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Absolutely, Mr Coffey. I have spent a huge chunk of the past 18 months listening to people and what they want to be changed. Some of the stories that I and my officials have heard are particularly galling; we have heard about problems that have reached crisis point because people have not been listened to at the right time, which is wrong. That is my point about the implementation gaps that have developed when changes have taken place previously. If there is one thing that I am absolutely adamant about, it is that we do as much as possible to get rid of those implementation gaps, because we cannot afford the amount of money that we are spending on crisis and we cannot afford the human cost of not getting it right earlier. That is why national high-quality standards are so important in all this.

We will continue to have local accountability, local flexibility and local design of services, but that must match up to national high-quality standards. We cannot afford postcode lotteries. Mr Coffey represents East Ayrshire where care delivery is very good, but I want everyone across the country to be able to expect that level of service and beyond. There are worries in certain quarters that, in all that we are doing, there might be a move backwards in certain places. That will not be the case. We must drive up the quality standard of care delivery right across the board.

The national high-quality standards will go a long way in reaching consistency. Beyond that, we have other pieces of work going on with voices of lived experience and stakeholders around and about the charter of rights and responsibilities. It is some of the earliest co-design work that we are doing; I was involved in discussions on that last week that, for me, were very exciting.

We must ensure that we get the right design and that we monitor as we build on the principles of the bill, ensuring that we get the secondary legislation right and removing the implementation gaps that have existed before.

Most important in all this is that, in order to change the culture that exists in certain places, we have to continue to listen to the voices of lived experience and to listen to and trust front-line staff, because a lot of what has gone on over recent years has eroded the autonomy, independence and flexibility that front-line staff have in certain places. When front-line staff have greater freedom, autonomy and flexibility, there is usually better service delivery for people. People have to be at the very heart of all this. Even once the bill is passed and the secondary legislation and regulations are in place after co-design, we must continue to listen all the way through so that we continuously improve.

Anne’s law is on the face of the bill and in primary legislation. Can I lay out the way in which this occurred? The consultation was published in August 2021, as I am sure the committee will recognise. That set out the proposals for change. The responses to the consultation supported change and a huge range of views were in favour of co-design principles. That allows us to work through all the matters that are important to people out there.

One of the key things that I should highlight to the committee is that, in the past, people have not been at the heart of the changes that we have made. That has created implementation gaps, and that is not good for anyone. It is not good for front-line staff and it is certainly not good for those folk who require care and support, or for their carers or their families.

This is the right thing to do. We never achieve perfection, but the way in which we are shaping this, with people at the heart of it, is the right thing to do. Again, I highlight the fact that, in terms of the co-design and the secondary legislation, we will consult all the way through in order to get this right. If we find that there are flaws in what we come up with in the secondary legislation, the fact that it is in secondary legislation makes it much easier to adapt. Some of the key frustrations that are out there are around about where the Parliament has set good legislation with good intention but there has been an implementation gap.

You may well seek an example, so I will give you one. The Social Care (Self-directed Support) (Scotland) Act 2013 is a good piece of legislation, which we will build on in the work that we are doing here, but some folk have used some aspects of that primary legislation to find loopholes in order not to deliver as per the spirit of the act. We need to change that, but it is not so easy to change something over a short period of time when it is set in stone in primary legislation. It is much easier to do that in secondary legislation. That is what the voices of lived experience want to see, rather than sometimes being stuck in a cul de sac in which the spirit of legislation is not being lived up to.

This has to be part of the co-design process. What we have ensure is that, if there is a need to be provider of last resort, we have the ability to transfer staff and assets. That may not necessarily be from local authorities, but the committee will understand the need for a local care board to be able to deal with emergency situations. I have explained the reasoning why that is in play in the bill. We can spell out that reasoning in more detail. We have to do it in order to protect people who may face difficult situations. This talk that we have already decided to transfer staff and assets wholesale is not the case.

Let me spell this out. I have not suggested that anyone’s employer will be a local care board.

I said last week that I do not want to pause the bill: we need to move forward. People who are in receipt of care and support—carers and the voices of lived experience—want us to move more swiftly than we are moving on all this. Many of them would say that they want change yesterday; I understand that strength of feeling.

On amendments, Parliament decides on amendments and, obviously, the Government will lodge amendments as and when necessary.

The key element that some people do not like relates to co-design. In order for us to get it right we need the voices of lived experience at the table with others. Mr Briggs mentioned my experience as a minister, when I have brought together as many people as possible to reach consensus. With changes to homelessness regulation, we managed to do the good work that we achieved because we had the voices of lived experience at the very heart of the process. I want to ensure that those voices are heard and that co-design is truly co-design. Obviously, parameters have to be set; people are realistic about these things. However, I want all stakeholders and the voices of lived experience to be involved, then we will end up with the best possible service.

I do not want a situation in which people are painting themselves into corners by saying that they are not going to play a part in the co-design process. That looks particularly bad for the folks who have experience of care; it looks to them as though, once again, certain sectors are not listening and are not willing to listen to their views.

Good morning to you, convener, and to the committee, and thank you for having me along to give evidence on the National Care Service (Scotland) Bill. It is fair to say that the national care service is one of the most ambitious reforms of public services since the creation of the NHS. It will end the postcode lottery of care provision across 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.

The bill sets out a framework for the changes that we want to make and allows scope for further decisions to be made as it progresses through Parliament towards becoming legislation. That flexibility will enable the national care service to develop, adapt and respond to specific circumstances over time.

