,000 new referrals each year. Even with the new legislation, only a tiny proportion of the instances of abuse will be picked up and become part of the case load. Is the figure of 4,000 simply a gross underestimate, as the research would suggest?

I think that the Executive was trying to build its figures on evidence, and it was given the Scottish Borders figures on the basis of what had happened down there. My answer to your question would be that the figure is indeed an underestimate, because there are unidentified cases and undisclosed cases. Those will not go away.

Through policies on child protection or policies to tackle domestic abuse, or through any of the other policies that have been implemented via legislation, awareness is raised. You will then find that it is not only present situations that come up but, as Alan McKeown says, a lot of historical cases too, with people saying, "That happened to me." We have to apply the same level of stringency to every case that comes in. We have a duty to investigate.

I presume that, for some cases that come before you, there will not have been abuse but there will have been perfectly reasonable grounds for suspecting that there had been.

Yes, but we have to investigate those cases as well.

Indeed—so perhaps the case load is not 150,000 or 200,000 but is significantly higher, once the false positives have been added in.

It could be. It is likely that, as a spotlight is shone on the issue, the volume of cases will increase. Some suspicions might be disproved, and that is valuable but, as Val de Souza said, we must investigate any case that comes before us. We have to take every case to its conclusion. We must apply due diligence or we would be found wanting in the eyes of inspectors and of the public.

The Borders example is useful. As I understand it, what is happening in the Scottish Borders Council area will, by and large, be what will happen Scotland-wide under the legislative framework. Val de Souza mentioned a cost of £1 million a year in the Scottish Borders area. The figure in the financial memorandum for Scotland is roughly £13 million of recurring costs, and you have said that that could be doubled. However, if we consider the Borders figure, and take into account the population of the Borders, the figure for Scotland would be around £50 million. Are you therefore saying that the potential cost could be anything from the £13 million in the financial memorandum, to the £26 million that you have suggested, to the £50 million that would be obtained by extrapolating from the Borders figure?

The committee's scrutiny process will give you a feel for that; I do not think that we can comment right now. Depending on how the services are structured and provided, you could be talking about a figure between £13 million and the upper figure. However, that would depend on the final process, what the schedules look like and how we handle things. John Swinney asked what we are doing already. Some of the projected costs might not necessarily be new costs in terms of a public sector reform agenda and some services might be shared across boundaries. We expect people to consider that, so we expect that efficiencies will be sought in organisations and in the way that services are organised and delivered.

My opening comment about it being very early in the process applies to the figure—we could say that it will be one figure or the other, but we just do not know. We will know more at the end of the process. We have to work with the Executive, our partners in the voluntary sector, and the police and the health service to ensure that we nail down exactly what we want to do and how we will structure and cost it. We know that the costs that are predicted at the start of a bill will never be the same as those that emerge at the end, so our scrutiny of the costs has to be very hard.

I accept that entirely. However, only one local authority provides such a service and if its costs were to be prorated up, that would suggest that the costs that are outlined in the financial memorandum are a quarter of what the total will turn out to be. It would be very useful if your line-by-line analysis of the various headings of the bill could show what the per capita cost will be in Scottish Borders relative to what your submission suggests. I am not suggesting that you do that today.

We are happy to do more work on that. The committee will be better informed through this process than we will be and it will come to a view about what it thinks is reasonable for the financial memorandum to suggest and whether the projected costs are appropriate for the delivery of the provisions of the bill.

Your submission contains a projected training cost in excess of that which is projected in the financial memorandum, albeit that the scale is somewhat lower. The examples from West Lothian are useful because they give us some understanding of how you reached your estimates.

You suggest a cost of around £700,000 for training. To what extent could that be substituted for other training? In other words, to what extent could the requirement for training be met out of the existing training budgets through not undertaking other courses? Is there any slack in training budgets that could be put into training for new legislation?

