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Official Report: search what was said in Parliament

The Official Report is a written record of public meetings of the Parliament and committees.  

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Dates of parliamentary sessions
  1. Session 1: 12 May 1999 to 31 March 2003
  2. Session 2: 7 May 2003 to 2 April 2007
  3. Session 3: 9 May 2007 to 22 March 2011
  4. Session 4: 11 May 2011 to 23 March 2016
  5. Session 5: 12 May 2016 to 5 May 2021
  6. Current session: 12 May 2021 to 25 May 2025
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Displaying 2623 contributions

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Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 25 January 2024

John Mason

Do you expect the NHS and the local council to hand over a sum of money to the local integration authority, such that the authority then has complete freedom over what it does with it, or are we expecting both the council and the NHS to take a hands-on approach, especially as to how money is spent but on other things, too? Would the national care board have any involvement in spending and so on?

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 25 January 2024

John Mason

So there will still be room for a bit of variation around the 31 integration authorities. Presumably, the way that Shetland does things and the way that Glasgow does things will always be slightly different.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 25 January 2024

John Mason

There is something that I noticed in the programme business case that I do not think we got round to discussing on Tuesday. It says:

“Another key area of benefits resulting from the NCS is the possibility of efficiency savings.”

What kind of efficiency savings would there be? Does that involve the third sector and the private sector, too?

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 25 January 2024

John Mason

One of the answers that we had on Tuesday was that we would better understand unmet need, and I think that you are confirming that. I am a little surprised that we do not know what that need is. For example, I guess that some people who are at home need to be in a care home but that there is no budget or space for that.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 25 January 2024

John Mason

Okay, so there are two different kinds of unmet need, in a sense: the one that we know about and the one that we do not know about.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 25 January 2024

John Mason

Are the third sector and the private sector involved in that discussion?

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 23 January 2024

John Mason

The convener touched on various areas, and I want to explore the integration authorities a little more.

This might be my ignorance, but a lot of terms are floating around. We used to talk about integration joint boards; in Glasgow, we talk about the health and social care partnership; and now we are talking about an integration authority. Are those just three different names for the same thing?

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 23 January 2024

John Mason

Okay—that is helpful. I will probably explore that on my own at some future point.

Some of the points that have been made refer back to the way in which funding has worked for integration joint boards or integration authorities. Sometimes, it seems that the council and the health board have put in funding and then almost taken it back. There is a suggestion—if I can find the wording—that it is an almost circular process. At one point, the business case document says:

“funds were ceded to IAs and then largely given back to the hosts”.

At another point, it says:

“In practice much of the funding appears to be ‘circular,’ with funding allocated to the IJB from the local authority and health board, which then directs it back to the local authorities and health boards (and Health and Social Care Partnerships)”.

Will the new system work better? Will there be better integration? On the one hand, integration is a good thing, but it can also make it difficult for councils and health boards to follow the pound.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 23 January 2024

John Mason

I was thinking of practical issues. It is a slightly different topic, but we had an issue in Glasgow with link workers, who are linked to general practices. The local general practitioner opinion—that is, the NHS—said that link workers were good and that we needed to fund them, but the HSCP said that it could not fund them and the Government came in with more money. Would that kind of decision making change in future?

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 23 January 2024

John Mason

In the programme business case, you contrast what would happen if we carried on as usual with what could happen if we had the new system. It says that a new system could enable various things, such as

“strategic integration, national oversight, accountability and opportunities to invest in preventative care rather than crisis responses,”

and the possibility of avoiding

“expenditure on poor outcomes such as those that are experienced by people who are delayed in hospital”.

The business case goes on to say:

“there could be considerable costs that are avoidable if the current system can be improved”.

Can you go into that a little bit more? Are we saying that passing the bill and having the national care service will automatically produce savings that we can put into preventative care? The committee has been looking at that issue for quite a long time now. Alternatively, is it just that there is a possibility of savings?