Chamber and committees

Within the constraints of limited resources, how can the twin pressures of increased pay and demands for additional staff be balanced in the NHS and social care?

The Scottish Fiscal Commission identified a risk that the budget does not account for the recent rise in national insurance contributions. How will the Scottish Government ensure that health boards can manage that uncertainty without compromising critical services? If the compensation that is provided by the United Kingdom Government does not match the estimated cost for national health service boards, are there strategies in place to address that funding gap?

Good morning, minister. How would you respond to criticisms that existing restrictions on vaping and tobacco are not being adequately enforced?

There are various provisions in the bill. Some are about the sale of vapes, but some are about smoke-free environments. We are supposed to have smoke-free environments outside hospitals, for example, but from my inbox as well as my experience, I know that that is not necessarily what is happening outside our hospitals at the moment. What comfort or assurance can the minister give people that the powers that are coming to the Scottish Government will be enforced and that we will see smoke-free environments happen? At the moment, for the most part, it is not happening outside hospitals, where it should be.

The register is obviously very different to the way that we handle alcohol licensing, for example. As a result of some of the things that are happening through the bill, does the Scottish Government have any plans to put additional restrictions in the register, to bring it in line with how we regulate other health-harming products, such as alcohol?

The cabinet secretary was on the same panel as me at a Scottish Care event where we heard that the impact of the rise could be as much as £300,000 for an individual care home.

Are any particular measures being taken to ensure that GP practices and third sector providers that fall outside that direct public sector boundary are not disproportionately impacted by the increased national insurance burden?

A key part of the Martins review was an examination of the value of instant messaging apps to ministers in emergency situations and to draw on best practice in other countries across the world. In its response to the review, how has the Scottish Government considered its preparedness for communicating during future emergencies?

I thank Mr Cole-Hamilton for his intervention.

At my party’s conference earlier in the autumn, the party voted for a motion that removed support for the bill in its current form, but expressed that we want to continue to support the provisions that will make progress for unpaid carers and the workforce. We are willing to work with the Government to see which of the issues that we all agree on we can continue to progress. I urge all parties to make sure that social care reform is their top priority and to bring forward alternative proposals and say what they would be willing to see to ensure that we make progress in social care reform.

I am coming to the end of my time, so I will leave it there for now.

I do not know what hope the debate will have given to anyone who is concerned about their care or that of a loved one. They will have watched MSPs shouting at one other and talking about parliamentary process rather than the vision that we should have for social care reform and, crucially, what we are going to do individually. I am committed to ensuring that we see reform and that there is equality across local authorities in what people are entitled to.

No one can argue that money is not hugely important but, as I stated at stage 1 of the National Care Service (Scotland) Bill, we do not need money to change the culture. The culture is a huge part of the issues that we have. We should have made an awful lot more progress on a great many things long before now. Jackie Baillie noted where we could amend other legislation to give effect to those things that the Parliament agrees on. The time that it could take to do that is one of my big concerns, especially as the Health, Social Care and Sport Committee is hugely busy and has a massive legislative load. I appreciate that the bill has been paused, but I still believe that substantial amendment and passing the aspects of the bill that we agree on would be the most expedient way to make changes. A great many stakeholders and individuals have put in time and effort on some of the provisions in the bill, and I remain hugely concerned about how demoralising it must be for those who have given their views in the process and how badly social care reform could be set back if we do not do something quickly and give those people hope.

The cabinet secretary mentioned disabled people’s organisations. I had the pleasure of speaking to some of them after our party conference and they were rightly angry that the bill is being used as a political football. They told me that although, for us, it is a legislation-making process, for them, it is their lives. It was hugely emotional, and I am very grateful to them for sharing their experiences, which have certainly stayed with me.

Alex Cole-Hamilton mentioned the workforce. As I reflected on early in my time in the Parliament, that is one of my biggest drivers because of my experience as an unpaid carer for my grandpa. Social care staff are hugely skilled and they deserve recognition and pay for what they do. We should have collective bargaining, as Paul Sweeney mentioned, as well as maternity pay, sick pay and clear career progression and training opportunities. I hope that the minister or the cabinet secretary—whoever will be closing in this debate—will be able to point to any progress that is being made in that area.

I know the negotiating effort that that took, but there are other things that we should be exploring, such as ethical commissioning. That would allow us to put in some of the provisions so that organisations do not take advantage of their staff or have profit leak from the system. We need to ensure that there is fair funding for all in the social care sector.

This week, many colleagues will have had emails about hospice funding. Many third sector providers are concerned about how their care homes are going to continue to operate. We also need to acknowledge the issues that the national insurance changes have caused for the sector. I know that Jackie Baillie heard about that at the conference that we both spoke at.

I am privileged to be the convener of the cross-party group on carers. I will be looking to amend some of the provisions that relate to unpaid carers in order to strengthen the access to carer support plans, and many other things.

I am aware that I am running out of time, Deputy Presiding Officer. There are many other issues that we need to solve, and I do not think that we have gotten anywhere close to them in the debate.

The recommendations of the Feeley review remain relevant. Today, indeed, they are more relevant than ever. It is vital that those recommendations are implemented to the greatest extent possible.