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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 1 July 2025
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Displaying 775 contributions

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Health, Social Care and Sport Committee

National Care Service (Scotland) Bill

Meeting date: 26 November 2024

Maree Todd

Yes. The data-sharing potential is absolutely crucial, and it can be delivered only by primary legislation. You are right that people regularly tell us how traumatising it is to have to tell their story time and again. Committee members will have heard evidence from people who have a variety of carers who wear health or social care hats, and those carers might go into someone’s house every day, but the systems do not appear to talk to each other. Therefore, we absolutely need to do better.

Data sharing would make the system significantly more efficient and free up a lot of time at the coalface. Such an approach would also be a lot kinder to the people who access social care, because they would not have to tell everyone the things that are important to them time and again—they would do that just once.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill

Meeting date: 26 November 2024

Maree Todd

As you will be aware, I am a junior minister with responsibility for those things in my portfolio. I work as part of a team of health ministers, and we work as part of a Cabinet structure within Government.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill

Meeting date: 26 November 2024

Maree Todd

That statement is incorrect. The forecast cost of the national care service, as refined, is £345 million over 10 years.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill

Meeting date: 26 November 2024

Maree Todd

Yes, absolutely. That is one of the most crucial things that people are asking us for. They are unhappy that they face a postcode lottery, with people in one part of the country having one type of social care system and access to certain services and people in another part of the country facing a completely different situation.

There is a focus on delayed discharge numbers not because they are the most important aspect of social care but because they are indicative. Delayed discharges are the tip of the iceberg and they indicate a dysfunctional system. Delayed discharge numbers vary by a factor of 10 across the country—the level of delayed discharges in the worst area in Scotland is 10 times that in the best area in Scotland. That is an unacceptable level of variation for our citizens to tolerate, and I agree with them that that needs to change.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill

Meeting date: 26 November 2024

Maree Todd

You are absolutely correct. During the bill process, I have personally spoken to hundreds of people who access social care, and the team has heard from thousands. People are telling us loudly and clearly that the system is not working. We have increased investment and, as I said, we have set ourselves a target of increasing investment. Many would say that the fundamental challenge is a lack of investment, and I would not disagree that social care needs more money. However, we have invested an extra £1 billion over the past few years, and we have not seen the systemic improvement that we would have expected from that investment. The Feeley review looked closely at the system, and Derek Feeley said that the system very clearly needs reform and that it is not simply a case of pumping additional money into a system that needs reform.

We have a suite of work. A lot of work is being done to improve conditions for social care workers. We have worked closely on, and are close to delivering, a collective bargaining system. A lot of work is being done to attract people into social care careers and to support them with continuous professional development.

As I described in the chamber last week, we have a weekly collaborative response and assurance group meeting at which Government and local systems come together to look at delayed discharges in particular in order to work out how to tackle them and how to tackle unmet need and to look at what can be done to improve efficiency in the system and pick up areas of best practice. It is difficult for local systems to pick up best practice in other parts of the country and translate that into their area. It is not a case of one size fits all, so people have to adapt best practice and apply the methodology that has been used in parts of the country where it is working well to their area. As I have said before, I live in the rural west Highlands, and it is clear to me that it is not a case of one size fits all. However, a national care service would enable us to better pick up best practice, share it around the country and ensure that our entire system works as well as it possibly can, despite the strains.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill

Meeting date: 26 November 2024

Maree Todd

I work closely with the trade unions. Many of the comments that they have made do not actually relate to the legislation; they are comments on social care in general, and their view is absolutely valid. To be clear, they are raising concerns about the social care system, not about the legislation.

It is important that I listen to all of the parties in Parliament and work out what there is support for. What I am hearing at the moment is that there is strong support for a number of aspects of the bill. In fact, I am not even hearing much concern being raised about amendments that might be needed. There is clear consensus around elements such as complex care commissioning, Anne’s law, information sharing and support for unpaid carers. There is strong support for those aspects.

