Seòmar agus comataidhean

Thank you, Presiding Officer, for the opportunity to address the Parliament today on the Care Reform (Scotland) Bill. I thank the convener and members of the Health, Social Care and Sport Committee and all the other committees that were involved for their diligent scrutiny of the bill, as well as members and their researchers who contributed and engaged with us on amendments to the bill.

I also thank stakeholders from across the health and social care landscape and everyone who contributed to co-design. Thousands of people from across Scotland with lived experience of accessing care have given us their time and expertise to shape the bill and wider social care reform. Their voices have inspired lasting meaningful change.

There is broad agreement that Scotland’s social care system must change. Although we have taken a revised approach to the bill, our ambition for a national care service remains. The bill is now focused on making vital improvements that we all agree are essential. They will make a real difference and provide a road map for the improvement of social care, social work and community health.

I am honoured to welcome the members of the care home relatives Scotland group who join us in the public gallery today. Among them are relatives of Anne Duke, who Anne’s law is named after. I have been profoundly impacted by the conversations that I have had with the group. The emotional harm and trauma that they and their loved ones and many others suffered as a result of being unable to see one another for such long and isolating periods during the pandemic must be acknowledged. To ensure that that never happens again, Anne’s law will recognise family and friends as essential care supporters and as key members of their loved ones’ care team, not just visitors.

All this started when Anne’s daughter, Natasha Hamilton, lodged a petition with the Scottish Parliament in November 2020 calling for care home residents to be allowed a designated visitor. Her tenacity and unwavering commitment mean that Anne’s law will become law today. Further, the bill now ensures greater oversight on visiting decisions. People will be able to request reviews of those decisions, which will ensure that the voices and needs of those living in care homes are truly heard. I thank the members of the care home relatives Scotland group for their constructive engagement over many years, which has led us to this point.

This week is carers week, and this year’s theme is “caring about equality”. Too many unpaid carers miss out on opportunities in life, and the bill will ensure that unpaid carers have a right to breaks, which will support them to have a life alongside caring. To support that, we have added £5 million to our voluntary sector short breaks fund for 2025-2026, bringing it up to £13 million, so that more carers can take the time off that they deserve. A new national chief social work adviser will champion social work across our health and care systems and provide professional leadership nationally. They will be supported by the national social work agency, which will spearhead the effort to promote the social work profession, strengthen collaboration and improve education and professional development.

The bill includes changes that will improve access to independent advocacy. The Scottish Independent Advocacy Alliance has told us that the best way forward is to incrementally increase funding year on year to ensure that services remain high quality and sustainable. I am really pleased to be able to announce an extra £500,000 in funding for 2026-27 to increase the provision of independent advocacy services and guarantee that people are heard and involved in decisions about their care.

Ethical procurement plays a significant role in the quality of care services, which is why the bill gives stakeholders more flexibility when buying services. It also introduces another procurement route for the third sector, which makes it easier to compete for contracts. The bill will empower people to access information, when they need it, about their own needs and care. It also helps professionals by improving the flow of information across care settings and ensuring the compatibility of systems, which will remove digital barriers so that people can focus on what matters.

The bill is only one element of our wider and ambitious programme of social care reform. Last month, the national care service advisory board met for the first time. It will provide independent oversight through a diverse range of voices, from unpaid carers and those who access care to care providers and national health service and local authority leaders, which will ensure that every perspective is heard. The board will help drive improvement and ensure that services are consistent, fair and high quality, no matter where people live in Scotland.

The advisory board will work alongside established national programmes such as: getting it right for everyone, which promotes and enables person-led support right across Scotland; self-directed support, which plays a crucial role by giving people more choice and control over the care that they receive, which is why we have invested £22 million in our SDS improvement plan; our commitment to fair work and fair pay for all care workers in Scotland, which includes increasing pay for social workers; and our targeted programme to reduce delayed discharge.

As I laid out in January, our new approach to the NCS means that local authorities and health boards will retain their existing statutory responsibilities. I look forward to working with the Convention of Scottish Local Authorities and the NHS to drive forward the improvements that the advisory board suggests. Each of the national programmes has improved social care services across Scotland and will be vital pillars in the national care service. They represent what thousands of people with lived experience have told us is needed. However, we need to pass the legislation to fully realise our shared goal of improving social care, social work and community health for the people of Scotland.

I move,

That the Parliament agrees that the Care Reform (Scotland) Bill be passed.

I would really like to make some progress—we have all had a chance to have our say.

The bill introduces Anne’s law, which will make a groundbreaking change by ensuring that the family and friends of people in care homes are seen not simply as visitors but as an essential part of the care team. The bill contains a legal presumption that suspending visiting is likely to cause serious harm to their loved one’s health and wellbeing.

