Chamber and committees

I call Ruth Maguire.

Given the caveat that there would be further consultation, how would the Scottish Government ensure that human rights were respected within any change, given that that would extend the buffer zones into many more premises and cover a much wider area across the country, particularly in urban areas?

Minister, you will be aware that the committee has taken evidence on the definition of protected premises. In both oral and written evidence, we have had very different views. Some stakeholder organisations were keen that the definition be expanded, while others were very much against that and were troubled by it. Could you outline the steps, planning and consultation that the Scottish Government will undertake to inform any decisions about extending the definition of protected premises?

To ask the Scottish Government what assessment it has made of the impact of the repayment of private finance initiative and public-private partnership debts on local authority finances. (S6O-03146)

I refer members to my entry in the register of members’ interests, which shows that I hold a bank staff nurse contract with NHS Greater Glasgow and Clyde.

I thank the Health, Social Care and Sport Committee clerks for their support during the committee’s inquiry and preparation of our stage 1 report. The committee began its stage 1 scrutiny of the National Care Service (Scotland) Bill in October 2022, having issued a call for evidence during the summer. There was extensive engagement with the initial call for evidence, and I thank everyone who contributed. The committee has listened carefully to all the views that were expressed throughout that process, which were invaluable in informing the committee’s recommendations.

The committee took oral evidence on the bill at nine meetings between October and December 2022. We took further evidence on the bill in May 2023 and at three meetings in October 2023. I am equally grateful to everyone who contributed oral evidence to the committee during that time.

One strong message that we heard throughout our scrutiny concerned the case for reform of social care. Such reform is badly needed to address existing inconsistencies in access, to ensure consistent application of guidance and legislation, to address on-going challenges in the social care workforce, to improve commissioning and procurement of services, and, most importantly, to improve outcomes for people who receive social care and support.

The case for reform motivated Derek Feeley’s independent review of adult social care to recommend the creation of a national care service. In responding to the Feeley report, the Scottish Government has sought to give people with lived experience a stronger voice in shaping the proposals through a co-design process. A witness who gave oral evidence to the committee described that as “a bold approach”.

At the same time, the committee heard many stakeholders raise concerns about an on-going lack of clarity regarding the definition, the precise scope and key areas of focus of co-design or the anticipated outcomes of the co-design process. In a recommendation that was unanimously supported by its members, the committee, in its report, calls on the Scottish Government to

“set out an overarching plan that includes a clear definition of co-design, parameters and intended outcomes of the co-design work and a timetable for its completion.”

We also want the Scottish Government to

“recognise the critical role the Scottish Parliament has to play in undertaking”

on-going scrutiny of the bill’s implementation,

“including in relation to the outcomes of the co-design process.”

During its scrutiny, the committee heard widespread support for the principles that are set out in section 1 of the bill. At the same time, our report highlights several areas in which the majority of committee members believe that those principles could usefully be clarified and strengthened.

Although the committee acknowledges the Scottish Government’s stated commitment to fair work principles, the majority of the committee would like the bill to be strengthened to include a

“clear and comprehensive definition of ‘fair work’”

and provide clarity on how those principles will be consistently applied and enforced.

The committee’s report seeks clarification on the remit of the planned national social work agency. The Scottish Government has said that the agency’s responsibilities will include monitoring and improving service quality, overseeing and supporting education, improving and scaling up good practice, workforce planning, training and development, and work on terms and conditions, including pay. The committee is keen to understand why the agency’s proposed remit is limited to the social work profession when there is an equally pressing need to address such issues for the wider social care workforce.

Furthermore, if the agency is to be set up as a Scottish Government department, how will it be ensured that it has the necessary operational independence to fulfil its role effectively?

I look forward to receiving the minister’s considered response to those concerns.

For a long time, we have been talking about the creation of a single electronic health and social care information record. Completing that work will be fundamental to the success of the proposed national care service and should be treated as an absolute priority. The committee’s report also highlights the importance of monitoring and evaluation. Without that, how can we judge whether a national care service has successfully achieved its objectives?

The committee has unanimously called for appropriate provision to be made in the bill for effective monitoring and evaluation of the proposed national care service. I acknowledge that the committee has been unable to reach a consensus position in many areas, but I am pleased to note that our recommendations on the parts of the bill on creating a right to breaks for carers and on implementing Anne’s law were unanimously supported. I hope that those important measures can be implemented with all due care and speed.

The Scottish Government’s overall approach to the legislation has shifted significantly since the bill was introduced in June 2022.

On a point of order, Presiding Officer. It is my understanding of standing orders that members should treat each other with courtesy and address each other via the chair. Can you confirm that that is correct?

The committee considered the bill in its entirety, including all the different sections, one of which concerns Anne’s law.

The consensus agreement with the Convention of Scottish Local Authorities on shared legal accountability means that a number of the bill’s key aspects will need to change. Accountability for social care will no longer be transferred from local authorities to Scottish ministers, and integration joint boards will no longer be replaced by local care boards. Instead, a national care service board is proposed, and local government will now retain social care functions, staff and assets.

Although many people welcome that shift in approach, we need to acknowledge that others have been left feeling disappointed that it fails to reflect the core aspirations of the Feeley review. There will be a job to do to rebuild trust with those people.