The things that the trade unions are asking for are outside legislation—so they are not part of the bill—and concern issues such as sectoral bargaining. We are making good progress on that and are close to the point of that being a reality. In fact, the legislation that Stephen Kinnock has introduced in the United Kingdom Parliament is probably more relevant in that regard, and I am in negotiation at the moment with the UK Government about how that legislation can apply in some way to Scotland, particularly given the work that we have already done to put fair work principles into social care in Scotland—we are well ahead of the United Kingdom Government in that regard. I am keen to collaborate with the UK Government on that piece of work, but that would be a separate piece of legislation from the NCS bill.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill

Meeting date: 26 November 2024

Maree Todd

You are absolutely correct; we are still committed to establishing a national social work agency. There is consensus that it would be a good thing, and it stemmed from a recommendation in the original Feeley report. We think that it is required for the social work profession, which does not have the same level of professional oversight and representation as do some of our other health and social care professions. An agency will help to drive change and continuous improvement and will provide support.

Committee members will all be aware of the number of newly qualified social workers who leave the profession. We want to provide a good and supportive environment so that people are supported to become effective professionals and to progress, through the course of their working life, into specialist areas, if that is required.

I think that Feeley picked out the social work profession particularly because it has a particular role in legislation. I always describe the social work profession as absolutely crucial to upholding human rights in the system. If we want to achieve a rights-based approach to social care in Scotland, it is vital that the social work profession is supported and enabled to fulfil its duties according to law in terms of upholding human rights in the system. That is why there is a particular focus on social workers.

That is not to say that there is no focus whatsoever on social care workers; everyone in the system is really important. The scale of the challenge that the social care system faces because of the change in employer national insurance contributions and how many people no longer working in the system that might translate into is really concerning. Everyone who works in social care is really important.

I am well aware that professionals such as occupational therapists work in the same sort of areas as social workers. We are working with their professional body to make sure that they are well represented in the decisions that we are making. However, it is important that social workers have their own professional body and that we, as parliamentarians, recognise how crucial that profession is to the delivery of human rights-based social care in Scotland.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill

Meeting date: 26 November 2024

Maree Todd

My main focus is on outcomes and on what we need to achieve for the people of Scotland. I have heard loud and clear that the system that we are currently overseeing to deliver social care is broken and that we need to fundamentally change the way in which we deliver.

I ensure that the voice of lived experience is heard loud and clear, which I think is part of my role as minister. I have been dismayed at how that voice has not always been heard in the discussion about social care. Some very strong institutions are involved in delivering local and social care, and the people who access social care are often not heard within that. I consider my relationship with those people to be very precious and, when I make representations to Cabinet, I absolutely talk about how the decisions that we make will impact on them, as well as what their wishes are and what outcomes they want to see in the system.

Those people tell me clearly that they want a human rights-based approach, to tackle the variation around the country, and a system of social care that protects their dignity, supports them and has in place early intervention and prevention before they reach crisis. They also tell me that, when things are not going well, they want a clear system through which to put in complaints or concerns and to have those concerns investigated and upheld.

I am a junior minister, and I am very happy to take the guidance and wisdom of all my senior colleagues. That is what happens with collective responsibility. We have a great deal of experience around the Cabinet table and in our Government. I listen carefully to how my colleagues think that we can deliver the improvement that we need to see, in the same way as I listen to all of you as parliamentarians.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill

Meeting date: 26 November 2024

Maree Todd

No—those costs will come every year. It is a permanent change to employer national insurance contributions. Social care will be hit particularly hard because of the number of part-time employees in it; there are lots of low-paid and part-time employees, so the change will hit the sector particularly hard.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill

Meeting date: 26 November 2024

Maree Todd

The group is not meeting at the moment, but we could revive it. I regularly meet a number of stakeholder groups. I meet very regularly with the social covenant steering group and the key stakeholder reference group, and have done so throughout the development of the bill. In fact, I am meeting them today, after my committee appearance. The expert legislative advisory group is a much broader group that focused particularly on the drafting of the bill. We could bring it back together in the future if we or Parliament feel that it would be useful.