The bill also contains a new right to breaks for unpaid carers to protect their health and wellbeing by giving them the rest that they need. There is expanded access to independent advocacy for our most vulnerable citizens to ensure that their voices are heard in decisions about their care. We are improving the flow of information across care settings so that people do not have to share their stories multiple times.

The bill also establishes a national chief social work adviser role to provide professional leadership and champion the sector. They will lead a new national social work agency, which will advance and advocate for the profession, and there will be new powers to improve social care procurement, including a new route for the third sector.

We know that we must improve the system for lasting progress to be made across Scotland, and in order to do that, it is vital that our hard-working and dedicated workforce feel engaged, supported and valued for their important work.

We are working hard to introduce voluntary sectoral bargaining for the care sector through the fair work in social care group. We continue to drive that work forward while we wait for the UK Government legislation to extend devolved powers. In the meantime, we are supporting the sector with funding to deliver the real living wage—I think that the bill for that is £950 million this year—so that care workers are paid what they deserve.

Despite an incredibly challenging financial situation, the Scottish Government has prioritised investment in social care, including almost £2.2 billion in social care and integration, exceeding our commitment to increase funding by 25 per cent over this session of Parliament by more than £350 million. There is more than £88 million a year in local carer support through funding to councils under the Carers (Scotland) Act 2016, £13 million a year for voluntary sector short breaks, a further £13.4 million to support growth in the independent living fund and £5.9 million of additional investment in the Care Inspectorate.

Despite our increased investment, we know that the social care sector is dealing with heavy and entirely avoidable financial pressure, thanks to the Labour UK Government’s decision to increase employer national insurance contributions and to lower the threshold at which employers start to pay them. That short-sighted and reckless decision is estimated to cost the adult social care sector more than £84 million in Scotland alone.

I have heard loudly and clearly from the sector that the UK Government must fully fund the cost of the national insurance hike to alleviate the pressure that the sector is under. I echo those calls, and the Scottish Government will continue to apply pressure.

I have listened to the debate in the chamber today, and I understand the strong feelings that many members hold. We have worked tirelessly to balance the concerns that were raised in Parliament with the urgent needs of the people in Scotland. This legislation reflects our shared commitment to strengthening social care, social work and community health. People who access social care, their families and everyone who supports them cannot wait any longer for the changes that they urgently need.

That shared commitment is no better embodied than by Anne’s law. For almost two years, at the end of her life, Anne Duke was denied the companionship and the touch of the people whom she loved. As her husband Campbell wrote,

“At your time of greatest need, they robbed you of the one thing you needed most—the unconditional love of your family and friends.”

This bill will make sure that no one else will ever again suffer the trauma and harm that were experienced by Anne, by her loved ones and by so many families across the country during lockdown. I urge members to support the bill.

Just to be absolutely clear, the Government is happy to support Jackie Baillie’s amendment 16 and Jeremy Balfour’s amendment 1.

I have concerns about amendment 63. I share Brian Whittle’s concern; ministers and officials repeatedly hear concerns from carer stakeholders about there being a lack of transparency in relation to spending on carer support. The Convention of Scottish Local Authorities has agreed to work with local authorities and IJBs to improve that. We are committed to improving the financial transparency of integration authority spending, including on social care. However, the amendment that Mr Whittle has lodged will not do that. In fact, it will cause confusion around and duplication of reporting requirements, which runs counter to the intent behind the amendment.

Amendment 63 also refers to health and social care partnerships, but HSCPs are not a legal entity; they are simply working arrangements between the various actors that are involved in the delivery of community health and social care services. The amendment also refers to “unpaid carers”. That term is not used in the 2016 act.

IJBs have a responsibility to publish transparent information on finances. We have said repeatedly at the Health, Social Care and Sport Committee and at the Finance and Public Administration Committee that it is really important that we are able to follow the money. We do not feel—not even I feel—adequately empowered to follow the money with regard to the spending that relates to the 2016 act.

However, I do not think that the amendment will improve the situation. We need to work with stakeholders and partners, including our local authority colleagues and IJBs, to make sure that we can spot where the money goes and follow it through from source to spending. I share the frustration of carers organisations that they are unable to do that. As I said, the amendment will not bring any more clarity to the powers that we already have.

You asked about amendment 10 and its reference to subsection (10A). Is the clarity that you are seeking to do with the definition of breaks?

I recognise that Brian Whittle has worked with pharmacy colleagues, but I am sure that they will understand what I am saying, because they will be as pedantic about this as I am. I am, after all, still a registered pharmacist—I refer members to my entry in the register of members’ interests.

