The next item of business is a debate on motion S6M-17858, in the name of Maree Todd, on the Care Reform (Scotland) Bill at stage 3. I invite members who wish to speak in the debate to press their request-to-speak buttons.
18:01
Thank you, Presiding Officer, for the opportunity to address the Parliament today on the Care Reform (Scotland) Bill. I thank the convener and members of the Health, Social Care and Sport Committee and all the other committees that were involved for their diligent scrutiny of the bill, as well as members and their researchers who contributed and engaged with us on amendments to the bill.
I also thank stakeholders from across the health and social care landscape and everyone who contributed to co-design. Thousands of people from across Scotland with lived experience of accessing care have given us their time and expertise to shape the bill and wider social care reform. Their voices have inspired lasting meaningful change.
There is broad agreement that Scotland’s social care system must change. Although we have taken a revised approach to the bill, our ambition for a national care service remains. The bill is now focused on making vital improvements that we all agree are essential. They will make a real difference and provide a road map for the improvement of social care, social work and community health.
I am honoured to welcome the members of the care home relatives Scotland group who join us in the public gallery today. Among them are relatives of Anne Duke, who Anne’s law is named after. I have been profoundly impacted by the conversations that I have had with the group. The emotional harm and trauma that they and their loved ones and many others suffered as a result of being unable to see one another for such long and isolating periods during the pandemic must be acknowledged. To ensure that that never happens again, Anne’s law will recognise family and friends as essential care supporters and as key members of their loved ones’ care team, not just visitors.
All this started when Anne’s daughter, Natasha Hamilton, lodged a petition with the Scottish Parliament in November 2020 calling for care home residents to be allowed a designated visitor. Her tenacity and unwavering commitment mean that Anne’s law will become law today. Further, the bill now ensures greater oversight on visiting decisions. People will be able to request reviews of those decisions, which will ensure that the voices and needs of those living in care homes are truly heard. I thank the members of the care home relatives Scotland group for their constructive engagement over many years, which has led us to this point.
This week is carers week, and this year’s theme is “caring about equality”. Too many unpaid carers miss out on opportunities in life, and the bill will ensure that unpaid carers have a right to breaks, which will support them to have a life alongside caring. To support that, we have added £5 million to our voluntary sector short breaks fund for 2025-2026, bringing it up to £13 million, so that more carers can take the time off that they deserve. A new national chief social work adviser will champion social work across our health and care systems and provide professional leadership nationally. They will be supported by the national social work agency, which will spearhead the effort to promote the social work profession, strengthen collaboration and improve education and professional development.
The bill includes changes that will improve access to independent advocacy. The Scottish Independent Advocacy Alliance has told us that the best way forward is to incrementally increase funding year on year to ensure that services remain high quality and sustainable. I am really pleased to be able to announce an extra £500,000 in funding for 2026-27 to increase the provision of independent advocacy services and guarantee that people are heard and involved in decisions about their care.
Ethical procurement plays a significant role in the quality of care services, which is why the bill gives stakeholders more flexibility when buying services. It also introduces another procurement route for the third sector, which makes it easier to compete for contracts. The bill will empower people to access information, when they need it, about their own needs and care. It also helps professionals by improving the flow of information across care settings and ensuring the compatibility of systems, which will remove digital barriers so that people can focus on what matters.
The bill is only one element of our wider and ambitious programme of social care reform. Last month, the national care service advisory board met for the first time. It will provide independent oversight through a diverse range of voices, from unpaid carers and those who access care to care providers and national health service and local authority leaders, which will ensure that every perspective is heard. The board will help drive improvement and ensure that services are consistent, fair and high quality, no matter where people live in Scotland.
The advisory board will work alongside established national programmes such as: getting it right for everyone, which promotes and enables person-led support right across Scotland; self-directed support, which plays a crucial role by giving people more choice and control over the care that they receive, which is why we have invested £22 million in our SDS improvement plan; our commitment to fair work and fair pay for all care workers in Scotland, which includes increasing pay for social workers; and our targeted programme to reduce delayed discharge.
As I laid out in January, our new approach to the NCS means that local authorities and health boards will retain their existing statutory responsibilities. I look forward to working with the Convention of Scottish Local Authorities and the NHS to drive forward the improvements that the advisory board suggests. Each of the national programmes has improved social care services across Scotland and will be vital pillars in the national care service. They represent what thousands of people with lived experience have told us is needed. However, we need to pass the legislation to fully realise our shared goal of improving social care, social work and community health for the people of Scotland.
