Seòmar agus comataidhean

They are big questions and they are questions that have been asked of me over the piece, particularly in relation to the implementation gap.

I said in my initial statement that we have been on a 20-year journey of integration and that things have improved. However, you have—quite rightly—heard from people about implementation gaps. I have, too.

You have heard about legislation that is—let us be honest—in many cases very good legislation, but the spirit of that legislation has not been put into practice and loopholes have been found to avoid implementing it in the way that was envisaged.

Why is the national care service needed and why will it make the difference? First, national high-quality standards will come into play to end the postcode lottery. An example of good legislation in relation to which there have been implementation gaps is the Social Care (Self-directed Support) (Scotland) Act 2013. Some folk around this table—Ms Harper, in particular—have seen that at first hand with me. In the case of that legislation, members of the Scottish Parliament came together to come up with what I think is excellent legislation.

However, in many parts of Scotland, the 2013 act has not been implemented as it should have been. Over the course of the summer, I spent quite a lot of time speaking to folk about SDS, including in Dumfries with Ms Harper, and there are stark differences in relation to whether folk can access all four SDS options and in the amounts of money that is given to folk for their self-directed support. There are vast differences in the flexibilities that are, or are not, allowed. That is really frustrating, particularly for folks who know people in other parts of the country who get more from services than they do.

Those are the things that we need to change. That does not all have to wait for a national care service and the national high-quality standards. Many of you will know that, at my insistence, we recently updated the self-directed support guidance, in order that we can do better. To truly end the postcode lottery in care provision, we need to go one step further by having national high-quality standards.

The national care service will oversee the delivery of care, improve the standards, seek enhanced pay and conditions for workers—as I said earlier—and provide better support for unpaid carers. One key element of all that is that the national care service will support ethical commissioning of care. Our approach to fair work will be an exemplar.

You asked a question about detail. I, too, have had folk asking me for more detail. Some people think that I am dodging the question when they ask me for detail about a particular thing. We have said that we will co-design, with the voices of lived experience, what we do as we move forward. The voices of those who currently receive care and support, their carers and front-line staff will help us to fill implementation gaps. The service will be shaped from the bottom up, to work for all.

Support has to be delivered in a way that suits everyone. Time and again, I have heard folk say that they have never been offered self-directed support, that they have been denied that support in certain parts of the country or that the offer that has been made to them has been very limited. That is not how self-directed support was supposed to work: folks were supposed to have the opportunity, and the right, to decide on their own care, and to have the flexibility and independence to do that.

I am not saying that everything out there is bad, because it is not. We know that there is some very good practice and that some authorities are going above and beyond the call of duty to build in flexibilities and to get support right for individuals and families. I want to see that thinking being done everywhere in Scotland. That is why the national high-quality standards are so important.

We also need to look at where things do not go right so that we can see what the complaint is and what redress there can be for the individual and their family. That is why we have committed to establishing, for the national care service, a complaints and redress service that will provide a fair, effective and consistent approach to complaints and redress. We will identify opportunities to improve how complaints are handled. The issue is not just that folk are not getting access but that, when they complain, they feel that they are not listened to. We need to change that.

Convener, Ms Kynaston has just pointed something out to me, and if I do not say it, she will give me trouble. Again, I refer the committee to the policy memorandum, where paragraph 38 has a commitment to

“Improve outcomes through prevention and early intervention”.

I think that that fits in here, and the issue is also referred to in part 1 of the bill.

I do not think that Ms White has necessarily been listening to some aspects of what I have said this morning about the financial memorandum and the fact that it covers a fair amount of costs in terms of staffing and terms and conditions.

What I would say is that we need to change. Folk recognise that change is required. We cannot continue with the same system. Derek Feeley highlighted that in the independent review of adult social care. We need to plan and invest for the future so that those of us who will require care and support in the future—that is probably the bulk of us—have the right care and support in the future.

As for the analogy of using a sledgehammer to crack a nut, there are many folks out there with lived experience who would have used sledgehammers long before now. I would be very naughty if I were to repeat what someone from the social covenant steering group said but, for many folk, the sledgehammer has not come out quickly enough.

