Seòmar agus comataidhean

At the moment, national sectoral bargaining is nigh on impossible, because of the current set-up. As I said, dealing with 1,200 disparate employers is difficult.

As the committee knows, in the past year the Government has increased pay twice for adult social care workers, but it has not been easy to get that money into the pockets and purses of folks on the front line. Through the national care service, we want to make improvements to terms and conditions, as I have stated many times this morning. That will include improvements through national sectoral bargaining.

Our work on introducing sectoral bargaining is progressing ahead of the national care service, in line with the recommendations of the fair work convention. In August, Government officials held, with key members of the fair work in social care implementation group, a session to start the initial exploratory work on sectoral bargaining. That meeting was, of course, also attended by COSLA and by trade union and provider representatives. Regular meetings with those key stakeholders are now taking place to move that work forward and to establish a set of recommendations.

It would be fair to say that I have spoken with and listened to a number of trade union colleagues over the piece; I will continue to do so. I have had a number of meetings with the GMB. The last big meeting that I had with trade unions was in the company of the First Minister and Mr Lochhead to talk about trade union issues across the piece. Obviously, the national care service played a major part in those discussions. We will continue to listen to trade unionists as we move forward, and we will continue to try to make improvements in the here and now through our fair work in social care implementation group.

That is a big question—a big set of questions. I should probably start at the very beginning, because the national care service consultation demonstrated without a doubt that there is strong support for a national care service charter of rights and responsibilities, so that people know what to expect. Therefore, we have commenced the work of developing that charter.

The design and development of the charter will set out the rights and responsibilities of people accessing national care service support, information on the national care service complaints and redress system, which will provide recourse if the charter rights are breached, and information about how to access further information, advice and advocacy services.

The charter will support people who are accessing NCS services to better hold the system to account and to receive the services that they need in order to thrive, rather than just survive.

One thing that has been at the fore of discussions that I have had with folk with lived experience is the many people who have had poor service—who have not been cared for in the right way—and who have then found it very difficult to get that sorted.

I often hear the same tale and have said that, if I had £1 for every time that I heard it, I could probably go on a round-the-world cruise, although that is not something that I really want to do in a pandemic. I have heard folk say that they complained about something and were told by the health and social care partnership that it was not its responsibility but that of the local authority or the health board. It goes on and on. That is not good enough. In the work that we have done, we have also come across numerous situations in which there were arguments between the health and social care partnership, the local authority and the health board about who pays for something and the person did not get the care for a long time, which leads to some real difficulties.

We have to get the rights and responsibilities right. I want people to be empowered and, as I hinted earlier, I was at one of the first co-design sessions on the charter of rights and responsibilities to hear what folk had to say. There are some polarised views that we will have to work our way through, but we have to get it right for people.

That is not the case. I do not know what has been said, so if I could get any quotations on that, we will have a look at them and respond accordingly.

No financial commitments are being directly made through the financial memorandum. The process of co-design will continue, and detailed work on the preferred options will be done through our business case process before spend is committed to.

Again, a number of things have been said about the financial memorandum that are not quite correct. For example, it is clear in the financial memorandum that more than 40 per cent of the projected costs relate to improved pay and terms and conditions for front-line social care workers, and not to bureaucracy costs. The estimated costs in the financial memorandum largely represent investments in service improvements and terms and conditions for front-line staff. Any suggestions that the figures relate exclusively to administration or bureaucracy costs are totally false.

Additionally, investment in areas such as support services will directly improve areas such as data analysis, planning and reporting, which will allow us to better understand outcomes and tailor future investment in order to have the biggest impact on our citizens.

The Scottish Government has said that we will increase social care spend by 25 per cent—some £840 million—by the end of this parliamentary session. That is in our manifesto, and we shall do it.

However, I recognise that there have been criticisms of the financial memorandum, which was produced before the current financial and economic crisis. We will consider what has been put to us and come back with an enhanced financial memorandum. However, not all social care spend that is going on now and will continue to go on is covered by the financial memorandum, which covers bill aspects only.

We have had a fair amount of discussion already this morning about implementation gaps and the postcode lottery, as well as about the fact that folk often feel that their complaints and concerns are not properly addressed. There are three things to take from that. We want to ensure that the implementation gaps are plugged and that we end postcode lotteries. It is galling for some folks to see people who live not far from them getting better services for their condition. The national high-quality standards will be important in ensuring that we end the postcode lottery. We also need to garner knowledge from people to help us to fill implementation gaps.

