Chamber and committees

Although we will obviously support an increase in care payments, there is a valid concern about the long-term sustainability of these types of increases, especially if the underlying financial pressures on the care system are not addressed. I therefore have the same concerns as my colleague Sandesh Gulhane around why we use this particular method to ensure these increases. There is conditional support, but I would definitely like to understand how we ensure long-term sustainability as we go forward.

Like Jackie Baillie, I am really pleased to see the minister’s amendment 50, although I agree that more clarity is required, because it does not go far enough in supporting Anne’s law.

As the minister has said, amendment 50A would set a requirement for care home service providers to provide a written reason to both the resident and the essential care supporter in any case in which a visit is denied. It represents an effort to ensure that records are retained that could be used as evidence for any future inquiries or for evaluation of the implementation of the law, which is pertinent to amendment 50D.

I welcome the minister’s comments about her intention to go further than what is proposed in amendment 50A and her offer to have further discussions on how we could strengthen the amendment. Therefore, I will not move amendment 50A.

Amendment 50B would place a requirement on the Scottish ministers to publish the code of practice in such a manner that it is publicly available and to provide it in an easy-read format. I welcome the minister’s support for that amendment and her intention to strengthen it. It is important that an accessible and easy-read version of the code of practice is available. Given that many care home residents will experience greater mental decline than the average population, it is especially important that the code is accessible to them.

Amendment 50C would place a requirement on ministers to revise the code if a significant number of problems have been reported. That is extremely important—we want to be able to trigger revisions to the code if it is clear that it is not working as intended. Amendment 50C would also trigger revisions in a timely manner.

Amendment 50D would place a requirement on ministers to publish a report on the implementation of Anne’s law, broken down by council area, each year. Given what we are trying to do with amendment 50A, I do not think that that would be a particularly onerous requirement, as we will be gathering evidence as we go along. Amendment 50D would improve parliamentary scrutiny of the implementation of Anne’s law and would help to identify any areas in which additional support is needed to make sure that Anne’s law is in place for every person who receives care in a care home and their families, which, surely, is what we are all here to try to do. Therefore, I intend to move amendment 50D.

My concern with amendment 53 is that the change may compromise the discretion of care commissioning bodies in their efforts to deliver services in the most efficient and effective way. I am concerned that that might force them to make imperfect choices, delivering less service for the same cost to the taxpayer.

Amendment 53A is a probing amendment, but it would broaden the set of organisations qualifying for reservable contracts by requiring only the area of operation in relation to the reservable contract to be of a non-profit nature, rather than the whole organisation. As I said, the amendment would tighten the language on reservable contracts. I accept that it is a probing amendment, and I wanted to give the minister an opportunity to respond to that.

The minister’s comments on my intention to leave out the whole of section 41 were not reflective of what I was trying to do, which was to take out of the bill all the sections that are left, to start again and to deliver a better bill than currently exists. However, as we discussed last week, I will not move amendment 139, at this stage.

Amendment 139 not moved.

Section 41, as amended, agreed to.

After section 41

Amendment 55 moved—[Maree Todd]—and agreed to.

Before section 42

The amendments have been prompted by recommendations from the stage 1 report. That report says:

“Irrespective of the model of accountability, the Committee believes proposals for the creation of a National Care Service need to be accompanied by a reinforced role for the Scottish Parliament in undertaking regular, structured scrutiny of its implementation and the extent to which it is achieving its defined objectives. To support this reinforced scrutiny role, the Committee calls for the Bill to include provisions enabling the Scottish Government to keep the Scottish Parliament regularly updated on the operation of the National Care Service including, in particular, an assessment of the extent to which this is contributing to improved outcomes for those in receipt of social care.”

That is, I suggest, what the bill is all about.

Amendment 143 would place on ministers a duty to report on Frank’s law, again to improve parliamentary scrutiny of its implementation. That will help to identify any areas that need additional support for implementation to ensure that that law is in place for every person who is entitled to personal care.

