Regulation of Care (Scotland) Bill: Stage 3
We now come to motion S1M-1965, in the name of Susan Deacon, which seeks agreement that the Regulation of Care (Scotland) Bill be passed.
I am very pleased to be speaking today at the final stage of the Regulation of Care (Scotland) Bill. The past five months in Parliament have been the culmination of work that has been under way since devolution. The bill will be a major achievement of our Scottish Parliament. It will deliver a better experience of care services for thousands of Scottish people every day. The new system of care regulation will help us move to better services—services that people deserve.
Debate has often focused on care homes but we should not forget that the framework introduced by the bill will cover a wide range of services, including home care, independent health care and housing support services together with a range of services for children, including childminders and pre-school education. Those crucial services impact on every community and every family throughout the land. Regulation of the work force will give people using care services more confidence in those delivering them. Importantly, the bill will do much to raise the status of often undervalued workers in the care sector.
As Malcolm Chisholm indicated this morning on a number of occasions, the bill, significant though it is, cannot and should not be seen in isolation. It links to many other crucial and on-going Executive initiatives such as the care development group's work on long-time care; work to promote the status and to recognise the needs of older people and people with disabilities; and work to promote the availability of better child care. That said, the bill represents a further significant building-block in the range of work that we have undertaken since the Parliament's inception to improve care and care services for the people of Scotland.
I want to take this opportunity to pay tribute to all those who have been involved in the development of the bill over many months. In particular, I thank the Health and Community Care Committee for its contribution. Stage 1 involved a considerable evidence-gathering exercise, and stage 2 led to thoughtful amendments and a very productive debate. I again pay tribute to members of the Health and Community Care Committee for their contributions to this morning's debate. The whole Parliament's deep concern about and interest in this area have been seen. I believe that we have a better bill as a result of the committee sessions and the parliamentary debate. Many of the amendments discussed this morning are a testimony to the efficacy of our parliamentary process.
The bill is also better because of the consultation process. I welcomed positive comments on that aspect during the stage 1 debate, and the process has continued. I want to thank the many hundreds of individuals and organisations that have contributed, particularly those involved in our reference group and everyone involved with the national care standards committee. I know that Malcolm Chisholm found it extremely helpful to have consultation meetings in March and April with the main stakeholders—users and carers, staff representatives, the voluntary sector, the private sector, local authorities and health boards, and educational interests. That process of discussion and involvement is the right one to allow us to make progress in this area, and is how we will continue to work as we proceed.
As a result of discussions in the lead-up to today's debate and in the debate itself, the bill includes general principles that put the user of care services firmly at the centre. The regulatory framework covers child care agencies, including those that supply nannies and sitters. We have agreed that there should be at least two inspections of residential services a year, at least one of which should be unannounced. Furthermore, we have provided for an integrated inspection regime with Her Majesty's inspectors of schools, and have strengthened the consultation provisions.
We had two very good debates on finance. On the issue of fees, I repeat Malcolm Chisholm's assurances that we will consider all the relevant factors and views before deciding the level that should be set for each care service. Although we want the commission to be self-financing, we do not want that to cut across objectives in other areas, including the need for a flourishing care home sector.
This morning we also had a very lively debate on commissioning. We are all agreed that the present way in which local authorities set fees for the services they purchase from the private and voluntary sector is not always as fair or as transparent as it might be. There are real issues to be resolved and, as Malcolm Chisholm made clear, both ministers and the Convention of Scottish Local Authorities are aware of the urgent need to address them. However, the bill is not the way to do that; the process that we have set up with COSLA and providers is, as it is aimed at addressing the immediate difficulties and finding a longer-term and sustainable solution. Furthermore, the work of the care development group, the implementation of the joint future group's recommendations and our wider programme of work on the development of community care will enable us to stay on the road of continuous improvement in community care and the development and delivery of care services.
We will continue to face challenges. Our next challenge will be preparing for the start of the operations of the Scottish social services council in October and the Scottish commission for the regulation of care in April 2002. I am sure that Parliament will follow with interest the work of those bodies and will look forward to seeing their first annual reports.
This bill is a major step forward in making life better for the thousands of people who use care services in Scotland every day. Although much remains to be done, the bill is a significant milestone in developing the kind of care system of which we can all be proud and in which we can all have confidence.
I move,
That the Parliament agrees that the Regulation of Care (Scotland) Bill be passed.
