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Let us take, for example, a call that I had yesterday with disabled people’s organisations, folks from the independent living movement and folks with lived experience of disability.

Although a lot of the conversation yesterday was about the national care service and how we move forward on that, folk also talked about the here and now, because that is relevant to them. A large part of yesterday’s discussion was not about the national care service per se; a lot of folk were discussing the difficulties that people in certain parts of Scotland have in accessing self-directed support. The committee knows that there is a bit of a postcode lottery with that at the moment. In some parts of Scotland, the options that are available to people are restricted, which does not really conform to the Social Care (Self-directed Support) (Scotland) Act 2013 itself or to the spirit of the act.

At the moment, we are reviewing the guidance on self-directed support to make it easier and more understandable for people to access what is their right. That is one example from yesterday that is not focused on the national care service and is focused on the here and now. As the committee is aware, we are reviewing the guidance in order to improve the law for people.

I touched on that earlier. It is absolutely right that folk take opportunities to move on if they are getting better terms and conditions. A lot of folk in the social care profession may be moving on after a period of time—staying within the social care profession but with better terms and conditions. Those employers whose conditions are not the best at the moment should be considering that because, every time they lose a member of staff, it is costing them—in recruitment costs and many other costs. It would be in their interest to act now to improve their pay and conditions.

I cannot remember off the top of my head what the number was, but the Coalition of Care and Support Providers in Scotland did a calculation not long ago of the cost of constant recruitment. We can provide the committee with that figure, I hope, but it was not insubstantial. Rather than constantly forking out money on recruitment, it may be best for some employers to invest and put in money to improve pay and conditions. Then they may be able to retain a lot more of their staff.

I will make this caveat a few times: I should once again say that there are employers out there who pay their staff well and have good conditions, and they are retaining their people.

We asked a number of questions in the consultation in order to get the views of stakeholders, including the BMA, and folks with lived experience. No decision has been taken on that move.

Commissioning is an aspect in which, I think it would be fair to say, there are vast differences—let us put it that way. Mr Torrance will be well aware, not only as an MSP but as a former local authority member, that commissioning arrangements can be vastly different in different parts of the country. We need to make changes there as we move forward. I have put great stock in ethical commissioning. That is extremely important. We have tried to provide some comfort to local authorities around changing their commissioning at the moment and I hope that we can make more progress on that front.

Let us look at what the independent review of adult social care said about current commissioning arrangements, because what we are trying to achieve is to begin to look at its recommendations and implement some of those.

I talked about trying to give comfort at the moment. On 6 December last year, the Government issued a Scottish procurement policy note, which was co-designed with key stakeholders, to advise public bodies that are involved in the commissioning and procurement of social care services of the action that they can take here and now to improve their commissioning practice. It is clear to the Government that, by taking action now to embed ethical commissioning and procurement principles, we can help public bodies and providers to fully engage in the new and changing responsibilities that will come with a national care service.

The procurement policy note includes advice on how to use resources well and how to extend or modify contract terms to support the transition arrangements, and it asks that, where a new procurement is required for community health and social care services, efforts are made to embed the ethical commissioning and procurement principles that I think we all want to see as we move forward.

Crises cost a lot of money, and there is also the human cost of not dealing with things early. The move to the preventative approach will save a lot of money that can be reinvested as well as stop some of the human costs of not getting this right. We know, because we have heard it from people themselves, that, where the focus has been on prevention, it has been much better for people and over the piece is much less costly for the public purse. It is very difficult for me to relay these things, because there is always the danger of identifying people, but I have heard stories of folks moving from almost constant crisis to a situation in which self-directed support has worked for them and crisis is now very rare. That is what makes the odds for folks, and it is less costly.

As we move forward, we have to analyse what is happening, and we will carry out tests of change to see what the financial impacts of these changes are. However, having listened to the stories of people’s day-to-day lives, I think it is beyond doubt that the move to prevention lessens the difficulties that they face, stops some of the horror stories that we have all heard about happening and is much less costly than crisis intervention, which costs a lot.

There are always challenges in retaining some folk. The Government places great importance on its relationship with senior health and social care leaders. My officials regularly meet integration joint boards’ chief officers, and I have been meeting chief officers almost monthly since I took office. Those meetings cover a wide range of topics, including leadership development and barriers to integration.

Officials recently met the executive group of chief officers to discuss what more support might be required—whether that is more capacity to provide peer support in learning, coaching and mentoring for individuals, or more structured programmes of support. We have also discussed engagement with wider staff groups to encourage participation in local and national strategic activity, with succession planning in mind.

The meetings that we have with chief officers also give them the ability to articulate what they are doing well and where they are having difficulties. There is also peer support, which is extremely important. At some points in the pandemic, folk felt that there was not enough time for that. All those things will be important as we move forward.

My role in all that is to listen to what is being said by chief officers about what barriers exist for them, and to see whether we can get rid of them. It is also to provide a forum to bring folk together for the support that is required.

There is absolutely no doubt that resilience is a part of that. However, much of the focus in discussions has been on how we have all supported one another during what have been very difficult and stressful times for many of us. There have been lots of discussions around the mental wellbeing hub support that we have put in place, for example. Local examples of good practice in mental wellbeing support have been talked about in the national group and folk have implemented them in their areas.

Coming together to talk about such things can be not only good for learning but can be quite cathartic, because at points during the past period, many of us have felt a little bit alone. When we talk to others about what is happening to us, we find that people have been in similar positions. How do we help one another through all that?

We have given a really good outline of what we want to do. You ask about defining benefits. Whose benefits are we defining? There are benefits for the public service itself, and for people using it—the list goes on. We must continue to work on defining what the benefits are. We will continue analysing all of that.

I go back to the report by the Christie commission: the key thing is to look at a joined-up approach and to get rid of the silos that still, unfortunately, exist. No matter what is in, or out, of the national care service, making the transition phases much better for people will be a major benefit. Without doubt, there will be a huge amount that will benefit people and the public sector as a whole. We will continue to work on all of that, and I am sure that Mr O’Kane will continue to scrutinise whether those benefits become a reality. I am hopeful that we will make real change, particularly for the good of folks.

Absolutely. A lot of the questions in the consultation came from suggestions and views from the voices of lived experience. We ask some difficult questions; that is how consultations work. The question about the GP contract came directly from the recommendation from Derek Feeley’s independent review. If we had not asked that question, people would have said that we had ignored a Feeley recommendation.

Mr O’Kane talks about the complexity of the consultation; other folk said that it was not complex enough. I recognise that folks always want more detail but, at the same time, in the areas where there was more detail in the consultation, some folks said, “Oh well, you’ve already made up your mind on that issue.” Sometimes, ye canna win in these regards. However, folk recognise where the Government is going with all of this—most stakeholders recognise that the consultation is only one part of the process. We will continue to discuss where we need to go with stakeholders and listen to the voices of lived experience, and that will include discussion of the benefits.

I am absolutely convinced that the service will be beneficial for all. We need to grasp the opportunity to get it right and ensure that we are doing the right thing in shaping the future of social care in Scotland.