I move,
That the Parliament agrees that the Care Reform (Scotland) Bill be passed.
18:09
I declare an interest as a practising NHS general practitioner.
The Scottish Conservatives will support the Care Reform (Scotland) Bill, which we are here to debate, but let us not pretend that we have arrived at this moment by design. We are here because of yet another Scottish National Party policy that promised the world and delivered a fiasco. The now defunct National Care Service (Scotland) Bill was once hailed as the most significant reform to health and social care since the creation of the NHS. In reality, it was a half-baked plan that was dreamt up by ministers in an ivory tower and clearly dead in the water before the ink had dried on the first draft.
What has been the price? Nearly £30 million has been spent on a policy that nobody wanted—not the unions, not COSLA and not care professionals.
The care service is not the only SNP debacle in the Parliament. When responding to Brian Whittle, the minister said that we can ask the Scottish Government questions about spending any time. Okay—£200 million has been spent on ferries that are still not finished; £180 million was spent on a deposit return scheme that was scrapped before it was launched; more than £600,000 was spent on failed Supreme Court adventures, from defining a woman to indyref2; and £140 million was spent on a Scotland-only census that flopped. Get out that abacus. Approaching £1 billion of public money has been torched in this parliamentary session alone on vanity projects that never delivered, all paid for by the Scottish taxpayer—and for what? There are big promises and bigger budgets, but zilch delivery.
The SNP now presents the Care Reform (Scotland) Bill—a more modest and workable approach that includes Anne’s law, which guarantees care home residents the right to see loved ones. We support the bill due to Anne’s law. In fact, we would have supported it years ago without the eye-watering price tag of the national care service experiment.
SNP ministers love bold commitments. They rail against Westminster one day but send their constituents the invoice the next. Their convictions are as reliable as the CalMac ferry timetable. Their principles are stirring in speeches but missing in action.
At least the new bill is stripped back and serious about protecting the rights of residents and empowering carers. There is no grandstanding or runaway spending, just practical reform—finally.
However, let us not forget how we got here. The Parliament has been a hall of shame for SNP governance—a flagship bill in ruins, two ferries that are still incomplete, a bungled census and legal stunts that never stood a chance. There has been £1 billion of broken promises and missed targets, with public services left in a worse state than before. Think about what that money could have done for classrooms, GP surgeries or community care.
We support the bill and we back Anne’s law, which should have been on the statute book a very long time ago, but let this be the last car crash in SNP policy making—enough with headlines, enough with hubris and enough with the costs. Scotland does not need another slick soundbite. It needs serious leadership with a plan, a purpose and a price tag that does not leave the public short-changed. The SNP loves to talk about conviction, but, when it comes to commitments, it costs the country a fortune and too often leaves our people stranded. It is time to stop paying premiums for pipe dreams. Scotland deserves better.
18:13
A decade and a half ago, I stood here and outlined Scottish Labour’s vision for a national care service—not a quango or more civil servants but a co-ordinated national approach to provide locally delivered care, raise standards and end the postcode lottery. How we care for our most vulnerable people is more important than party politics, which is why Scottish Labour committed to help the Scottish Government to deliver such a service. However, I warned at the time that the devil would be in the detail.
In 2021, Derek Feeley published his review of social care. Having listened to people with lived experience of social care, those delivering social care and front-line workers, the review provided a blueprint for a national care service that we all supported. The SNP promised to implement the Feeley recommendations, but, instead of steering safely into harbour, it headed straight for the rocks. The Feeley review highlighted the importance of national accountability while allowing for local delivery. Instead, the SNP attempted a power grab by centralising control. It is therefore no surprise that COSLA walked away, warning that the bill could lead to significant destabilisation of services.
Four years later, three First Ministers later, three health secretaries later and £31 million later, we have before us a drastically reduced bill with no national care service in sight, and not a single extra penny of that money has gone directly into social care.
That, of course, is the elephant in the room: the lack of funding for the social care sector. Unless social care has true parity of esteem with the NHS, the SNP will continue to underfund services. Just look at John Swinney’s raids on integration joint boards’ budgets, which have left them on a financial precipice. Just this March, Audit Scotland warned that there will be a?projected funding gap of £560 million next year. As for the reality on the ground, while the SNP spent four years tinkering with its failed bill, there have been social care transport cuts in Aberdeenshire, supported living services put at risk in Glasgow, cuts to learning disability services in Edinburgh and the closure of the work connect project for people with learning disabilities in West Dunbartonshire.