Training budgets are never overly funded. When we introduce something new, we have to ensure that our staff are equipped to deliver it. If we were to substitute the required training for other training, something else would not get done. That is a dilemma and we have to go through a financial wrestling process. We might be able to consider whether the training could be sourced regionally or nationally and whether we could achieve savings that way. The figures in the submission just show the potential magnitude of the training that would be required if everyone were to deliver the services in the way that we want them to be delivered, so that when a service is inspected, we know that we have done all that we can to ensure that it is at the right level.

The costings were done on an interagency basis, so they do not represent just the cost to the local authority. There would be a drawing together of responsibilities from other sources. There is an interagency agenda and training is delivered and received on an interagency basis, so the costs can be meted out accordingly.

I assume that it would be difficult at this stage to indicate the extent to which the costs for training and everything else would be split between the various agencies that will be involved. There must be some blurring around the edges between, say, health boards and councils

We would need to know the final make-up of the bill and how the training will be handled in the localities before the costs could be decided on and apportioned. There are various ways in which that money could come into the system to meet those training needs. If training is to be done on an interagency or regional basis, it would be inefficient to fire money out in three ways only to pull it back together so that it could be sent out the door another way.

When we legislate to deal with an issue that has not been addressed in previous legislation, there is a danger that we try to create an ideal framework and—as you suggest has been the case—pick out an example of best practice and seek to generalise it for use throughout Scotland, which might have an associated substantial increase in cost. That increase may not be affordable, but perhaps it also should not be seen as being affordable in the context of the demands on social work budgets, because what is spent on the bill must be set against what is spent on other social work functions and activities. Are we getting that right? Is the bill drawn too widely in respect of the real problems? Is it overspecific in putting in place procedures that might be ideal but which are not necessarily required for every client to whom the bill might apply?

Val de Souza will talk specifically about social work. There may be the potential to consider how social work services manage their risk portfolio. We are shedding particular light on one aspect of that and it is right that we do that. The bill is about protecting people—I do not think that anybody would disagree that we must do that. You are right to say that we must consider the budget in its totality and that, if we continue to add high-profile, staff-intensive and stressful case loads to social workers' work, it will take a cumulative toll as well as a toll on the specific budget. We might have to think about ways of managing the totality of risk, perhaps by having authority-by-authority risk-management strategies. We raised that in the social work review, so we might be able to consider it across the board. Val de Souza will probably give you more of a social work feel.

I appreciate the point that you made, convener. To put the matter in my language, I sometimes wonder whether we are getting caught up in an adult protection industry. At the front line, if an at-risk-of-abuse referral comes in, it is difficult not to deal with it immediately and not to put pressure on staff to pull everything in from every corner to deal with the situation because we would be hammered if we did not—excuse my language. Besides, it is not acceptable to know that a person may be at risk of abuse or of being exploited and neglected but not to deal with it.

Many things have been happening since the Borders inquiry. Social work services have been getting many more referrals: if we get them, we have to deal with them. The police have the same line—if they get a referral, the family protection unit has to deal with it. They cannot leave it till tomorrow or say that, because they have heard it before, they will not deal with it.

From a practice point of view, it is difficult to see how matters proportionalise across the agency. Staff say to me that, because they have to deal robustly and systematically with every referral that comes in, other cases are not dealt with. For instance, another agenda that we are trying to promote and pursue is carers assessments. However, staff do not have much of a decision to make on whether to deal with a carer assessment or with a person who is on the point of being exploited or is being put at risk. Staff have to follow the person who is being exploited, neglected or abused. On a day-to-day basis, it is difficult to translate that into flattening the agenda or making it more proportional across the piece.

Since the Community Care and Health (Scotland) Act 2002, hospitals and big institutions have been closed but, on risk and abuse, there has been no great feel for what measures and support we are trying to bring into the community. We know about that in terms of care packages, but we are having to manage many folk who are now living in communities and who are both perpetrators and victims of abuse. I do not think that that has ever been quantified.

What we are dealing with now, especially with the bill, is recognition that we have been under the cosh in trying to deal with the problem cumulatively over the years. We have now to achieve standards that are dictated by the Social Work Inspection Agency. West Lothian Council will be inspected later in the year. Even as I talk, I am thinking about a meeting that I will have to go back to this afternoon and am wondering whether we have got it right and what they might find in our systems that is not right. The pressure in respect of the protection of vulnerable adults agenda feels acute at the moment. I am not sure whether that answers your question, but that answer is as good as I can give because I am in the middle of it all.