If we put a term into law, it is really important that it has a legal definition and that there is a common understanding of what it means. There is neither for the term that Mr Whittle wishes to include in the bill. However, I believe that the aim of Mr Whittle’s amendments has been achieved by the bill that we are voting on today.

As I said, I cannot support amendment 2C, which would add a list of things that were to be treated as health and social care information. In the context of amendment 2, there is no need for a non-exhaustive list of what is to go into a digital care record. Amendment 2 sets the scope of the ambition and appropriately leaves the detail to be worked out through co-design with stakeholders, including members of the public. Requiring that a digital care record must include health records or social care records, for example, as amendment 2C sets out, could cause confusion, as a digital care record is the person’s record.

Jackie Baillie’s amendments 4 and 9 will extend the definition of health and social care information in amendment 2 for the purposes of all sections in part 2 of the bill. Amendment 2C would therefore be harmful in the context of section 37A because of the definition that it would set. I expect that that was not Mr Whittle’s intention.

I am afraid that I will not support Mr Whittle’s amendment 52, which would turn the power in section 36 to make regulations for an information-sharing scheme into a duty to do so. As we have discussed, Jackie Baillie’s amendment 2 will place a duty on ministers to use the powers in part 2 of the bill, including the section 36 power, to ensure that there can be a digital care record for everyone. Amendment 2, which I support, will place a duty on ministers to use the section 36 power for that purpose. If the intention is to require ministers to use the section 36 power for the purpose that is covered by amendment 2, amendment 2 is all that is needed. If amendment 52 were also to be agreed to, it would create an implication in law that ministers must use the section 36 power for a purpose over and above what amendment 2 requires, and it is not clear what that purpose would be. I therefore invite Mr Whittle to support Jackie Baillie’s amendment 2 and not move amendment 52.

I am sympathetic to the principles behind Mark Ruskell’s amendment 53, but I cannot support it. The way in which the amendment is framed would bring the bill into the reserved subject matter of data protection, and I cannot support any amendment that would risk putting the bill outside the legislative competence of the Scottish Parliament.

I am grateful to Mr Ruskell for highlighting the importance of individuals having a say in who accesses information in their records and of ensuring that health and social care information is accessible. Jackie Baillie’s amendment 2 already recognises that in a way that is within Parliament’s competence. I assure Mr Ruskell that, even without that statutory encouragement, those considerations are very much at the forefront of our minds. On the basis that it is unnecessary and jeopardises the lawfulness of the whole bill, I invite Mr Ruskell not to move amendment 53.

Finally, I turn to my amendments in the group. I will be brief, because they are technical. Amendment 3 is simply to make it clear that regulations under section 36, which establish an information-sharing scheme, can lay down the acceptable uses for the information that is shared through the scheme. Amendment 7 expands the range of persons who can be made subject to information standards to cover various NHS contractors, such as general practitioners.

The purpose of setting information standards under section 37 is to ensure that health and social care information is handled securely and in a consistent way. Given the criticality of the information that is held by those who provide services under contract to the NHS, it is important that the standards can be applied to them.

Amendments 5, 6 and 8 are minor drafting changes in consequence of amendment 7.

In summary, I support and welcome Jackie Baillie’s amendment 2 and the connected amendments 2A, 4 and 9. I urge members to support my amendments 3, 5, 6, 7 and 8 and to reject Brian Whittle’s amendments 2B, 2C and 52 and Mark Ruskell’s amendment 53.

I welcome, and will support, Katy Clark’s amendments.

Amendment 74 and the supporting amendment 85, which would require ministers to report on the social care market in Scotland, would be an important step in enabling increased financial transparency in the market, which is something that I know that stakeholders have been calling for. It would, for the first time, give a clear national picture of the social care market in Scotland.

In order for ministers to be able to produce reports on the shape of the market, they will need to have the necessary market information, and amendment 75 would give us the powers needed to obtain that information.

I appreciate that service providers may be concerned about the potential burden of data collection, which is an issue that Mr Cole-Hamilton raised. However, I see the benefit of having in the public domain information about the state of the market, and I believe that the requirement to provide information that is relevant to the production of such reports is entirely proportionate and, indeed, minimal. Reporting will be done only every three years and we will, of course, work with the sector on implementation.

I encourage all members to support all the amendments in the group.

Subsection (10A), which was introduced at stage 2, removes the concern that the current definition encompasses breaks that are unrelated to the caring role. It explicitly confirms that breaks can be taken with the cared-for person, and it describes different arrangements for such breaks when taken together and how they are linked to the caring role.

Amendment 10 agreed to.

Amendments 11 to 15 moved—[Maree Todd]—and agreed to.