Our committee has noted the Scottish Government’s intention to bring about changes to the bill through amendments at stage 2. A majority of the committee expressed a willingness to recommend that the general principles of the bill as introduced should be approved at stage 1. However, we have made that majority recommendation on the understanding that the Scottish Government is prepared to give the committee sufficient time to take further oral and written evidence on the details of those amendments prior to commencing the formal process of considering and disposing of amendments at stage 2.

I acknowledge the interim response that was received from the minister yesterday, and I am grateful to her for providing the committee with a summary target operating model for the proposed national care service. The minister has also given a commitment that she will formalise the extensive input that has so far been received from a wide range of stakeholders in a legislative advisory group that will guide the on-going development of the bill.

A majority of the committee specifically called for the full text of the Scottish Government’s stage 2 amendments, a marked-up version of the bill as introduced that incorporates those amendments in a highlighted format, and an updated policy memorandum and explanatory notes to be published no later than 29 March. I am particularly encouraged by the minister’s commitment, in her interim response, to accept that recommendation and

“to facilitate what the Committee requires, and to do this as quickly as possible.”

I look forward to listening to all the contributions to this afternoon’s debate. I acknowledge that, ultimately, it was not possible for the committee to reach a consensus position on the general principles of the bill. I recognise the strongly held positions of all members on the committee and across the chamber. However, if, later today, the Parliament agrees to approve the general principles of the bill at stage 1, as the majority of the committee recommended, I hope that all members, whatever view they express today, will continue to engage constructively with a reinforced scrutiny process at stage 2.

I refer members to my entry in the register of members’ interests. I hold a bank contract with NHS Greater Glasgow and Clyde. Will the cabinet secretary give further detail on how the public inquiry and the independent clinical review will work in parallel and complement one another?

South Lanarkshire Council, which is the local authority for my constituency of Rutherglen, will be paying about £40 million this year in disastrous PFI repayments. That yearly figure will only rise over the coming decade. When the council entered into those contracts, Labour was in power at council level, in Holyrood and at Westminster. The £40 million is being removed from the council’s spending power this year at a time when the council proposes to close local facilities and cut free school bus provision. Will the Deputy First Minister assure me that, although it is contending with Labour’s toxic PFI legacy, which has failed to deliver the best value for the taxpayer, the Scottish Government will never return to the disastrous PFI model?

The Health, Social Care and Sport Committee has undertaken extensive scrutiny of the National Care Service (Scotland) Bill since its introduction in June 2022. That has included two calls for written evidence, 18 panels of witnesses, three oral evidence sessions and multiple exchanges of correspondence with the responsible minister. The committee held a number of informal engagement sessions with a range of people with lived experience and different experiences. To inform its scrutiny further, the committee commissioned a literature review of international models of social care, including a combination of different models in UK countries, European Union countries, Nordic countries, Switzerland, Alaska, the USA, Canada, Japan, Australia and New Zealand.

The committee also went to Aberdeen, where members met representatives of the Granite Care Consortium and visited the Camphill community to engage with staff and service users. We visited Dumfries, where members had informal discussions with Stewartry Care and other organisations that represent registered care homes and that provide registered care-at-home services, as well as with wider community and third sector organisations. On a visit to Glasgow, committee members met representatives from the Coalition of Care and Support Providers in Scotland and service users and front-line staff from the organisation Key, before holding a formal meeting at the William Quarrier conference centre.

Meanwhile, six other committees have undertaken their own scrutiny of aspects of the bill that are relevant to their remit.

On 12 July last year, the Scottish Government wrote to inform the committee that it had reached an initial consensus agreement with COSLA on a partnership approach that will provide for shared legal accountability with respect to the proposed national care service. On 20 September, the Government confirmed its intention to lodge amendments to the bill to reflect the changes that were required as a result of the consensus agreement with COSLA. My committee subsequently wrote to the Government on 7 November requesting additional information regarding the precise implications of the consensus agreement for the bill, and we received a detailed response from the minister on 6 December.

The committee’s stage 1 report, which was published last week, sets out in detail the conclusions and recommendations that we have reached as a consequence of our exhaustive scrutiny. The consensus agreement with COSLA on the shared legal accountability means that a number of key aspects of the bill will need to change. Accountability for social care will no longer be transferred from local authorities to Scottish ministers. Integration joint boards will no longer be replaced by local care boards. Instead, a national care service board is proposed, and local government will now retain social care functions, staff and assets.

The Scottish Government has made clear its intention to bring about those changes to the bill through amendments at stage 2. On that basis, a majority of the committee has recommended that the general principles of the bill be agreed to. However, we have done so on the understanding that further scrutiny of the changes that the Scottish Government now proposes to make to the bill should take place as part of an elongated stage 2 process. That would include a further written call for evidence and the gathering of additional oral evidence before we progress to the formal part of stage 2, which is the consideration and disposal of amendments to the bill.

I regret that it was not possible for the committee to reach a consensus position on the general principles of the bill at stage 1. However, I underline my commitment to ensuring that substantial further scrutiny takes place at stage 2, as I have outlined.