Chamber and committees

Are you giving me half an hour, convener? [Laughter.] I will try to be quick.

Our ambition for the national care service is that it puts people at the heart of the new arrangements, that it is holistic and that it enables people to have the life that they want to lead.

Derek Feeley answered a lot of questions about adult social care—that was his remit—but he also said that there were a lot of unanswered questions. Mr O’Kane asks why we enhanced the scope. Folks have told me about some of the difficulties that they face and it is recognised in the proposals that transition periods are often very difficult for folk. That is also recognised by Pam Duncan-Glancy’s proposed member’s bill.

In all of that, we decided to ask the questions about bringing everything together and getting rid of those transition periods, and seeing what folk out there think. Mr O’Kane mentions learning disability groups being wary about it all coming together. I have talked to a fair amount of folk from the learning disabled community and only a very small minority expressed concerns.

I know that, for some, change is threatening. However, we have a huge opportunity to get it right. That is why we have asked some of the questions in the consultation. We will analyse the responses—there are some 1,300 of them, although some may be duplications. We will also consider all that we garnered from all the meetings that were held and then we will come to a conclusion on the way forward.

We have to get it right. It is all about people. Some of the responses that I have seen focus almost entirely on people and others do not. If the committee goes out and talks to folk—as I am sure it will do over the piece—it will find that they want change. People do not feel that the delivery of social care is right in many places. They think that the postcode lottery that clearly exists is unfair and they feel that there is a lack of accountability. We have to get that right.

There will be a huge amount of modelling in various areas. Some of that work is on-going, and we will continue to look at the results from the analysis. Obviously, a huge amount of work needs to be done in looking at the 1,300 or thereabouts responses and everything else that has come in from consultation events. I can assure the committee that a lot of work is going on, because we have to get it right.

I can also reassure the committee that—as was the case in my previous role—I am happy to come back to the committee to deal with such issues subject by subject if necessary, because that is how we get good legislation. I say to Ms Webber and every member around the table that there will be a lot of hard graft, because I am determined to get this right.

Can I tackle that point, because it is a big question, although it was a shorter sentence than Mr O’Kane’s previous point.

I disagree profoundly with Dr Gulhane that Covid has not had an impact: it most definitely has. He should spend some time talking to folks with lived experience and the folk who work in front-line services about the impact that it has had.

His point about digital services is important. During the past period we have adapted quickly, and digital services are among the things in which we have invested. Cognitive behavioural therapy has been provided, which has worked well for many folk. We will continue to invest in digital services.

There is no doubt that digital services work well for many people, but there will still be a need for group therapies and individual face-to-face consultations, as we move forward. We can learn a lot from what we have gone through, so we are considering how to embed that in services in order to create hybrid provision where it is required. However, as always, we need to take a person-centred approach and to see what is best for the individual. Much of that is down to what clinicians think is best for the individual.

Without a doubt, lessons have been learned from the pandemic: we will take full advantage of the technological changes that we have made to get treatment right for people.

I know that folk canna wait, and that is why we have already made additional investment. I will just run through some of that, if you do not mind, convener.

We invested an extra £1.1 million in the short breaks fund through Shared Care Scotland last year, and £300,000 in our Young Scot young carers package to support carers of all ages to enjoy some time away. As we know, however, some folk will not do that, so we need to encourage it. This year, we have already committed an extra £570,000 for the short breaks fund.

We also recently launched the £1.4 million ScotSpirit holiday voucher scheme for tourism businesses to sign up to help low-income families, unpaid carers and disadvantaged young folk to take a break from caring.

The other thing that I want to do in the short term will require co-operation from partners including the Convention of Scottish Local Authorities, and it is to get rid of eligibility criteria, particularly some of the local eligibility criteria that have cropped up. That is of major importance to delivery.

As Ms Callaghan rightly points out, unpaid carers have seen a decline in their mental health during this time. The national wellbeing hub that I talked about earlier is also open to carers. Yesterday we talked with managers from carer centres and, although a lot of work is being done to signpost folk to the hub, we still need to do more on that front. The national wellbeing hub also has a dedicated section for unpaid carers, and we are developing a dedicated page for young carers.

Those are some of the short-term things that we have done, are doing and will do.

Convener, you are right to point out that we are talking about remobilisation here, but folks have put in a hard shift over the course of all of this. Some services were disbanded during Covid, but the vast bulk of folk who were in those services moved and worked elsewhere. We owe a huge debt of gratitude to those who have kept our most vulnerable folk cared for during these very tricky 20 months.

I am sorry to repeat myself, but we are in a precarious time. In fact, it is the most precarious time. It would be fair to say that, in many areas, there are staff shortages. Some of that is down to illness and some of it is down to the fact of Brexit. One service that I spoke to had lost 40 per cent of its staff, who returned to their home countries after Brexit. That is inevitably going to have an impact.

We also know, because we have heard the stories, that other folks have left social care for the moment because they are tired and they have gone into what they see as easier jobs in hospitality. I hope—I think that we all hope—that those folks come back, and the national care service proposal gives us an opportunity to consider national pay bargaining for them, with a real hard look at pay and conditions and, beyond that, at opportunities for career progression.

We all have a duty to recognise that care is a profession. We have a wee bit of education to do with some folk around that, but we should continue—and I hope that the committee will continue—to refer to it as a profession as we move forward.

I turn to Ms Bell to talk about the folk who are involved in the remobilisation plan because I cannot remember off the top of my head.

Some solutions have to be found locally. That is why we are having conversations with partners across the country to mobilise everything and to ensure that we do the right thing.

We do not have the luxury of not involving everyone. There must be collaboration and co-operation between Government, local authorities, health and social care partnerships, NHS boards and the third sector so that we can do our level best for everyone in these precarious times.

The cabinet secretary, Humza Yousaf, recently announced additional resources for hospital at home. It is a great way forward. I recently had the pleasure of meeting teams in Edinburgh and Lanarkshire. The deputy chief medical officer, Graham Ellis, is from Lanarkshire and has been a great advocate for hospital at home. That is why we are investing to expand the programme further, which is a good thing.

I cannot give the retention numbers off the top of my head, but we will furnish the committee with that information.

I have spoken to a lot of social workers. Last week, I spoke to criminal justice social workers, and I have spoken to social workers in children and families services and adult services over the past few weeks and months. It would be fair to say that there is a lot of pressure on them, as there is on everyone else, and things have been very difficult for them at points, particularly during the lockdown periods, because of the way that they work. However, folks have behaved admirably, and they have done amazing things over the piece.

In conversations with social workers, one of the key messages from them is that front-line staff should be more empowered. We must do that. Social workers sometimes feel that they are the poor relation of other professions, and we have to change that. Part of the conversation in the consultation is about whether we should move to a social work agency, which was Derek Feeley’s suggestion. There is that issue to consider, and we will look at the analysis on that issue.

One big bugbear of social workers is that they feel bound by the eligibility criteria, which are often set locally. As I said, we must work with COSLA in the short term to eradicate some of that, because we are not doing good by the professionals and front-line staff, or by the individuals and families whom they serve.