The Feeley review outlined the importance of paying social care staff properly—something that Scottish Labour has been calling for over the past four years in budget after budget, to which the SNP has kept saying no. Fair work is a principle that we all support but, when it comes to taking action, the SNP is last in the queue. In fact, at the stroke of a pen, it has cut £38 million that was earmarked to improve the terms and conditions of social care workers. Just think what could have been done with that money, or indeed the £31 million that has been spent on the bill: that would be the equivalent of 1 million hours of social care. Right now, nearly 10,000 Scots are waiting on a?social?care?assessment or?a care-at-home package, yet the bill does not pay for a single extra carer.
The Feeley review based its recommendations on testimony from people with experience of social care. Rather than implementing those recommendations, however, the SNP Government set up more conversations with those with lived experience. I do not demur from that, but people have consultation fatigue; what they want is action.
As Lorraine, a parent of a young man with special needs, told me:
“The Feeley Report was really good and well received by carers. However, having spent many millions on this, the government have chosen to ignore what would have been a huge starting point.”
She ends by saying:
“We need ACTION!”
It is in that spirit of action that Scottish Labour has worked with the Government to salvage what is possible from the bill, and I commend the minister and her officials for working with us on a series of amendments: on Anne’s law, so that those in care know that they will always have the right to see a loved one—righting the wrongs done to them during the pandemic; on breaks for unpaid carers; on better sharing of information between health and social care; and on fair work, with better procurement and more besides.
Taken together, those measures will improve the social care system. Let us be clear, however: it is a job half done.
18:17
First and foremost, I pay tribute to the carers and care workers who have consistently looked to the Parliament to legislate for a fairer and much more compassionate social care system. Many of them have joined us here throughout the afternoon. I know that Anne’s family are here, too.
I also wish to thank the many third sector organisations—those that gave evidence throughout the different stages of the bill and everyone who has engaged with, shaped and challenged the bill. Their contribution has been invaluable.
I acknowledge my colleague Gillian Mackay, who worked tirelessly throughout the process. Her engagement and her amendments at stage 2, which were developed in close partnership with carers and supporting organisations, have been instrumental. I am proud to have lodged amendments that build on her work, particularly around strengthening independent advocacy. I also thank the Minister for Social Care, Mental Wellbeing and Sport for her constructive engagement with Gillian and, latterly, with me.
There is no hiding the fact that the bill has been enormously challenging, however. The intention and ambition behind the original bill deserve recognition. The National Care Service (Scotland) Bill aimed to build on years of efforts to better integrate health and social care. Going back to my time as a councillor, I remember how hard it was, in the early days, to bring that provision together on the ground.
Reform of this scale requires openness and collaboration, particularly when we are trying to fix issues that many people across the sector have been raising for years: unclear leadership, poor information sharing, fragmented funding streams, a postcode lottery for care and an overcomplicated landscape. Those cracks, which were already present, were deepened by the pandemic. We know how wide the gap can be between good policy ideas and real improvements on the ground that people feel.
Health and care reform has always been tough, and this bill is no exception. Integration, although necessary, remains deeply complex. My hope is that the Government reflects carefully on the missteps in this process. It is not time to retreat from that ambition but to learn how to do better next time. It is obviously important to involve people sooner, build consensus earlier and maintain focus on the people who the reforms are meant to serve.
As we get into the stage 3 debate, it is important to be honest. We wish that the bill had delivered more—more for those who rely on social care, for paid and unpaid carers and for the workforce. The need for improvement has not gone away; it remains urgent, and care reform must not be shelved.
It is clear that this is a long-term goal that must now be achieved incrementally. The bill has moved a long way from where it started. It is not perfect and key issues remain up for debate. However, we have arrived at a place today that reflects a more consensual approach from the sector, carers and parliamentarians across the chamber.
For many, the bill will feel like cautious progress, but it is progress nonetheless. It delivers some important changes—Anne’s law, centrally. That is huge progress. Strengthened independent advocacy, new rights for unpaid carers and steps towards fairer procurement are welcome and necessary.
I call on the Scottish Government to continue the work to implement the recommendations of the Feeley review, but it must do so while learning from its mistakes, engaging earlier and building wider consensus. Greater compromise will be essential, especially with local government and third sector partners in the unions. The complexity of care reform should never be a reason to give up, but it should be a real reason to lead.