Two questions arise from that. First, to what extent do you think the bill reflects the defensive agenda of practitioners who wish to ensure that they cannot be attacked or penalised for not doing the right thing in handling cases? That is the issue that came out of the Borders case, and there is a fear that that might be an issue again somewhere else in Scotland. To what extent does the bill take a practice-driven approach and to what extent does it approach the matter not from a social worker's perspective, but from the perspective of what is best for the client?

Derek Brownlee asked what additional money you would need to make the ideal system in the bill work. If I was a councillor—which I have been in the past—I would be asking you the reverse question: Within the available money, what can you do, what cannot you do, and where would your priorities lie? There will not be unlimited resources, so what do we absolutely need to do and how can we specify that in a way that makes best use of resources? Are there things that are, in a sense, bolt-ons or less necessary?

There are three elements to adult protection: there is practice, in terms of guidance and supporting staff; there is training; and there is monitoring. If I was to prioritise for a council, I would say that we have to offer administrative support to our practitioners in basic things such as minuting meetings and tracking referrals. At the moment, practitioners spend a huge amount of professional time doing administrative tasks. That would be the number 1 hit for me.

We also need to ensure that we get the training right, because things are moving awfully fast at the moment. Since the Borders inquiry, the number of changes that staff have been asked to take on board in two years has been insurmountable. Training is needed to keep people up to speed and well informed.

Thirdly, we need to monitor what we are doing and we need to try to get the best value for what we are doing. There is very little research and knowledge of what we are up against, which is why some of the work is difficult to quantify. We need really good monitoring systems. My three priorities would be staff support and guidance, monitoring and administration.

I would come at the matter from the angle—that of being a councillor—that the convener suggested previously. If I was a head of service looking at the bill, I would be wondering what we would be able to deliver for the money that we will get when it is made available in its community planning totality. If things do not go quite right or if things change, we need to be able to say that we said at the beginning that that was what would happen. We need to be able to say what we can do for the money, and that if the money is not put in we will have either to stop doing something else or change what we are doing in respect of the bill. We have to become much smarter in how we work in social work because of the pressures that we face. We are not quite there yet, but it is something that we have to do. We are continually introducing people-centred bills, which is taking its toll.

The general policy direction in both health and social work has been to change the culture from dealing with crises and to move into the world of prevention. That direction is absolutely right, but it takes time, requires careful planning and needs a strategic overview that sets the changes in context so that everyone knows exactly what they are doing and the standards to which they need to perform. In a range of issues on which Parliament has introduced improvements, we are just working through what is still a relatively young process. We need to think carefully so that we make commitments that we know we can deliver rather than commitments that we would like to deliver.

To be more specific, if the money that has been mentioned turns out to be all that is available, what will authorities be able to deliver under the bill?

We will know that only at the end of the process—I am sorry if that sounds like a cop out. Only when we get the schedules will we know exactly what we will be able to do and how we will do it. We cannot be certain before then. I would like to give a more specific answer, but I cannot until we have gone fully through the process and have put flesh on the bones.

Our difficulty is that stage 1 of the bill is when we need to consider the financial memorandum. If the bill's policy intent cannot be delivered because it does not marry up to the available resources, something will need to give. The inclination of people on your side of the table is always to say that more money must be fed in, in order to achieve the policy intent. However, I am putting the reverse question: if those are the financial constraints in which we need to operate, what policy choices do those constraints force people to make? In your professional judgment, where will authorities go with that? I know that that is not a question that you want to answer.

Frankly, I think that we would be struggling to answer. I do not know whether Alan McKeown is reluctant to answer.

With a limited pot of money, we can do only a limited number of things. If one thing costs £1 and we have a budget of £100, we can do 100 things.

Which things would local authorities choose not to do in that context?

We need first and foremost to protect the individual.

Going back to what I said earlier, I think that monitoring and supporting staff by providing administrative help are what I would do immediately. It is really difficult to say what I would not do; none of the bill's provisions is superfluous.