I want to take time to reflect on why change of such scale is necessary. Scotland’s community health and social care system has seen significant incremental change over the past 20 years. Despite that, people with experience of receiving care support, and of providing it, have been clear that some significant issues remain. Those were detailed in the 2021 independent review of adult social care services, which set out a compelling case for change, including recommending reform of social care in Scotland and strengthening national accountability.

We are not just changing to address the challenges of today; we must ensure that we build a public service that is fit for tomorrow. Today, about one in 25 people receives social care, social work or occupational health support in Scotland, and demand is forecast to grow. The NCS must be developed to take account of our future needs. We will build a system that is sustainable and future proofed to take account of the changing needs of our population. I believe that the principles for an NCS, as set out in the bill, support that aim.

This is not about nationalisation of services. The bill sets out that, at national level, the functions are focused on consistency through national oversight. Services will continue to be designed and delivered locally. That is the right approach, to support delivery with and for our communities and the people whom those services serve. Local government will be an important partner as we design the detail.

We are conscious of the importance of the role that housing plays in supporting independent living. We will look at how services such as housing support, adaptations and technology contribute to the principles that are set out in the bill. Of course, those services should deliver increased early intervention that prevents or delays the need for crisis care. It is for that reason that we recognise how valuable the interfaces between housing and homelessness services with the NCS will be. We want everyone in Scotland to have choice, dignity and freedom to access suitable homes that are built or adapted to support their needs. We are embedding a person-centred approach that will align the NCS with housing and health services.

The NCS will bring changes that will benefit the workforce, too. The importance of staff in the social care sector has never been clearer, and we are fully committed to improving their experience, because we recognise and value the work that they do. The NCS will ensure enhanced pay and conditions for workers and will act as an exemplar in its approach to fair work. Our co-design process will ensure that the NCS is built with the people whom it serves, and those who deliver it, at its very heart. We are committed to working with people with first-hand experience of accessing and delivering community health 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. Of course, convener, the service must have human rights at its very centre.

As many committee members will know, I have a background in local government—I served for 13 years on Aberdeen City Council—and I recognise the importance of local government and local democracy. As we move forward with the national care service, local government will still play a major part in the delivery of services, if it chooses to do so. It is extremely important to set that out.

We have also said—I reiterated this at the Finance and Public Administration Committee last week—that, with the changes that we propose, we aim to create a cost-neutral position for local government as we move forward. However, it is clear to us from the feedback in the consultation, and it was absolutely apparent in the responses to the Feeley review, that people want to see a change in accountability for how care is delivered in Scotland. Disabled persons organisations, individuals and other groups feel that accountability is lacking at the moment. When I took up this post, I was surprised to find how important accountability is for people. At the moment, there is no national accountability to Scottish ministers. We aim to change that and to make local accountability more important.

One issue is that people often feel that they are pushed from pillar to post—the committee may have heard that but, if not, I appeal to you to go and speak to those who are receiving care and support at the moment. People go to a health and social care partnership with a complaint about the care that they are receiving and will be told, “That’s not our responsibility—it’s the local authority’s responsibility,” or that it is the NHS’s responsibility. Therefore, accountability is extremely important for the many people whom we have talked to and, more importantly, listened to. It was also raised as being an extremely important issue in the evidence that Derek Feeley took. That is why his recommendations moved us towards introducing the national care service.

Since the beginning of this parliamentary session, we have put a number of things in place in order that we can listen to the views of people, including the social covenant steering group. Some folk think that a framework bill is somewhat unusual, but a framework and enabling bill is exactly the way in which the NHS was established.

In listening to people—those from the social covenant steering group, in particular, but also other stakeholders—it became very apparent to us that people wanted to be involved in the co-design process all the way through, and that is why we decided on a framework and enabling bill, as was done with the NHS, to allow folk the opportunity as we move forward to co-design all the elements that slot into that framework bill. It is very important, particularly for those folks—the voices of lived experience—that we have done it in that way.

I know—I heard it at the Finance and Public Administration Committee last week—that some folk have asked why we did not do it the other way round, but it is difficult to design something without the framework of primary legislation in place. That is why we have done it in that way.

I think that I should say exactly what I said at the FPA Committee. There has been a concentration on some aspects of what we are trying to do here and not on others. I said to the FPA Committee last week that what people need to do is to look at the suite of documents that we have produced—not just the bill and the financial memorandum but the policy memorandum and the other documents that were produced. That gives us a very clear idea of what we are aiming to achieve here.

Some people want answers to all of the questions now. However, if I was to answer all the questions now, giving my opinions, that would blow the entire concept of co-design out of the water. What I want is for stakeholders and the voices of lived experience to be at the table to help us to co-design the service.

As you can imagine, I have been watching the evidence sessions not only of this committee but of others too. Many of the witnesses have vested interests in terms of where power, accountability and resource lie at the moment. What would be good to see is a committee taking evidence from those folks who are receiving care and support, their carers and families and front-line staff.

I have spent the past 18 months or so listening to people about their experiences, and where they think we have done well and where we have gone wrong over the past two or three decades in terms of changes to care support. It is a duty on all of us not only to listen to those folks who have a vested interest—there is no doubt that they are important stakeholders—but to listen to people. That is why so much emphasis of the work that we have put in is not only to listen to COSLA, SOLACE, the Chartered Institute of Public Finance and Accountancy and others but to go and hear the views of people. That is why we have had numerous events not only during the course of the consultation but since. That is why we had the national care service forum in Perth the other week, which was extremely well attended.

I ask the committee to look at the responses that came out during the course of that national care service forum. I also appeal to you to listen to and hear from witnesses from disabled people’s organisations, from third sector groups, such as Enable, and from people themselves about their experiences. You will then garner the reasoning why co-design is so important in order to get rid of the implementation gaps that have existed in previous changes that have been made.