I cannot remember seeing the letter from Lauren McNamara. We will have a look at that and respond accordingly.

I have a lot of comments on that. I know that some folk out there are not even getting 45p a mile. I declare an interest, convener, because I have two nieces who work in social care, one of whom works in rural Aberdeenshire, so I know how hard those mileage costs have hit.

That is why I have written to the UK Government, not once but on several occasions, to ask it to change the rates that it sets in order that we can do better for folk out there. I have also urged the UK Government to find additional resource to deal with increased fuel costs; the UK Government is taking in much more money in fuel duty and VAT because of the increased prices, so let us use some of that money to pay better mileage rates to social care and other vital workers across the UK. Unfortunately, I have yet to hear from the UK Government on that issue. I wish that it would take cognisance of the elements that I have laid out, for the good of social care workers and other vital workers, not only here in Scotland, but right across our islands.

Ethical procurement and fair pay and conditions are at the heart of the bill. Do we aspire to do better in all of that? Absolutely, we do. We need to do this for the simple reason that if we do not, we will be unable to grow the social care profession, which has taken a huge hit in recent times. We have lost lots of people because of Brexit, and we need to replenish that staffing core. In order to attract young people to the social care profession, we will have to do much better with regard to pay and conditions and in providing career pathways, so that they see the profession as being the right one for them. That is the only way that we will make the workforce sustainable for the future.

I have no desire to take folks’ electric cars off them, to be honest with you.

There are some myths about assets and staff transfer. The bill gives the Scottish ministers powers to transfer staff from local authorities to care boards or the Government as part of the NCS, but there is no desire for wholesale transfers of staff. Many local authorities are delivering good social care services and we see local authorities as being essential delivery partners, as we move forward. However, because care boards will be the providers of last resort, the bill has to include the ability to transfer staff if a care board becomes that provider of last resort.

It is by no means a foregone conclusion that local authority staff will have to transfer their employment. The Scottish Government’s position remains that the new local care boards will work collaboratively and in partnership with local authorities, NHS boards and the third and independent sectors locally and nationally. Our intention is that local staffing decisions will be taken by local care boards as they are established.

That is where we are. I have heard rumours about 74,000 staff being transferred. That is not on our agenda.

Let me take the example that Ms Callaghan gave in relation to drugs and mental health. At points, it seems as though Angela Constance and I are joined at the hip in respect of getting it right for folks who have more than one difficulty. I have to be honest and say that services in many parts of the country are not what they should be when it comes to dual diagnosis. That is why we are already changing standards and there are several pilot projects aimed at getting that right. Those things should become the norm. That is why we need national high quality standards in order to get it right for everyone. We cannot have a situation where we are pushing folk from pillar to post. That is one of many reasons why we need to have a completely joined-up approach.

Where folk have substance use and mental health difficulties, on many occasions, we have managed to overcome those barriers for those folks through housing first. We should—and need to—do that right across the board for everyone who has that kind of situation in their lives.

It can be achieved. We are seeing changes in certain areas now in the way in which we are dealing with folk, so it can be done.

I will start off with national collective bargaining, which Mr Marra has highlighted. The social work and social care profession has had difficulties with pay and conditions for many years now, because of the disparate amount of employers in social care—there are 1,200 in Scotland—and because of the competition, even between local authorities, in trying to attract folks into social work.

Having talked and listened to younger folk in social work and social care, I can say that, although pay and conditions are extremely important—pay is way up there, without a doubt—they want more of a ladder for career progression. They do not think that is there at the moment, and it is something that I think we can build on in the national care service.

As for resourcing, there is undoubtedly a job of work to do in looking at what the co-design process will come up with and what the costings will be. As I have said, I am not here to talk about the totting up of annual budgets—that is a matter for Parliament. As we move forward with co-design and all the elements of the national care service, we will come up with the costs—and, indeed, the benefits. After all, some of the things that have been proposed or that will be proposed during the co-design phase might well have benefits as well as costs.

That work will continue. As I have said to the committee, to other committees and to Parliament as a whole, we will come back with the analysis and the business cases setting out our intentions with regard to any change that comes out of our co-design work.