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Official Report: search what was said in Parliament

The Official Report is a written record of public meetings of the Parliament and committees.  

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Dates of parliamentary sessions
  1. Session 1: 12 May 1999 to 31 March 2003
  2. Session 2: 7 May 2003 to 2 April 2007
  3. Session 3: 9 May 2007 to 22 March 2011
  4. Session 4: 11 May 2011 to 23 March 2016
  5. Session 5: 12 May 2016 to 5 May 2021
  6. Current session: 12 May 2021 to 5 August 2025
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Displaying 1072 contributions

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Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Paul O'Kane

I want to turn to some of the financial implications and the financial memorandum. Last week, we heard from Cathie Russell from Care Home Relatives Scotland and the social covenant steering group, who said:

“What worries me, to some extent, is that we hear figures such as the £500 million cost of the new structure—Audit Scotland thinks that it could be more than £1 billion—but we will not get one extra hour of care for that. None of that will be spent on the front line.”—[Official Report, Health, Social Care and Sport Committee, 13 December 2022; c 38.]

Can the minister explain why existing Government commitments on the reform of social care as listed in the financial memorandum were not included in the bill? Can you give an update on any progress that there has been on fulfilling those commitments?

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Paul O'Kane

The minister will hear no complaints from me if he is singing the praises of East Renfrewshire. He makes a fair point about the length of time for which integration has been part of the fabric of certain communities and the importance of trying to learn from that.

I turn briefly to the social work element of that, and the further consultation that the minister intends to undertake on children’s services and criminal justice social work. What are the minister’s intended timescales for that?

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Paul O'Kane

What was your rationale for giving a promise of co-design after the bill is passed rather than doing that during the preparation of the bill? Is it your view that co-design after the fact is better than co-design before legislation, and who decided that the bill should proceed in that manner?

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Paul O'Kane

Okay. That might be comparing apples to oranges.

I will move on slightly, and quote some of the evidence that we have heard. The minister said that he feels that he has adopted a logical process, but we heard the following:

“at the moment, it feels as though it is a one-size-fits-all system, and I do not think that that will work”.—[Official Report, Health, Social Care and Sport Committee, 25 October 2022; c 38.]

We heard that

“So much is left to secondary legislation and co-design that we do not feel that we have the detail ... to be able to comment”,

and that

“We are talking about a substantial bill on a national care service that has been introduced without clear detail”.—[Official Report, Health, Social Care and Sport Committee, 1 November 2022; c 2, 23.]

We heard that

“this bill does not deliver the changes that are required”,

and, finally, that

“It is like buying a house without ever having seen it or knowing know how many rooms it has or where it is located.”—[Official Report, Health, Social Care and Sport Committee, 15 November 2022; c 35, 39].

That was a cross-section of the evidence that we heard from legal experts, Common Weal, care providers, local authorities and trade unions. Those are very serious concerns about the way that this has been done. Would the minister like to comment on some of those quotes?

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 20 December 2022

Paul O'Kane

Does the minister not recognise that there is a principle here around decisions being taken as close to people as possible and the role of local government in doing that? He is right to say that he and I have both served on local authorities as councillors, as have other colleagues on the committee. I am keen to understand why he feels that there will be more accountability by virtue of 129 MSPs and the minister having that control as opposed to local councillors having it. Does he feel that local councillors are not accountable enough now and do not represent their constituents on these issues?

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 13 December 2022

Paul O'Kane

Good morning, panel. The first section in our briefing paper for the meeting is titled “General hopes and fears”. That is a broad theme, but I am keen to understand the concerns that people might have about how the bill has been structured and came to be.

Over our evidence sessions, we have heard significant concern about the bill being a piece of framework legislation and the detail being co-designed after the bill has been passed. I will quote Tanith Muller, chair of the Neurological Alliance of Scotland, who said:

“Scotland is being offered a new structure for care—but without blueprints, a schedule or a budget. We can’t tell if it will even stand up, much less that it will meet the care needs of people in Scotland. Ministers need to go back to the drawing board and show us all the plans that they have developed with people before they ask MSPs to legislate.”

I know that MND Scotland is a member of the Neurological Alliance, so I ask Susan Webster whether she shares some of those concerns, and to say what could have been done differently.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 13 December 2022

Paul O'Kane

Susan, you have pre-empted my next question, which is on the consensus that came out of the Feeley review. Given the nature of a condition such as MND, would you have preferred to see more action being taken more quickly on some of the issues that were raised in the review, particularly on the workforce, non-residential care charges and support for people and their families?

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 13 December 2022

Paul O'Kane

Should there have been more co-design before the bill was introduced? What co-design would you like to see included in secondary legislation?

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 13 December 2022

Paul O'Kane

My question is this: if, for example, Mr and Mrs Smith decide to make a representation to an elected member, where does that responsibility sit most effectively and appropriately? I take your point, but I wonder about that more local focus.

Convener, if I may, I would like to move on to the points that Age Scotland made in its submission about aspects of the Feeley report that the bill does not cover. Adam, you alluded to the financial memorandum not correlating with what is in the bill. Are you concerned that things are being missed because they are not in the bill? I am referring to things such as free personal nursing care rates, the removal of non-residential care charging and the terms and conditions of social care staff. Should they have been in the bill in the first place?

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 13 December 2022

Paul O'Kane

My next question, which is for Elinor Jayne, is on a broadly similar theme. Obviously, the scope of what is proposed has extended beyond what was in the Feeley report, and we have heard suggestions that elements of social work could go into the national care service. How would SHAAP feel about that, given the strong links between social work and support for those with problematic alcohol and drug use?