Preventative approaches must be at the heart of all that we do. We talk a lot about person-centred care; lots of folk get person-centred care, but we need it to apply to everyone. That is why getting it right for everyone is also at the heart of all this. Crisis costs a lot of money, so it would be much better for the public purse, and in terms of the human cost when we get it wrong, to move to there being more prevention, rather than dealing with crises.

Ethical procurement and fair work are important to delivery. We need to ensure that we improve recruitment and retention, which we know are problems. More than that, as I said in an earlier answer, we need to attract new folk to the profession; we need to attract young people into this vital work. To do that, we must show folks that they are valued—not just in terms of pay and conditions, but in terms of career progression. At the moment, we have 1,200 employers; it is often difficult to deal with that many. However, ethical procurement and fair work being at the heart of every single contract will mean that we can do much better.

The National Care Service (Scotland) Bill will allow the Scottish ministers to exercise powers, under section 78 of the Public Services Reform (Scotland) Act 2010, to require care home service providers to comply with any directions that are issued by ministers.

The key issues that you have talked about as having been raised by stakeholders are that our proposed approach to delivering Anne’s law through such directions does not go far enough and that Anne’s law should be extended beyond adult care homes to cover additional settings. We have talked to others about that, and there is dubiety about it.

Stakeholders have also talked about the importance that is placed on local decision making and, understandably, the importance of human rights and a person-centred approach. In the recent parliamentary consultation, some respondents indicated concern about whether our approach of using directions is the right one. It is absolutely the right approach.

The most challenging issue has been in how to balance the use of the directions with the views of some—in the main, Public Health Scotland—who endorse the occasional need for restrictions on health grounds. Although the directions envisage continuous visiting during outbreaks, we expect that formal advice from Public Health Scotland will highlight that that is a risk to outbreak management. At the moment, therefore, a piece of additional work is looking at every aspect of that. However, as a minister, I want to ensure that people have access to their loved ones. There will have to be a balance, but that is my expectation.

Rightly, people will always be concerned. At the back of their minds, they will be thinking about what went on during that Covid period. We do not want that to happen again. That is why we are doing all the work that we can to ensure that we get this right for relatives, families and loved ones.

Absolutely. The Care Inspectorate should be their first port of call. Actually, the care home should be their first port of call. They should ask why a change to access has been made and why they are being denied access. If they do not get the right answer or they do not get access, they should go to the Care Inspectorate. The number of complaints has gone down dramatically, but we will provide you with information for your reassurance.

That would be the case if there was service failure. Let me give you an example of a provider of last resort scenario.

It might well be that a care home in a particular place collapses because the company goes out of business. In some circumstances, the local authority might, as the provider of last resort, move in and take the home over to ensure continuity of care for people. Unfortunately, such things happen fairly regularly—not only with care homes, but with care-at-home provision and so on.

Ms Callaghan is, I think, enticing me to be naughty, which I am not going to be. I am not going to name things that are necessarily good or things that are necessarily bad.

It is clear that areas where there is increased delegation to IJBs and to health and social care partnerships, and where there are budget flexibilities, tend to perform better.

However, there are other aspects to consider, such as the scrutiny agenda. I do not know how many members around the table are as anorakish as I am, but at times I have gone out of my way to dig a little bit deeper, which I am always prone to doing. When I look at some IJB agendas and minutes, I can see quite clearly that they are taking their scrutiny responsibilities very seriously and are making key decisions.

Frustratingly, however, the other side of the coin is that in some IJBs, often agenda items that are pretty serious are for noting only, and it disna look like there is the level of scrutiny or decision making that there should be. Members do not need to take my word for that—they can go and look at the documents themselves. We need to get to a position in which local care boards are scrutinising and taking decisions, and being accountable to the populace as a whole for those decisions.

I have heard the suggestion about a national care board, but I am not entirely convinced. It might just become another bureaucratic layer, and I am not one for bureaucracy, as the committee well knows. Nevertheless, my ears are still open on that one.

For transparency, in the letter that I write to the committee, I will give full details of everything that I have outlined already, and I will also outline how we are running public workshops on co-design—information on that is available on the Scottish Government website. There are two registers promoting this heavily, as I have outlined already. All registrants will have detailed training around co-design.

I am more than willing to be as open and transparent as possible. I know that co-design is new for many folk. Some folk see it as being very brave; I see it as being necessary in terms of our getting it right. In our letter to the committee, we will outline all that we are doing.