18:21
In my first days as leader of the Scottish Liberal Democrats, I was visited by John-Paul Marks, who at the time was permanent secretary of the Scottish civil service. He explained to me the very parlous funding outlook for the Scottish Government and that pretty much all budgets across all directorates would be contracting, save one, which was the increase in spending that was allocated to deliver the SNP’s flagship, election-winning promise of delivering a national care service. That was a promise that we had opposed from the outset, but, nevertheless, the SNP had won the election, and I understood why he was apportioning that extra money. What a waste.
This week is national carers week, yet here we are, marking it with a piece of legislation that falls far short of what Scotland’s carers and those who they care for truly deserve. The bill is not what it says on the tin, either—there is nothing about it that delivers needed and demonstrable reform. We might have very different visions of what reform the care sector needs, but this is none of them.
Care workers are overstretched and undervalued. People who need care are waiting too long or going without altogether, and family carers, unpaid and unseen, are burning out because the system is simply not coping. That crisis demands attention, urgency and leadership, with real reform. Instead, what we have had from SNP ministers is confusion, waste, retreat and attempts at centralisation.
Let us not forget that the bill began life as a national care service bill—a bureaucratic power grab to hoard control of social care in Edinburgh, rather than empowering those closest to the people who need it. The Scottish Liberal Democrats were the only party to oppose that flawed idea from the very first. We did so—and we did more than just oppose it—in budget negotiations this year. We took action to ensure that it was excised from the pages of this legislation, finally. We made it clear that we would not support any budget that contained a single penny on national care service spending, and we won, but, sadly, not before the SNP had squandered £30 million of the money—earmarked and identified to me by JP Marks all those years ago—that could have paid the salaries of 1,200 care workers for an entire year. In those budget negotiations, we secured millions more for front-line social care and fashioned new training pipelines for care workers through Scotland’s colleges.
The Scottish Liberal Democrats have a proud record in this area. We introduced free personal care for the elderly, we enshrined the right to carers’ leave in employment law and we have just secured a change to let family carers earn more without losing the support that they depend on.
My colleague at Westminster Sir Ed Davey has made care a cornerstone of our manifesto and has spoken bravely about his experiences as a carer. I am sure that many members will be familiar with his story. We also want to see a United Kingdom-wide care wage that is at least £2 above the minimum wage and removal of the national insurance hike on care providers. That is the vision for care that the sector and Scotland need. It is what carers deserve, and it is what my party—the Scottish Liberal Democrats—will keep fighting for.
My party is prepared to support the bill that is before us, but let me be clear that it does not represent the transformational change of our care sector that we need to abate the crisis. We will support it because of the positive changes that it will make in recognising carers’ rights to breaks, strengthening advocacy and ensuring that loved ones can stay connected to people and homes through Anne’s law. I pay my personal tribute to Anne’s family, who are with us today. The bill will also improve information sharing and it offers better procurement routes for the third sector. Those are useful steps, but they are no substitute for the real reform that the sector desperately needs.
We are also glad that, finally, the bill no longer contains the most damaging parts of the original plan, which would have centralised decision making away from the communities that understand how best to deliver care, particularly in remote and rural communities, and instead placed it in the hands of ministers. However, we must not let the bill pass without a reckoning. The SNP Government should apologise to care users, to care providers and to Scotland’s incredible care workforce.
We move to the open debate.
18:26
I put on the record my entry in the register of members’ interests. I am employed as a bank nurse by NHS Greater Glasgow and Clyde.
Earlier this year, I underlined my commitment as convener of the Health, Social Care and Sport Committee to ensuring that substantial further scrutiny of the Care Reform (Scotland) Bill would take place. I express my thanks to all those who contributed to that process and to all the stakeholders, members of the public and MSPs who shared their views.
We know that the social care system in Scotland needs to change. Partners across the public sector, including across local government and our national health service, agree. We have also heard repeatedly from people with lived experience that the current adult social care system must change to drive up standards in a consistent manner and ensure that there is access to high-quality social care across Scotland whenever it is needed.
The status quo is not an option. Change must be sustainable, our social care workforce must be allowed to flourish, and the sector must be future proofed. The Scottish Government has a long-standing commitment to the principles of fair work for the social care sector that is underlined by a total investment of £950 million to improve pay. That commitment sits alongside a clear focus on both local and national workforce planning, leadership and learning and development support for the sector. Irrespective of the bill, the Scottish Government has been committed to taking immediate action to improve outcomes for people who access care and support.