I feel a little sorry for the Deputy Minister for Health and Community Care, who has done all the hard work through the bill process, only to have to stand aside at the last minute so that the Minister for Health and Community Care can take all the glory. That is a shame. However, I pay tribute to Malcolm Chisholm for the work that he has put into this bill. I also pay tribute to the clerks of the Health and Community Care Committee, to my fellow members of the committee and to all those who gave evidence during the bill process.
On behalf of the SNP, I welcome the imminent passing of the Regulation of Care (Scotland) Bill. The bill will result in major improvements in our care system, through the constant and effective regulation of care and the people providing it. For too long we have read and heard about appalling cases in which the care system has failed to provide a proper standard of care—a standard that we would expect for our relatives and for ourselves.
The vast majority of people working in the care system do a marvellous job. Through an effective system of regulating the work force, which this bill will provide, we can ensure that the 500,000 service users in Scotland receive a high-quality service. The public needs to have confidence in the care system. When standards are not met, people need to feel able to bring that to the attention of the Scottish social services council or the Scottish commission for the regulation of care, so that action can be taken to rectify the situation.
The bill has been strengthened by the many amendments that have been passed at stages 2 and 3, in particular the recognition of the requirement for two inspections of care homes and the inclusion of fostering and adoption services in the bill. The focus on extending consultation and information provision for users and carers is also to be welcomed.
My main regret is that the Executive did not listen to the care providers and interest groups when they raised concerns about fees and the impact that they will have on service provision. At this point, all we can say is that time will tell who was right on that issue. I was also concerned by the removal from the bill earlier today of the important safeguard for voluntary organisations. I believe that that will cause the voluntary sector immense problems. Again, time will tell.
On a happier note, the bill provides us with an opportunity to improve the delivery and monitoring of care for some of the most vulnerable people in our society. We all support that aim. The Health and Community Care Committee invested much time and energy in hearing a great deal of evidence, so that the bill could be improved. There has been much agreement across the parties on the content of the bill, and it is all the better for that.
I am proud to have been associated with helping to improve the care system in Scotland through the passing of this bill. I look forward to the real changes and benefits that it will bring to the people of Scotland.
Like my colleagues, I would like to thank the clerks to the Health and Community Care Committee, along with the other members of the committee.
There is no doubt that this bill will raise standards of care. It will ensure consistent standards of care and will help to bring dignity and respect to people dependent on care. The progress of the bill at stage 2 was an example of committee working at its best. It was enhanced by the minister's willingness to acknowledge concerns that were raised by the committee and by individual members of the committee, irrespective of their party loyalties, and his willingness to take on board the evidence and submissions from the many organisations that gave evidence to the committee.
The Scottish Conservative party welcomes the bill, which will provide a national system for the regulation of care, early education services and the social services work force. We also welcome the minister's and the Executive's acceptance of the many amendments, suggestions and points of clarification that have strengthened the bill. We endorse the fact that the provision of care by local authorities will be registered and inspected to the same level as provision in the private and voluntary sector, and we welcome the independence of the Scottish commission for the regulation of care.
Like my colleagues in other parties, I have concerns over the level of funding and its potential impact on care services: not only a potential reduction in care services, but the harm that it may do to the diversity and subsequent choice of care services. I remain concerned that there is not a system for the scrutiny of contracts and referrals from local government, but I look forward to ensuring that that will be addressed in the forthcoming bills that were mentioned by the minister this morning. I understand that that issue may be examined by the care development group that is considering the long-term care of the elderly, but that group will not address the concerns that have been raised by the Scottish Association for Mental Health and Capability Scotland.
We can only accept in good faith that the minister will ensure that future regulations will address the issues of openness, fairness, transparency and accountability in relation to local government. If the budget deliberations of the Health and Community Care Committee and the director of finance of the Scottish health department cannot unravel the spending of councils on care in the community, I wonder how ordinary voters will be able to hold councils to account for their commitment to spending on the elderly, those with mental illness and the disabled, as was mentioned by John McAllion this morning.
Given the fact that many of the contentious issues regarding fees and the provision of care will be addressed in the regulations, I ask the minister for an assurance that the Health and Community Care Committee will be given the opportunity to scrutinise future proposals. The Scottish Conservatives welcome and support the motion to pass the bill.
