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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 7 August 2025
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Displaying 2881 contributions

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Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 25 January 2024

John Mason

Are they happy with where we are going?

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 25 January 2024

John Mason

Is that unmet need that we have to meet included in the budget, or will that be additional, further down the line?

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 25 January 2024

John Mason

So the bill will make the system better, but it will not produce more money. One reason why South Lanarkshire Council could not put my mother in a care home was that it did not have enough money. The bill will not put more money into the number of people in care.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 25 January 2024

John Mason

That sounds positive. I hope that that is the case.

When it comes to the word “efficiency”, one of my thoughts is that, certainly when I was in the care sector, there was a move from smaller to larger care homes. Certainly, some third sector care homes and others are quite small. One means of efficiency is to close the smaller care homes and have much bigger ones. Glasgow has tended to go down that route. Is that part of your thinking as well, or is that separate?

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?

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 23 January 2024

John Mason

Surely, information sharing cannot in itself lead to big savings, can it?

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 23 January 2024

John Mason

I have one other question about integration authorities. I note that VAT is mentioned. If money went directly to the integration authorities, would that create a VAT problem?