Chamber and committees

That is a very good question. Sometimes there is confusion. Co-design means working with people in an equal and reciprocal partnership on design of services, policies, frameworks and interventions. Involvement starts from understanding the present to decide what the future should look like and how we will all get there.

There are three clear phases to the national care service collaborative design. The first is understanding; that is, building on the shared understanding of the current challenges that I mentioned. The second phase is sense making—what we can deliver and how in order to make the improvements that we all want. The third phase is agreement. Do the proposed changes address the issues that have been raised by people?

The initial co-design themes were launched at the national care service forum in October, and they focus specifically on the information that will be needed to develop policy that is directly associated with the passage of the bill. They are:

“information sharing to improve health and social care support”,

which includes measures such as data sharing;

“realising rights and recognising responsibilities”,

which is the human rights work and the charter development;

“keeping health and social care support local”,

which will consider care boards, geography and board representation, for example;

“making ... my voice ... heard”,

which will consider advocacy and complaints; and

“valuing the workforce”,

which will consider issues such as ethical commissioning.

I hope that that helps Ms Harper and the committee.

Absolutely. Although we need everyone to adhere to the national high-quality delivery standards, we must also have the ability and flexibility to create the right services for places. That will also allow for innovation.

I will give an example. I have had discussions with folk from our island communities; it might be the case that we need to do things differently there. We will listen and we will act and react accordingly. Ms Harper is right that delivery might be somewhat different in rural Galloway from what it is in Glasgow. We have to allow for flexibilities.

I will give an example of what I see as an opportunity. During the Covid period, many community organisations stepped up to the plate and provided help, care and support for some of our most vulnerable folk, when others were unable to do so. That work has continued in some places. Ethical procurement provides an opportunity for community wealth building. It might be that some rural communities—and some urban ones—choose to deliver care in their own locales. Often, the current procurement practices have been a barrier to such approaches, but ethical procurement can open the door. Therefore, others might come forward to provide care and support in rural Galloway, Orkney or maybe even Glasgow and be able to do so through ethical procurement methods.

That subject is very close to my heart, because of my previous job—just because you change jobs, you do not forget about things. The greatest breakthroughs that we have made in recent times in tackling rough sleeping and the issues of the most vulnerable folks have come through the work that we have done on the housing first approach. That policy brings housing, care, health and other services together in order to create the right environment for a person to thrive in their own home.

That has been immensely successful—more successful than any of us could have hoped to imagine. In the most recent figures that I saw, which might be out of date, there was 90 per cent tenancy sustainment. We need to ensure that, no matter what services are, they are wrapped around the individual in order to get them right for people. Some of our changes in homelessness legislation will put duties on folk to do that.

The national care service has a big role to play in that. I talked earlier about the linkages that we need to create to ensure that we get it right. That is why I have met, and will continue to meet, folk from the housing and homelessness sector. It is also why Shona Robison and I have met officials fairly regularly—to get it absolutely right.

That is a big question.

It does not necessarily need to be mentioned in the bill, but we all have to be cognisant of the need to make sure that, in the co-design, we get everything, including integration, absolutely right.

It has been strange to me that many folk have said that various things should not be in the bill—for example, that criminal justice and children’s services should not be in the NCS. There are numerous arguments about that. The Government has not yet taken any decisions about whether those two areas should be in or out of the national care service.

However, at the Local Government, Housing and Planning Committee the other week, there was a suggestion from a member that housing and homelessness services should be in the bill and in the NCS. Of course, that is not going to be the case. However, we have to ensure that the national care service, no matter what is in or out of it, has linkages with other services across the board, including housing and homelessness services. There are areas that are perhaps not being seen by you folks to be discussed as much as they should be, but those conversations are being had right across the board.

Number 2 on my list was

“realising rights and recognising responsibilities”,

which includes the charter development. The others were: information sharing to improve health and social care support, which we have touched on already; keeping health and social care support local; making sure that voices are heard; and valuing the workforce. As I said, we will write to you on all of those.

I revert back to my point about the SDS legislation. We all thought that that was a fantastic piece of legislation, but some folk have found loopholes that have not been challenged and have not been easy to change. I have tried to change some of that through guidance. As you know, vehicles for primary legislation sometimes do not come along very often. If we find a flaw or loophole, or if something changes in the way that we deal with an illness or condition, we can change secondary legislation quite easily, or more easily. That does not mean that we do not have folk scrutinising and that we are not open and transparent on that. If and when secondary legislation requires to be changed, I expect that we will continue to have the voices of lived experience guiding us on that.

The figure of £1.4 billion relates to what is in the bill. The issue that Tess White raises is not in the bill; it is action that we are taking now. That statement of intent covers a huge number of things, including pay and conditions—maternity pay being a condition. Not all of those things are spelled out individually in the statement of intent. Off the top of my head, I picked one that is extremely important to me.

Again, off the top of my head—I will correct this in writing if I am wrong—I believe that the cost of the policy is around £4 million.

We published the new statement of intent yesterday. There are constant meetings between officials and COSLA officials. As you can imagine, I see Paul Kelly, the COSLA health and social care spokesperson, regularly because he is involved in many of the relevant groups, including the ministerial advisory group, which he co-chairs with the Cabinet Secretary for Health and Social Care, to deal with the here and now.

I will give one example of where I want to see improvement, and to see it quickly. As I am sure COSLA officials would agree, I believe that it is scandalous that many women who are working in social care at the moment have no maternity-pay entitlement. That is absolutely scandalous in the 21st century, and it is one of the first things on my list for improvement. I think that the statement of intent will help us to move forward on that front and to get rid of some of the antiquated employment situations that exist.

I am fine.