Throughout the bill’s progress, the Government was committed to listening and engaging, and it revisited its approach to further engage with people who have lived experience, COSLA and the NHS, among others. The new non-statutory advisory board is allowing vital reform to be driven forward at pace, bringing key partners together. We are already seeing progress across Scotland in reducing delayed discharges thanks to a focus on supporting the local areas that are experiencing the most challenges.
The changes that are before us today will improve the lives of those who have been calling for reform. People have told us about their frustration and trauma when they have had to share their stories repeatedly. That is why a key component of the bill is enhanced information sharing to improve co-ordination, ensure consistent information standards and lay the foundations for integrated digital approaches that will make it easier for people to access and manage information about their care.
The bill recognises the incredible contribution that is made by unpaid carers in our communities. It introduces a right to breaks to support people to protect their wellbeing and sustain caring relationships. This year’s budget provides £13 million for voluntary sector short breaks, which represents an uplift of £5 million, and a working group has been established to bring together carers and third and statutory sector representatives to make sure that their voices are central to on-going discussions on the matter.
The implementation of Anne’s law will give adult care home residents a legal right to see their loved ones, formally recognising the role of their family and friends in providing care, support and companionship. It is a formal recognition that family and friends are not simply visitors; they are an integral and essential part of the care team for their loved ones. The core elements of Anne’s law are already in place through guidance and strengthened health and social care standards on visiting for care homes, but the Government is committed to enshrining that in legislation.
Ultimately, all of us in the Parliament share a common goal. We all want everyone to have access to consistently high-quality social care support across Scotland, whenever and wherever they might need it, and we want our social care workforce to flourish. That goal is also shared by the social care sector, the public, families, their loved ones and, most importantly, those whose lives and wellbeing depend on us getting this right. So, let us get on with it.
18:30
The saga of what we are now calling the Care Reform (Scotland) Bill is a microcosm of this SNP Government. It started with a vainglorious press release and the applause line for the leader’s speech—light on detail, certainly, and quickly unable to marshal any detail at all. Absent leadership and political incompetence led to financial chaos, all resulting in messy, watered-down law that will achieve none of the lofty ambitions that were declared at the outset. The Government then moves on and hopes that nobody will notice—rinse and repeat, year after year.
This legislation will not lead to a single extra carer being employed. It will do absolutely nothing to ease delayed discharge, and there is nothing in it to fix the crisis in social care in Scotland, despite the expenditure of tens of millions of pounds of taxpayers’ money and untold public resources being applied. From start to finish, the bill has been a total calamity.
A succession of ministers have been unable to answer basic questions about the legislation that they were meant to be steering. On 8 November 2022, the then minister responsible for the bill, Kevin Stewart, was aghast at COSLA’s estimate that the bill would cost more than £1.5 billion. He defiantly stated to the Finance and Public Administration Committee that
“COSLA has made assumptions that we do not recognise”.—[Official Report, Finance and Public Administration Committee, 8 November 2022; c 18.]
Lo and behold, on 23 January 2024, a little over a year later, Scottish Government officials told the Parliament’s Finance and Public Administration Committee that the cost of the bill that Mr Stewart was talking about would have been £3.9 billion—a truly astronomical figure, which is more than double the figure that the minister did not recognise and equal to the entire annual transport budget. Critically, there is absolutely no way that the country could have afforded that. Of course, by that point, the legislation had rightly and mercifully been blown entirely off the SNP’s course towards bankruptcy. One of the principal reasons for that was that the Parliament’s finance committee had rejected the financial memorandum as utterly incoherent and entirely incompetent.
Just a fortnight ago, minister Maree Todd and her officials returned to the finance committee with updated financial information on the unrecognisable legislation that we are debating today—or, rather, the minister came with some of the information. The public are left cross-referencing the most recent document with the original financial memorandum from 2022 and the updated version from 2023, which are three large financial documents with different timescales. Some sections measure costs across five years, some across seven years and some across 10 years. That is comparing apples not just with oranges, but with broccoli and spuds as well. At the last moment, the committee received an update, but there was an error in the updated financial information that had been received—utterly shambolic.
Deciphering the true cost of the bill has been compared with assembling a jigsaw in the dark, which, frankly, is an unfair comparison. In this case, we are perhaps assembling five different jigsaws. The pieces are all different sizes and the people who made them are not even sure that they gave us all the pieces in the first place. From start to finish, there has been a total lack of transparency and myriad documents that are littered with errors, making it absolutely clear that neither civil servants nor—particularly—ministers had the first clue what they were doing.