If the bill is passed, local authorities might well end up having to make such a choice two years down the track.

We might then need to talk about choosing not to do things in other areas of the social work budget, which might mean examining free personal care and what we charge and do not charge for. That may be a bad example—I will deal with that issue later—but we would be forced into such hard choices and that is the world in which we would need to operate. As I said, the bill will be delivered within the context of a drive for efficiency whereby we share costs, provide leaner services and work smarter so that we get better at what we do, but we might still need to raise thresholds for services, reduce the level of services by one hour per person and cut services and jobs. We would need to know exactly what the bill will look like in its final stage, but that is the type of process that we would need to undergo. If the money is not made available, we will need either to do things better or to do fewer things. Is that the answer?

Mr McKeown may not have given the answer, but he has certainly summed up the dilemma. I want to push you just a little bit further on the efficiency savings that you have mentioned several times. The committee is always interested in the extent to which better working practices can help to create the type of model that the bill is trying to establish, or whether it is simply that more money is required. Mr McKeown's previous answer highlighted how local authorities face the dilemma of, for example, allowing timescales for free personal care for the elderly to slip so that other services can be paid for. I would not criticise local authorities for providing a realistic expression of the dilemma that they face.

Given that the bill is structured in a way that emphasises joint working, will it provide an opportunity for the cost of the proposals to be met by achieving efficiencies across the health service, social work service, police service and the voluntary sector? Also, once you achieve some of those efficiencies, will there still be a net additional cost that will need to be funded from new money?

The reality is that there may be more costs in the short term as we try to bring everyone together, to rationalise systems and to deal with culture, personality and boundary issues. In the long term, the bill provides an opportunity to work much smarter and to work better to drive down the costs of processes. That will need the establishment of a sound infrastructure, which we know will not happen overnight. In the long term, I hope that we can have smart systems, but we may find that, as a result of developing the policy, the case load increases and any efficiency savings are therefore balanced out.

The answer to the question is that I expect us to drive toward efficiency savings on a range of fronts. However, we will need to keep in mind what might happen to our case loads. Our experience of introducing such legislation is that it results in increased case loads. People know that there is a service, so they rightly want to highlight their issues.

I will carry on from that, but on a different level. In the past one or two years, the agencies have been working together much better. The added value from that is that we are delivering better services to the people whom we try to protect. Because of better information sharing, we can identify problems more quickly. However, it is difficult to say whether that results in a cost saving. If we identify problems more quickly, the down side is that we sometimes have to deal with them for longer because they do not go away or get better. However, the evidence is that interagency working is creating a much better culture of joined-up working and that it is getting it right for the people whom we try to protect. That does not exactly answer the question.

I am keen to explore some of the nuances that have arisen. Has much thinking been given to how we can reduce the incidence of abuse and hence the incidence of case referral? That would have huge financial implications.

I do not know whether anybody has the answer on how to reduce the incidence of abuse and referrals. Little research has been done on that—that is another matter for which money is required. We are finding that many people do not disclose abuse when it happens, but do so later in their lives, so we are discovering a whole lot more abuse than we ever suspected or wanted to think was out there. I cannot answer your question logically.

Let me come at the matter from a different angle. Are there any countries that have a markedly lower incidence of abuse? If so, have you studied them and do you understand what is different there compared to here?

No. I do not—

Are you saying that no other country has a lower incidence of abuse?

I could not say that, because I have not done any research on it. I am not sure that much research has been done on the issue; people from the Executive may have done some. In England, where similar policies have been in place for several years, the statistics are high and similar to those that we mention in our submission. Certainly, issues such as physical and financial abuse are hugely underestimated. Another issue that has been pointed out in an English report is that, sadly, people are often abused by care workers and other people whom they know and who are involved in adult protection. People know that that happens in child protection, but the situation is mirrored in adult protection.

We should realise that vulnerable children become vulnerable adults. The people for whom we create child protection practices and legislation do not disappear at the age of 16; rather, they become vulnerable adults who then have children who become vulnerable. The pattern is cyclical.