On amendment 144, which would place a duty on ministers to publish a report on the equality of social care services by local authority area, the Government’s original intention behind the bill was to reduce the inequality in care services across Scotland. I am—along with everybody else, I am sure—supportive of reducing health inequalities, including those occurring in care spaces, and it is important to gather data on where services are unequal if we are to be able to know how to address that problem in the future.

It is also important to measure the bill’s impact on equality of services. Amendment 147 would, therefore, place a duty on ministers to report to Parliament outcomes that are contained in the bill. Much of the bill will have been revised at stage 2, and if it passes fully, it is important to understand what it is achieving for all those who are in need of social care and for those who work in the sector.

On amendment 157, during the evidence sessions on the bill, stakeholders were very concerned about its financial aspects, and the committee had particular concerns about the financial memorandum with regard to part 2, on health and social care information. Given the significant number of amendments and revisions that are being made to the bill, it is important that its costs be quantified. That will ensure that the Government is able to budget appropriately in the future and that the bill’s provisions are funded, unless the Government chooses otherwise.

I move amendment 143.

Given the minister’s comments, I will not move amendment 50C at this stage, but it relates to an important area that needs to be explored further.

Amendments 50C and 50D not moved.

Amendment 50, as amended, agreed to.

Amendment 138 not moved.

Section 40, as amended, agreed to.

After section 40

On amendment 139, I think that the problem is one of ambiguity and what could come off the back of it. I talked about the incompatibility with ethical commissioning and procurement and the recommendations of the Scottish Parliament’s Health, Social Care and Sport Committee. In paragraph 89 in the summary of recommendations in the stage 1 report on the bill, the committee says that there is

“an inherent contradiction between reserving the right to participate in procurement by type of organisation, and the principles of ethical commissioning.”

I understand what the minister is trying to do with the provisions, but we have to remove the ambiguity and the potential off the back of that.

I have to say that the attempt to tag on to the bill Anne’s law and rights for unpaid carers is quite disturbing. We all support Anne’s law 100 per cent—we all recognise the need for unpaid carers to have a break—but trying to force the bill through on the back of that is, frankly, disgraceful. If the public knew the way in which the bill has sometimes been dealt with, they would be up in arms. As my colleagues have said, Anne’s law and unpaid carers breaks could have been introduced in secondary legislation three and a half years ago. There is no need for the bill.

The reason why I am asking for the bill to be started again is that I do not believe that, as it is drafted, it will do what it could and should do for those whom it pretends to support.

I press amendment 123.

Amendment 146 is from a recommendation in our stage 1 report. It states:

“Irrespective of the model of accountability, the Committee believes proposals for the creation of a National Care Service need to be accompanied by a reinforced role for the Scottish Parliament in undertaking regular, structured scrutiny of its implementation and the extent to which it is achieving its defined objectives. To support this reinforced scrutiny role, the Committee calls for the Bill to include provisions enabling the Scottish Government to keep the Scottish Parliament regularly updated on the operation of the National Care Service including, in particular, an assessment of the extent to which this is contributing to improved outcomes for those in receipt of social care.”

Despite its intention, there are real concerns among stakeholders about section 41. Amendment 146 seeks to assure those stakeholders that the guidelines will be reviewed. That will help Parliament to understand the impact of ethical commissioning and interactions with other procurement contracts, if any.

I listened to the minister with a degree of frustration as she contradicted the Scottish Government’s intention and what her own cabinet secretary said. Listening to Sandesh Gulhane, who spoke from the perspective of a healthcare professional, it was clear how unbelievably important it is to have such a platform. I repeat that, in 2018, the Scottish Government produced Scotland’s digital health and care strategy, which drew on the Health and Sport Committee’s report on technology and innovation in healthcare and social care, in which the committee agreed that data sharing through a single platform that connects the other systems is the best way forward.

I should point out that the amendments that have been lodged reflect committee recommendations that were made at stage 1. On lived experience, I should say to the minister that I spoke with the Scottish Independent Advocacy Alliance to make sure that the wording that I used for amendment 91 fits with what it would want.

I am minded to press amendment 91, although, as I said at the start, I am perfectly prepared to work with other members to tighten the definition of “advocacy” to ensure that it is fully independent.