That chaos, incompetence and direct negligence has come to typify every significant piece of legislation that has passed through the Parliament in this session: the National Care Service (Scotland) Bill, the Circular Economy (Scotland) Bill, the Children (Care and Justice) (Scotland) Bill and the Police (Ethics, Conduct and Scrutiny) (Scotland) Bill. It is no wonder that Scotland’s budget is in such a mess and the SNP’s legislative agenda for this session is in tatters.
Ultimately, the legislation that will pass this evening will result in some very modest gains that have been wrung out of the process by stakeholders—and I am glad that some of those stakeholders are with us tonight. Scottish Labour amendments have strengthened Anne’s law, which will give care home residents the right to visits, and the right to breaks for carers. However, that did not need a process this long and at such expense to the Scottish taxpayer.
The bill will not deliver the lasting and positive legacy of fit-for-the-future, high-quality care that Nicola Sturgeon promised back in 2020. With her anti-Midas touch, this landmark legislation has turned to mud. Next year, Scots can call time on the incompetence, chaos and failure of the SNP by joining the people of Hamilton, Larkhall and Stonehouse in electing a Scottish Labour Government that will set a new direction for Scotland and get our health and social care system back on its feet.
18:35
As we conclude the final stage of the bill, what matters most is what happens next: how the legislation is implemented, how it delivers for the people it is meant to serve and how we respond to the many challenges that remain.
For all its difficulties, the bill has laid the groundwork for progress. It is not the transformation that many had hoped for, but it is a step towards a more equitable and consistent care system in Scotland. It will introduce important changes that will make a real difference to people’s lives, and I do not want to lose sight of that. Many members have spoken movingly about Anne’s law, and I pay tribute to her family. In addition, I think back to the confusion and desperation of our constituents during the Covid crisis.
We have made really important progress today. The improved rights for unpaid carers and the strengthening of independent advocacy are not small things and they should not be overlooked. They are important changes that this Parliament has made. They are the product of advocacy, campaigning and hard work across the sector, in the Parliament and beyond, and we must recognise those wins.
However, our job is not to rest on our laurels. We must not stop here; we must continue and deliver progress. The cracks in our social care system remain, and they have been made deeper by the years of underinvestment. We still face the same core issues: workforce pressures, fragmented structures, unclear lines of accountability and a system that too often leaves people navigating complexity when they are at their most vulnerable.
The ambition to bring more of the care sector into public hands should not be dropped. It should be pursued strategically and incrementally, recognising the financial and logistical challenges while staying true to the long-term goal. I hope that the Parliament can agree to that and that the Labour Party will not drop it but will work towards a more publicly delivered care service. Public care should continue to be seen as a necessary investment in the dignity and wellbeing of our communities.
If the Parliament is serious about the issue, we must treat the bill as the first step and as a foundation. That means committing to on-going dialogue with local authorities, the workforce and people who receive care. It means funding the changes that we legislate for, being honest when things do not go to plan and being open to doing things differently.
I acknowledge the constructive spirit in which the Opposition and the Government have worked together between stages 2 and 3, which has undoubtedly made the bill stronger.
The complexity of care reform is not an excuse to walk away from it; it is the very reason why we must rise to the challenge. We cannot lose sight of the people who are at the heart of the reforms, because they are counting on us—and will continue to count on us—to get this right.
18:38
When I joined the Parliament, back in 2021, there was genuine enthusiasm, following the Feeley review, about the prospect of a national care service. Only four years later, that enthusiasm has been depleted and we have a much-reduced bill. What was once heralded by the Government as the “biggest public sector reform” of a generation is now a limited number of stage 3 amendments.
The bill does not address the fundamental problems in social care, and the Government seems to be unable to tell us how it will address those issues. That is a great shame. It was our duty to build enthusiasm and support for what could have been such far-reaching legislation. As we have heard, it is a missed opportunity to be transformative, which is due largely to Government inability and lack of vision. Although it is not the legislation that I or many wanted, what is important now is that we make it as robust as possible and take on board the concerns that many of my colleagues, the trade unions and professional organisations have raised throughout the bill process.
I say a big thank you to all our constituents—people such as the care home relatives Scotland group and many more—who have truly influenced the bill and worked with us. They have contacted us, and it is our responsibility to ensure that the legislation progresses.