I welcome the Regulation of Care (Scotland) Bill, and I pay tribute to many people, as we tend to do at this stage.
First, I thank my colleagues on the Health and Community Care Committee for the incredible amount of hard work that they have done in their careful consideration of the bill. From the speeches that have been made this morning and this afternoon, it is obvious that it has been a team effort. Contributions to amend and improve the bill have come from all parties and have been accepted in that spirit by Malcolm Chisholm, whom I thank for the way in which he has steered the bill through the committee system and through this morning's debate. The manner in which he has dealt with the committee and his willingness to listen to deeply felt and real concerns that we have expressed have done him and the parliamentary committee system credit.
I thank the clerks to the Health and Community Care Committee for a certain amount of hand holding and for calming me down, and I thank our adviser, Peter Cassidy, who assisted us as well. Thanks also go to the people who have been involved in the consultation processes that have taken place, including those who have given evidence to the committee. I give special thanks to the National Association of Inspection and Registration Officers, whose representatives took me on an inspection visit of the Peacehaven home near Leven, where I met several people who are at the sharp end of all this. I thank them also for their indulgence and help.
The bill is obviously a genuine attempt to improve the quality of care services in Scotland through regulation, inspection, enforcement and the achievement of national standards. It is a good piece of legislation, which sets up the commission for the regulation of care and the social services council and brings with it regulation of a professional work force and, it is to be hoped, the recognition that those people deserve. I hope that it also brings with it the common sense to see that, as with any work force, the level of a worker's experience counts. Already, one constituent has contacted me to say that their local council has said that their qualifications, which have been acceptable for nine years, will no longer be acceptable as a result of the proposals. I ask that authorities use common sense and take people's experience into account.
It is also to be hoped that the bill will bring an end to the confusion that arose from a situation in which nursing homes were regulated by health boards and local authorities had queries about their independence. The council as service provider, commissioner and regulator is a thing of the past. We also have the potential for homes that combine residential and nursing care, so that people will not need to be moved when their condition deteriorates. Such moves can threaten their well-being.
The bill is an attempt to protect the weakest in our society: the children in our care homes and in aftercare; the elderly in our residential homes and nursing homes; and the children in our secure units. It covers a wide range of care services and I am glad that we were able to add more care services to those that were covered. A number of areas of concern have been resolved or partially resolved. The one of which we should be most proud is the increased frequency of inspections. There will be children lying abed tonight who will thank us for that. That is the main success of the committee's involvement in the bill.
The bill includes a statement of general principles to the effect that the safety and welfare of all persons who use care services are to be protected and enhanced, that there will be a diversity of choice and that the independence and dignity of the individual will be promoted. Throughout the bill, there are references to equal opportunities and to consultation with users and providers of services so that, as we make progress with secondary legislation and with all the work that flows from the bill, their expertise will enhance that process.
Many issues that the Health and Community Care Committee has dealt with are not in the bill and have not been discussed in the chamber. We have discussed the location of regional offices and the input from local care service users and providers. We welcome the national forum that the minister will set up and the fact that the commission can set up sub-committees to ensure that local people have an input.
Wind up, please.
That input will be useful in ensuring that we monitor the effect that the bill has. Most of the effects will be good but, as we heard in today's debate, the bill will have financial implications. It will be important to monitor the effects of the bill at a local and a national level.
I thank the minister and the committee for the work that has been done. I welcome this bill and commend it to the Scottish Parliament.
I hope that Margaret Smith has left some time for me to use in this debate. [Laughter.] Members may laugh, but I point out that only once during the consultation and stage 2 debate did the committee make a breakthrough and finish before 12 o'clock. Obviously, Margaret Smith does not intend to make a similar breakthrough today and will not keep to any of the agreements that we made.
I welcome the passage of the bill. Many members have campaigned long and hard in the interests of protecting the vulnerable in our society. They have waited long enough for this day. The passage of the bill ensures that the highest level of services and care provision will be the norm rather than the exception. Throughout stages 1 and 2, witnesses who gave evidence to the Health and Community Care Committee complimented the Executive on the level and quality of the consultation that had been afforded to them. That is something that all other ministers should take on board when they are pursuing legislation through the Parliament. It is also encouraging that future consultation has been enshrined in the bill.