In his Allander series lecture, James Heckman offered us advice and guidance on how to break out of that cycle and made a cost justification for effort made with children at an early age in an attempt to break that cycle. There must be other people breaking that cycle at later stages and there must be good international experience that could help us save on costs.

Certainly, we can try to find out whether there is any other research. I am not aware of any—I would not say that I spend a lot of time looking at international research in this area, but I keep an eye on what is happening in England, Wales and Northern Ireland.

You talk about multi-agency co-operation and agencies working together. What are those agencies?

I can speak only about the situation in the Lothians and the Scottish Borders, in which practice has been dictated by Lothian and Borders police's catchment area. In that area, the three statutory agencies are working together: health; social work; and the police. The voluntary sector is also involved to a degree.

Are there no examples of people dealing directly with communities or the education services?

People from such services have been invited to take part in the training that we run. Our community education colleagues have all been through the training, as have people in the voluntary sector, the private sector and the independent sector and we have invited service users and carers to take part. We have kept the scope very broad but, largely, the people who are involved are from health, social work and the police. They are the main statutory element.

One of the matters that is raised from reading the financial memorandum and your evidence is how you facilitate information sharing; there is not a lot of detail in that regard. Are we talking about there being some sort of electronic record of people at risk?

As the convener said, when we are given an opportunity such as the one that is presented by this committee, there is a risk that we might get carried away and list all the things that we want to fix. With that in mind, we wanted to keep our contribution on information sharing brief. We think that it probably relates to somebody else's mandate.

Alan McKeown talked about infrastructure. At the moment, we do not have a good infrastructure in terms of sharing information across health, the police and social work—the systems do not talk to one another. If we are going to do this right, we need to get information sharing right and if we do that, we will have smarter working and quicker practice. It would be difficult to walk away from the opportunity in giving this evidence of saying something about information sharing. There are a number of levels of information sharing. There is the infrastructure element and there is the element that involves changing hearts and minds so that people talk to each other. We have to change the cultures that we work in to ensure that people who are aware of situations tell other people about them. That is a training issue. There is a huge amount that can be done in that regard, but some of what we are talking about relates to mainstream practice, such as that which is being done by the community health and care partnerships, and other work.

So there is no tangible proposal on the table.

I think that integrated children's services might say that there are pilots on-going in relation to information-sharing protocols and infrastructures. The joint future unit and the joint improvement team in the Scottish Executive are working on information systems and on ways of sharing information better in terms of protocols and infrastructure.

I understand that work on information sharing will come out later this year. It is crucial that we get that right without much delay.

Has thought been given to integrating that with the move to electronic health records?

There are enough problems with the internal national health service systems without having to try to map an external system on to them. However, work is being done on information sharing in relation to e-care and there are some resources and political drive behind that. All of us in local authorities and health boards are trying to play our part in that.

That is the work that I referred to in terms of the integrated children's services agenda. I think that pilots are on-going in that regard, possibly in one of the Lanarkshire council areas.

We are aware of problems relating to electronic systems, particularly given the massive cost escalation that we have seen south of the border. I presume that if you do not add on to an existing project but develop a stand-alone system that is fit for purpose and which has all the security provisions and protocols that are needed in relation to professional standards, it could be a significant and expensive undertaking.

On cost, if you give an information technology company the opportunity to develop a national system, you could just pick a number and multiply it by 10.

In practice, the councils have enough to cope with in relation to the systems that are in place. They would like to have something that would dovetail with what they have rather than something new.

If we are talking about information sharing between—

Derek, we need to draw this discussion to a close.

The financial memorandum talks about making minor improvements to existing systems. Based on the existing systems that you are aware of, is that feasible in terms of achieving the goal of sharing information across agencies and between areas?

We have such a wide range of information management systems in use that it is possibly realistic. However, I doubt that it is realistic to consider action in one wave across the board.

I thank our witnesses for coming along and answering our questions. I hope that the experience has not been too difficult. We will take more evidence on the bill from Scottish Executive officials at next Tuesday's meeting. After that, we will prepare our report, which will go to the lead committee.

Meeting suspended.

On resuming—