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As I have said, we intend to establish local care boards and the co-design and delivery of those care boards will be worked on with the voices of lived experience, front-line staff and stakeholders in order to get it right.

There is a huge amount of learning to be garnered from what has happened in health and social care partnerships. Mr O’Kane represented East Renfrewshire Council on the health and social care partnership that achieved a great deal. I come back to the point that I made earlier about areas where more services have been devolved as seeming to work better. I want to ensure that the learning and good practice from health and social care partnerships, such as the one in East Renfrewshire, are captured in delivery of our future services. I also want to look at those places where that is not working so well and learn lessons from that, too.

That is a huge question, which might take a long time to answer. I will be as brief as I can, and I will fill in some of the other detail in writing to the committee.

With regard to the care boards themselves and the design work regarding who is around the table and all the rest, that is, as I have already said this morning, part of the co-design process.

It has been thrown at me that the bill itself means that I or my successors could appoint and discard care board members at will. That is not the case—many of the powers that we are talking about in the bill are for NHS boards, and such powers are used extremely sparingly indeed.

However, I probably need to tease out even more detail on that area for the committee, so if the convener agrees, I will follow up on that in writing. I will also provide the committee with some of the comparisons that I have made with other bodies, if that would suit you.

There might be other reasons why staff transfer to a care board. For example, it might well be that a care board puts in some specialist provision in relation to the flexibilities that it is allowed in its area, and it might want to transfer staff to fill those positions. Of course, that would still have to come with the agreement of all in that regard.

I come back to the question of why we would transfer huge swathes of staff if the current employer is a good one and is delivering good high-quality social care. I have made no bones about that point during the course of these discussions. There are folk out there who continue to say that I want to grab and transfer 74,000 people to the national care service as part of a bit of empire building. That is not the case. I hope that local authorities across the country will continue to be good prime delivery partners that serve people in their communities. That is the ambition.

As I have said at other committees, alongside the draft bill, there is a suite of documents, which includes the policy memorandum. Paragraph 48 of the policy memorandum spells all of that out. I direct the committee to that paragraph and suggest that it looks at it in depth. I also ask others to look not only at the draft bill but at the policy memorandum and the rest of the suite of documents that we have published.

Beyond that, in respect of all of those issues, I continue to, and will always, listen to what folks have to say. I want to allay fears and concerns. I want to ensure that people are enthused by what we are trying to achieve here. The key thing for me—I declare an interest as a trade unionist and a member of Unison—is that I want to ensure that we have a workforce that is bolstered by fair work and that has ethical procurement guarding its back in terms of fair work and pay and conditions.

Structural change is important but it is not the be-all and end-all of what we aim to achieve here. We have to make sure that we have a service that works for people. There are quite a few arguments about structural change out there, but the focus of all that we do here has to be on people.

The committee will have heard some of the comments that I have made to the other committees that I have appeared in front of about the purpose of care boards, some of which I will go over again. I think that I spoke about some of that in an earlier answer to Emma Harper.

The national care service will balance the need for local flexibility by having the care boards plan and commission care while providing national consistency through ministers being ultimately accountable. Although local boards will have their own budgets and staff, they will be directly accountable to Scottish ministers. That will ensure that the standards that we have talked about are maintained across the country so that high quality services are in place that reflect local circumstances as they are delivered.

I have had lots of questions, and I am sure that Mr O’Kane will follow up on some on them, about the number and composition of care boards, and so on, so I will go through some of that just now.

Care board membership will be examined in detail as part of the co-design process, as will the number of care boards. Based on consultation responses, we are looking at how membership will include people with lived experience. The one point that I am adamant about, as I said earlier, is that lived experience is at the very heart of decision-making. For some folk, that has been controversial. Some people have suggested to me that folks with lived experience on care boards will have vested interests so they should not be there. The same argument is often used for local authority members and various other things, and we declare interests and sometimes leave if we have an interest. I do not see that as a problem.

Through the co-design, we will also consider how we might include carers, other professionals and service providers, and local authority elected members in local care boards. We are committed to ensuring that all who are on care boards will have full voting rights.

The other aspect might be the number of care boards. That is another matter for co-design. However, we need to be honest here. I have heard it suggested that there should be 250 local care boards. I do not think that that is possible, and we have to be honest about some of the parameters in the co-design.

On the last point in your question—the independence of this one, that one and the other—we will have to work some of those questions through. It has to be part of the co-design process. We have to consider the accountability aspects, too.

Some of that will be worked through in the co-design but we hope that we will have a skeleton—a draft—of it all by next summer. That is ambitious but I am sure that, with the co-operation of the folk who are helping us to develop the service, it is achievable.

I outlined some of the main areas that we need to consider in the co-design. I will repeat some of them, although I will not go into all the detail that I did earlier.

We continue to speak to and, more importantly, to listen to everyone. This morning, I have given Ms Harper an outline of how the collaborative design will work. I realise that that was a fairly lengthy comment, so I will not repeat it.

We will send the committee a letter on all of that, so that you know exactly what was said this morning. I will also outline the on-going work that my officials and I, alongside others, are doing in that area. I am more than happy to write to the committee to outline who we have been speaking to, who we will be listening to, the meetings that we have had, and who has applied to join the stakeholder groups. I am willing to share all that information and to be open and transparent about it. I will set out all that in writing if that is what the committee wishes.

We will set out all of that in a letter to the committee. Obviously, as part of the co-design, there will be discussion about the end product, too.

That is an extremely important question, which comes to the crunch around prevention, rather than crisis—which I talked about earlier with Ms Mackay. In some areas, freedom and autonomy are already being given to front-line staff, who are the folk who recognise whether Mrs Smith is becoming frailer or is improving.

In my home city of Aberdeen, the front-line staff at the Granite Care Consortium have the ability to step up and step down care. Obviously, that must be done in consultation with the person receiving care and support and their family, and there is of course more stepping up of care than stepping down, but the ability of the staff to do that puts the person front and centre.

Beyond that, the best way to stop delayed discharge, for instance, is to prevent folk from going in the front door of a hospital in the first place. By stepping up Mrs Smith’s care, are we saving a journey to accident and emergency and perhaps a lengthy stay in hospital? I reckon that we are doing that in a lot of cases.

We need to change that situation with autonomy, freedom and independence for front-line staff, which largely do not exist in many places, because of contracts. We are trying to change that in the here and now. I do not want to wait for the NCS if we can get some flexibility in that regard in the here and now, which would be brilliant. That would be good not only for health and social care partnerships and local authorities; it would be very good for people.

We will continue to try to persuade and give comfort to local authorities and health and social care partnerships on the matter of trying to change contracts at this point. That is clearly working in Aberdeen. Changes have been implemented in Fife, too, which I think are benefiting people there. We need to see more of that, and I want to see more of it before the NCS, although the NCS gives us that complete opportunity with ethical procurement.