Scottish Labour’s vision was for a bill that really addressed the long-term needs of social care, putting it on a footing with our NHS and creating a system fit for the future, for staff and users. Throughout the stages of the bill, we have sought to ensure that the legislation will address commissioning and fair work, which is essential to ensuring improvement in social care. We brought both of those issues back at stage 3, and we are pleased that our amendments have been successful. We would have wished for much more, but it was clear by stage 3 that the Government had no ability or vision to deliver that. We want to see Anne’s law, carers’ right to breaks, improved commissioning and digital care records in place as quickly as possible, which is why we will, of course, support the bill this evening.
However, there is much work to be done. I have to trust that the bill will achieve what the minister believes it will and that it will fulfil its potential to create change, because the care sector in Scotland can no longer wait for serious reform: it needs action now. We heard from my colleague Jackie Baillie that 10,000 Scots are waiting for care assessments or for care, and Michael Marra reminded us about the Government’s financial incompetence. Our constituents need delivery, because they are the ones who will suffer in the long run.
Scottish Labour will work with the Government to build on any potential and, as I have said, will support the bill this evening, but make no mistake: Scottish Labour in power will deliver a national care service that is worthy of the name, and that is what we look forward to.
18:41
We often say that it is a privilege to do the job that we do. Even after almost 10 years of walking into this place, I am still a bit in awe of working here, and I remind myself every day of why I came here. I imagine that it is similar for most of us here, because we have a passion for our country and want to have the privilege of making a difference for the people we serve. There are many good people in this chamber, some of whom I agree with and some of whom I do not agree with. All elected members, of whatever persuasion, have my respect for sticking their heads above the parapet. Nonetheless, I believe that there are some who have allowed their political objectives to overtake the fundamentals of what we are meant to be doing here.
When we make laws, our overriding objective should be to make the very best law possible for our constituents and for the country, but this bill is a prime example of how not to do that. A bill that began as the National Care Service (Scotland) Bill has been hollowed out after years, and the Scottish Government has wasted millions of pounds on a fundamentally flawed plan. The husk of that bill has been reshaped as the Care Reform (Scotland) Bill, a grab bag of random policies that have been sitting in the Scottish Government’s social care filing cabinet, gathering dust. Of course, the bill does contain policies that we support. Anne’s law is long overdue, as is unpaid carers having the right to breaks, but there are serious questions about why the SNP has waited until now to deliver on pledges that have been so desperately needed for so long.
Scotland’s social care system desperately needs reform—we all agree on that—but this bill is not going to deliver the level of reform that is needed to secure the future of social care in Scotland. A more accurate title for the bill would be the “Care Reform (Tinkering Around the Edges) (Scotland) Bill”. Far too many of its proposals fall into the category of, “We must do something about social care and I’ve found something, so let’s do that.” There does not seem to be a clear aim in mind. Many of the initial proposals were vague to the point of abstraction, and, as I have said, there does not appear to be any overriding objective for the changes.
We will support the bill today, not because we believe that it is the best solution available, and not even because we believe that all of its aspects will deliver progress, but because, within this disaster-strewn bill, there are a few ideas—including the carers’ right to breaks and Anne’s law—that have the potential to deliver meaningful change. The issue of digital patient records was also raised, although the minister and the Government do not seem to understand the phrase “agnostic technical interoperability” and therefore voted against that amendment.
Much still depends on the Scottish Government following through effectively on its commitments. As members know, I am one of life’s great optimists, but the minister called me cynical for daring to suggest that we measure the outcomes of the bill and that we should know the outline cost of it. The reality is, I believe, that most members are engaged in developing and amending the bill in an honest way to deliver the very best for Anne’s law and for carer respite. I find it quite disrespectful and disingenuous, therefore, to suggest that I was cynically trying to delay the implementation of the bill and the introduction of Anne’s law and provisions for carer respite. The cynicism lies at the feet of the minister and the Scottish Government. The Government has cynically—once again—delivered a bill whose outcomes and the cost of which it does not want to be measured against. To be frank, I think that it is cynical of the minister to make everyone wait for the legislation instead of bringing forward items via regulations. That is politics at its worst.
Social care is in crisis. Four years and £31 million later, the SNP is desperately trying to claim a victory. The members of the Scottish Government have forgotten why they are here. This place is not about trying to save political face; it is about delivering the very best for Scotland. Once again, the Scottish Government has fallen very far short of what could and should have been achieved.