This morning, we heard much about care staff's terms and conditions and about how they could be linked to the eventual contract prices. From my experience in a previous life, I have to say, "If it were only so simple." Many people employed in the social care field would value the right to be a member of a trade union that was recognised by their employers. If we can achieve that with this bill, we will have achieved something significant. The opportunities for the staff who will be registered under the provisions of the bill, for example, in continuing professional development, will in themselves serve as a driver for higher wages and for having the professions recognised.
The confidence of staff, of the public and of users will be high, thanks to the safeguards that the bill affords them. It is right and proper that those in our society who are vulnerable in any way are assured that those who are caring for them work at the highest standard. The standards that are to be set for care homes will, following consultation, set out the way forward. "The Future for Care Homes in Scotland: A Consultation Paper", which has been produced recently, sets the scene for what some people in Scotland have already embraced.
It would be remiss of me not to congratulate East Ayrshire Council, Ayrshire and Arran Health Board and the owners of two nursing homes in Kilmarnock and Loudoun constituency, the Torrance Lodge Nursing Home and Gracelands Nursing Home, which have used foresight in anticipating the direction taken by the consultation paper.
It would also be wrong if nothing was said about the other areas that the bill addresses, particularly those that relate to young people. The joint work that we carried out with colleagues in the Education, Culture and Sport Committee demonstrated the commitment to comprehensive, high-quality provision, to safe care and to a regulated work force. I certainly hope that the Minister for Education, Europe and External Affairs—it is a shame that he is not in the chamber—considers the questions that have been raised about the work force in regard to nursery nurses.
In conclusion—because I am getting a wind-up look from Nicola Sturgeon—I wish to place on record my grateful thanks to the Health and Community Care Committee clerks and to our adviser, Peter Cassidy, for their guidance to and forbearance of committee members during the many meetings that we had to consider the bill. I have much pleasure in commending the bill to Parliament.
Shona Robison will be pleased that I will get the last word on this matter, although she may not be pleased if I get it on certain other issues.
I wish to thank everybody who has been involved in the bill over the past five months, first on the Parliament side. That involves a great many people. I think that five committees were involved with the bill at stage 1, which illustrates the superb scrutiny that we give to legislation at that stage. That is a unique feature of this Parliament. I cannot name all those committees, but I thank in particular the Health and Community Care Committee, which did such an enormous amount of work on the bill at each stage. I thank the clerks to that committee and the other parliamentary officers who helped with the bill.
I am not sure whether I am supposed to do this, but, secondly, I would like to thank my officials. A regulation of care team has been working on the bill for several months, and it should be congratulated for the very open way in which it has conducted its work. That leads to the third group of people to thank, which is the large number of members of the general public who have participated in the work carried out on the bill. The enormous strides that we have made in engaging with the public over the past two years is sometimes not appreciated. That engagement was always one of the ideals to be mentioned in connection with the Parliament, and we have seen that in action with this bill.
The working groups that considered care standards involved representatives of the stakeholders and of the users of services. If the public becomes aware of that procedure, they will realise that the Parliament is moving towards a new way of doing business, particularly in relation to legislation. I suppose that I am more aware of that, as I am able to compare our procedures with those of Westminster. In passing, I note that John McAllion was pleased because this was the first time than an amendment to a bill lodged by him had been accepted, after 14 years at Westminster. I accepted an amendment of his that changed "may" to "shall"—[Laughter.] He said that that never happens at Westminster.
Mary Scanlon referred to the importance of the regulations that will follow in the wake of the bill. We agreed to an amendment this morning that will ensure full consultation on those regulations. I am sure that the Health and Community Care Committee is looking forward to them.
I will mention one particular set of regulations on local advisory committees, which is an issue that was not aired this morning. Margaret Jamieson lodged an amendment about local advisory committees at stage 2, in response to which I indicated that the Executive was minded to set up a national advisory forum. I gave certain details about that proposal to the Health and Community Care Committee recently, but it has yet to get into the public domain. I hope that all those in Scotland who were concerned about that issue will recognise that we intend to set up a national advisory forum by regulation. That forum will be an open body that will have the power to set up sub-committees, which could well be like the local sub-committees that many members support.
When we implement the bill's provisions, we intend to continue the inclusive process through which the bill arrived at this stage. Without being too self-congratulatory, we should be pleased with the procedures adopted for the bill. In the midst of the bad publicity that sometimes attaches to the Parliament, we can be proud of what we have done.
I thank everyone, and I hope that the bill will be passed.