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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 4 May 2021
  6. Current session: 13 May 2021 to 15 March 2026
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Displaying 1038 contributions

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Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 31 October 2023

Tess White

Wow. That is it in a nutshell.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 31 October 2023

Tess White

I can. Thank you, Dr Elder-Woodward.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 31 October 2023

Tess White

Thank you, convener. I have a question for Dave Moxham, one for Cara Stevenson and one for Lilian Macer, if I may.

Dave, you made some criticism of the sector’s current organisation. To what extent are your members confident that the National Care Service (Scotland) Bill will provide a suitable framework for a robust and sustainable social care and support service?

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 24 October 2023

Tess White

I register my interest as a fellow of the Chartered Institute of Personnel and Development.

My question is for Professor Sengupta. You said that it will be real only if we can pay for it. Most staff—76 per cent—are employed by private sector providers. The current model involves outsourcing to the third sector, and it focuses on cost and the lowest price for those providers. One of the consequences of that has been that, historically, wages have been kept low—if there is competition on price, wages are kept low. In your view, how does that conflict with fair work and ethical commissioning? Does the new model need to involve a significant change?

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 24 October 2023

Tess White

The buck has to stop somewhere.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 24 October 2023

Tess White

I will ask one final question. In relation to accountability and responsibility, if the assets, staffing and budget stay with councils, is there not a huge concern that there is a difference and that one party will be responsible and another accountable?

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 24 October 2023

Tess White

My point is that you cannot have both. Your point was that it is not real if we cannot pay for it, but the new model talks about variety and individual needs, while the one-size-fits-all approach is a low-cost model.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill: Stage 1

Meeting date: 24 October 2023

Tess White

Professor Sengupta said earlier that it will be real only if we can pay for it. We have talked about the balance between the one-size-fits-all approach and variety. The one-size-fits-all approach is a lower-cost model, but when you add variety you add complexity and cost, so you cannot have both. I realise that that is a dilemma. With the NCS, we started off talking about a one-size-fits-all approach, but we have now moved completely to a different model—I could say that it is a fudge, but we are saying that we will have variety and we will individualise, but that has a huge cost.

Health, Social Care and Sport Committee

Subordinate Legislation

Meeting date: 24 October 2023

Tess White

Thank you for coming today, minister.

Was any consideration given to other reforms? The current focus is on a disease-centred model. Did you look at preventative, instead of disease-centred, approaches?

Health, Social Care and Sport Committee

Subordinate Legislation

Meeting date: 24 October 2023

Tess White

I have a final question. What difference will the single capitation arrangement make to patient access and treatment options, and how will you assess the impact of that change?