Seòmar agus comataidhean

Good morning, and thank you for having me along today to give evidence.

It is fair to say that the national care service is one of the most ambitious reforms of public services. It will end the postcode lottery of care provision in Scotland and ensure that those who need it have access to consistent and high-quality care and support to enable them to live a full life, wherever they are.

People with experience of receiving social care support, and providing it, have been clear that there is an urgent need for change. The bill sets out a framework for the changes that we want to make and allows scope for further decisions to be made. That flexibility will enable the NCS to develop, adapt and respond to specific circumstances over time.

The principles of any new system will be person centred, with human rights at the very heart of social work and support. No decision has been made yet on whether justice social work will be included in the national care service, but we are making provision to enable that and we are considering what the best approach would be.

I acknowledge that, unlike care, justice social work has the unique feature of being court ordered, placing requirements on those in contact with the service and adding different practical considerations. To fully support those involved in the justice system, a holistic approach that recognises the links between offending and other care and support needs is required, whether justice social work is included in the NCS or not.

The work in progress will collate evidence, work with partners to develop options for the future of justice and include a public consultation at the end of 2023, which is a result of the feedback from stakeholders in the consultation. Justice social work staff and people with lived experience will be central to our programme of work.

The NCS will bring changes that will benefit the workforce, too. The importance of staff in the social work and social care sector has never been clearer, and we are fully committed to improving their experience as we recognise and value the work that they do.

We are committed to co-designing and working with people with first-hand experience of accessing and delivering social work and social care to ensure that we have a person-centred national care service that best fits the needs of the people who will use and work in its services, with human rights at its very centre.

I recognise that, sometimes, folks are wary of change; however, others see opportunity. The Cabinet decision will be taken on the basis of evidence that is collated by the sector. I was clear at the cross-party group on social work and I will be clear with the committee today that the social work profession should be—needs to be—at the heart of shaping the future. We need to listen to the profession. That is what I have committed to doing, and it is why I have made all the appearances and visits that I have made: to listen to what folks have to say.

I do not know the history of the previous proposal, but I am quite happy to go and look at that. I might be able to fit in that reading over the Christmas and new year holidays.

I am fine.

I do not see this as centralisation, at all. Some folk around the table will already be aware of this, but I will just point out to the committee that I was the first minister to island proof a bill—the Fuel Poverty (Targets, Definition and Strategy) (Scotland) Bill—before the Islands (Scotland) Bill had been passed. In all the work that we are doing, we are taking cognisance of the different airts and pairts of our country and of how we need to get this right for everyone.

As a result, we have a separate workstream that is looking at islands and what can be done there, and we are looking at some of the suggestions that authorities have made about how they can deliver on the bill in a different way. A few months back, I was in Shetland to listen to people’s views, and I am due to go to Orkney at the beginning of the year. There have been suggestions from some island leaders—although not all, I hasten to add for the record—with regard to single-island authorities. The Government will look at that.

As for our more rural areas, particularly our remote rural areas, there is, as I have said, an opportunity to use ethical procurement to change the way in which we do things, and I hope that that opportunity will be grasped. We have to look at how we deliver across the board. I will do so, and my officials know what needs to be done in that regard.

Again, I note that we have, so that we can get this right for everyone, gone out of our way to find voices of lived experience from our remote rural and island areas, given that the difficulties that they face are often very different to those that are faced by folks in my community in Aberdeen, for example.

I have already given an assurance this morning that we are moving on many of those fronts. That is why we have the statement of intent with COSLA. There are things that I want to have been done yesterday. We will continue to try to advance on all those things. I say to Ms Mochan and others on the committee that, sometimes, such things are not so easy. I would, for example, like to see national sectoral bargaining, as is envisioned in our NCS proposals.

Whatever we invest in the national care service is for the good of people, but we know that there is work to do in the here and now. It is not all about the formulation of the national care service. That is why we are also acting in the here and now, which will also be for the good of the establishment of the NCS.

I am very pleased that the Convention of Scottish Local Authorities has now agreed, through our joint statement of intent, to support additional actions that we will jointly take over the next 12 to 18 months to bring about improvements in delivery of social care.

We have heard repeatedly from people with lived experience that the current adult social care system must change in order to drive up standards to a consistent level across our country. We need to tackle the postcode lottery of care, so a different approach is needed. We must have a system in which high-quality community health and social care support helps to create thriving communities across Scotland. That is why we have introduced the National Care Service (Scotland) Bill, which is a framework bill to support collaborative design and address the historical implementation gap that has been mentioned. The implementation gap between policy, legislative intent and service delivery must be closed. That is top of the agenda for people.

The NCS is important, but the work that is being done here and now is absolutely important, too. That is why we will work with the Convention of Scottish Local Authorities to ensure that we cover the additional actions in our newly published statement of intent.

I said at the finance committee that there also would have been detractors if we had done it the other way round. The approach that we are taking allows for the scrutiny of the principles of the bill before the co-design starts, which provides reassurance for people in the co-design process that their contributions matter.

That is a good question. I will not dodge Ms Mackay’s question, but I will start off with something that I should perhaps have said in my response to Ms Harper. Some folks have asked what co-design is. One key element is that we have a job of work to do on the introduction to co-design sessions, many of which are now complete. Those sessions demystify the process for people, and more than 200 folk have taken part in them so far. That has given them a fair grounding in the task that they are going to embark on.

Ms Mackay is right that we want to ensure that we have all the voices that we can possibly have at the co-design table, and we have gone out of our way to attract folk with various conditions from various parts of the country. We also have to take cognisance of the fact that some folks require help and support, which may mean financial support, in order to take part in the process. We will continue to listen to people and provide what support we can.

We have to ensure that we continue that listening process along the way and continue to encourage people to come forward. We also have to look at the activities around co-design, which will vary. A number of activities will be suitable to meet the needs of individuals, including one-to-one sessions, surveys and group sessions. Recruitment for the lived experience panels, for which we now have more than 400 folk, will continue throughout the development of the national care service. I said “more than 400 folk”, but I should probably say 450, because that is the latest number.

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.