Amendment 16 moved—[Jackie Baillie]—and agreed to.

Amendments 17 and 18 moved—[Maree Todd]—and agreed to.

Section 38A—Duty to prepare adult carer support plan

Amendments 19 and 20 moved—[Maree Todd]—and agreed to.

Section 38B—Duty to prepare young carer statement

Amendment 21 moved—[Maree Todd]—and agreed to.

Section 39—Enactments relating to carers: minor modifications

Amendments 22 and 23 moved—[Maree Todd]—and agreed to.

Section 39A—Short break services statement

Amendments 24 to 29 moved—[Maree Todd]—and agreed to.

After Section 39A

Amendment 1 moved—[Jeremy Balfour]—and agreed to.

Section 40—Visits to or by care home residents

I do not support Mr Whittle’s amendment, and I am grateful that he will not press it. The short title of a bill should give a fair summary of its content, as it helps to index the statute book for users of it. The wording “Social Care and Support”, which Mr Whittle’s amendment proposed, fails to meet that standard. The bill is significantly concerned with healthcare as well as with social care.

Its current short title, which was changed at stage 2, properly signifies the full range of the bill’s content by referring to care in the round, which is a precedented approach in the conventions for assigning short titles. We rehearsed those arguments during stage 2. At the time, I explained that the short title needs to reflect the content of the bill. It is disappointing that the issue has come back at stage 3, but I am grateful that Mr Whittle will not press the amendment to a vote.

At the moment, Scottish ministers already have a duty under the Health and Care (Staffing) (Scotland) Act 2019 to prepare and lay before the Parliament an annual report on staffing and care services. That is a summary of how care providers, local authorities and integration authorities are discharging their duties and the effect that staffing levels have on the discharge of those duties. It is also a summary of the steps that ministers have taken to support staffing levels in care services and to ensure that funding is available for them to assist the discharge of their duties, as well as how the above will be taken into account in determining the future supply of registered nurses, medical practitioners and other kinds of care professionals.

Because the 2019 act came into force in April 2024, the first ministerial report will be laid before Parliament in October this year. That might be why parliamentarians are unfamiliar with the richness of data and analysis that will be available through that report.

I am not against collecting and reporting on data. I am pleased to support Carol Mochan’s amendments 76 and 77, which will require ministers to produce a fair work strategy for the care sector and to report on the extent to which fair work is being realised. Unlike Mr Kerr’s amendment 66, that would not duplicate existing reporting requirements because there are currently no duties to report on fair work in the sector. The duty aligns with the Government’s existing commitment to advance fair work in social care and the workstreams of the fair work in social care group to improve pay and conditions.

Annual reporting by ministers will ensure transparency on the data and on our assessment of progress, and it will provide accountability in any actions that are necessary to improve practice. I also welcome that the provisions provide time after commencement to develop an efficient and proportionate data collection and reporting process through consultation. The strategy should not create a reporting regime that places unnecessary burdens on the system.

I cannot support Jackie Baillie’s amendment 79, which would require ministers to use sectoral bargaining to negotiate employment conditions. As we have already heard, the amendment is about industrial relations, a matter that is reserved to Westminster and therefore not within this Parliament’s competence to legislate on. As members know, the Parliament has very limited scope to legislate in that area. Should the amendment be agreed to today, the whole bill might be referred to the Supreme Court, which would impede getting royal assent for the bill for months—possibly for the rest of the session.

I certainly intend on doing that, but it is important that I set out the consequences of voting for amendment 79, too.

There are important provisions in the bill for which there is broad consensus for change across this Parliament, including Anne’s law, the right to breaks from caring and independent advocacy. Those would be significantly delayed if the amendment is agreed to. That is why I find it extremely disappointing, given the clear issues of competence and the extensive engagement that has taken place since stage 2, that Jackie Baillie chose to lodge it.

I assure members that I am committed to progressing sectoral bargaining for the social care sector. The fair work in social care group has been working with the sector to develop a voluntary sectoral bargaining model to provide a mechanism to determine pay and terms and conditions on a voluntary participation basis.

The Scottish Government is constructively collaborating with the UK Government on its Employment Rights Bill. Although the provisions of that bill are being debated at Westminster, there is clear intent for it to establish provision for a national social care negotiating body for Scotland, which will offer the option of providing a statutory footing for setting pay and terms and conditions for the social care workforce through fair pay agreements.

With employment law being a reserved matter, it is only the UK Parliament that can introduce legislation in that area. Of course, I find that fact deeply regrettable. If Jackie Baillie does as well, we will be delighted to have her support in campaigning to have competence over employment matters and for industrial relations to be transferred to this Parliament.