I call the minister, Maree Todd, to wind up the debate.
18:45
In 2021, following publication of the Feeley review, the Government made a clear commitment to reform Scotland’s social care system. Over the past four years, my predecessors and I have spoken to hundreds of people who use care services, to their families and to those who deliver care, and each of those conversations has left a profound and lasting impression. Today, we have an opportunity to reflect those voices in our decisions by passing legislation that will make a real and lasting difference.
The Conservatives and the Lib Dems—as we have heard today—have always opposed the creation of a national care service. From the very beginning, they were against it. The Labour Party claims to support a national care service—in fact, it was apparently Jackie Baillie’s idea, long before Feeley—but there has never been clarity on what that would look like.
Every member in the chamber knows that the status quo is not an option and that social care must improve. The Government is unwavering in our commitment to create a national care service that meets the needs of the people of Scotland.
I agree with Mark Ruskell that now is not the time to dampen our ambition. As I laid out in my opening speech, we will drive enhanced oversight and support of the care system, through the national care service advisory board, to provide a level of independent oversight that has been missing for too long. However, in order to unlock the full potential of the national care service, we must pass the vital changes that the Care Reform (Scotland) Bill will bring.
Will the minister give way on that point?
I would really like to make some progress—we have all had a chance to have our say.
The bill introduces Anne’s law, which will make a groundbreaking change by ensuring that the family and friends of people in care homes are seen not simply as visitors but as an essential part of the care team. The bill contains a legal presumption that suspending visiting is likely to cause serious harm to their loved one’s health and wellbeing.
The bill also contains a new right to breaks for unpaid carers to protect their health and wellbeing by giving them the rest that they need. There is expanded access to independent advocacy for our most vulnerable citizens to ensure that their voices are heard in decisions about their care. We are improving the flow of information across care settings so that people do not have to share their stories multiple times.
The bill also establishes a national chief social work adviser role to provide professional leadership and champion the sector. They will lead a new national social work agency, which will advance and advocate for the profession, and there will be new powers to improve social care procurement, including a new route for the third sector.
We know that we must improve the system for lasting progress to be made across Scotland, and in order to do that, it is vital that our hard-working and dedicated workforce feel engaged, supported and valued for their important work.
We are working hard to introduce voluntary sectoral bargaining for the care sector through the fair work in social care group. We continue to drive that work forward while we wait for the UK Government legislation to extend devolved powers. In the meantime, we are supporting the sector with funding to deliver the real living wage—I think that the bill for that is £950 million this year—so that care workers are paid what they deserve.
Despite an incredibly challenging financial situation, the Scottish Government has prioritised investment in social care, including almost £2.2 billion in social care and integration, exceeding our commitment to increase funding by 25 per cent over this session of Parliament by more than £350 million. There is more than £88 million a year in local carer support through funding to councils under the Carers (Scotland) Act 2016, £13 million a year for voluntary sector short breaks, a further £13.4 million to support growth in the independent living fund and £5.9 million of additional investment in the Care Inspectorate.
Despite our increased investment, we know that the social care sector is dealing with heavy and entirely avoidable financial pressure, thanks to the Labour UK Government’s decision to increase employer national insurance contributions and to lower the threshold at which employers start to pay them. That short-sighted and reckless decision is estimated to cost the adult social care sector more than £84 million in Scotland alone.
I have heard loudly and clearly from the sector that the UK Government must fully fund the cost of the national insurance hike to alleviate the pressure that the sector is under. I echo those calls, and the Scottish Government will continue to apply pressure.
I have listened to the debate in the chamber today, and I understand the strong feelings that many members hold. We have worked tirelessly to balance the concerns that were raised in Parliament with the urgent needs of the people in Scotland. This legislation reflects our shared commitment to strengthening social care, social work and community health. People who access social care, their families and everyone who supports them cannot wait any longer for the changes that they urgently need.
That shared commitment is no better embodied than by Anne’s law. For almost two years, at the end of her life, Anne Duke was denied the companionship and the touch of the people whom she loved. As her husband Campbell wrote,
“At your time of greatest need, they robbed you of the one thing you needed most—the unconditional love of your family and friends.”
This bill will make sure that no one else will ever again suffer the trauma and harm that were experienced by Anne, by her loved ones and by so many families across the country during lockdown. I urge members to support the bill.
That concludes the debate on the Care Reform (Scotland) Bill at stage 3.
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Care Reform (Scotland) Bill: Stage 3