Seòmar agus comataidhean

As members have said, independent advocacy is absolutely vital in helping people to have their voice heard and to realise their rights. It sounds as though there is consensus in supporting the sector to flourish and grow, as was envisioned by Derek Feeley in his review. I thank members for that.

Amendment 44 agreed to.

Amendments 71 and 70 moved—[Brian Whittle]—and agreed to.

Amendments 72 and 73 moved—[Mark Ruskell]—and agreed to.

After section 13

Amendment 45 moved—[Maree Todd]—and agreed to.

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 welcome Jackie Baillie’s amendments. I am committed to increasing the understanding of social care needs to inform and support health and social care reform.

Last week, the Scottish Government published an analysis of self-reported unmet care and support needs in older adults aged over 65. Amendment 46 will build on our evidence-led approach, requiring ministers to periodically evaluate how needs might change in the coming years and to continue to develop our approaches to further increase understanding, particularly around the kind of needs that are unmet and why that might be the case.

As I have said in the discussions about other groups this afternoon, I am pleased to support data and evidence gathering with a purpose. I encourage all members to support amendments 46 and 51.

I am pleased to begin today on a note of consensus. I welcome Jackie Baillie’s amendment 2, which places a duty on ministers to ensure that everyone who receives healthcare or social care in Scotland can have a digital care record. As members will be aware, the integration of health and social care records is a long-term ambition of the Scottish Government, which the powers in part 2 of the bill were always intended to support. Amendment 2 enshrines that ambition in law, recognising that a digital care record would improve outcomes for the workforce and individuals throughout Scotland.

Brian Whittle has proposed three amendments to Jackie Baillie’s amendment 2. Amendment 2A would change the label from “digital care record” to “digital integrated care record”. I recognise that the spirit of the amendment is to underline the need for integrated care, so I am happy to support it.

However, I cannot support amendment 2B, which would add the words “technology-agnostic interoperable solution” to amendment 2. As a matter of law, it is not clear what that phrase means. Although it is right that we should be aiming for a flexible digital infrastructure in health and care, and I agree with the intent, I am concerned about putting something that is so unclear into law.

As I said, we are keen to ensure that the requirement to provide information is proportionate and minimal so that it does not place a burden on people who operate in the sector. We are keen to have a healthy market in Scotland—particularly in the Highlands, which is an area that is very close to my heart—and to ensure that we do not dissuade people from coming into the sector.

In 2021, following publication of the Feeley review, the Government made a clear commitment to reform Scotland’s social care system. Over the past four years, my predecessors and I have spoken to hundreds of people who use care services, to their families and to those who deliver care, and each of those conversations has left a profound and lasting impression. Today, we have an opportunity to reflect those voices in our decisions by passing legislation that will make a real and lasting difference.

The Conservatives and the Lib Dems—as we have heard today—have always opposed the creation of a national care service. From the very beginning, they were against it. The Labour Party claims to support a national care service—in fact, it was apparently Jackie Baillie’s idea, long before Feeley—but there has never been clarity on what that would look like.

Every member in the chamber knows that the status quo is not an option and that social care must improve. The Government is unwavering in our commitment to create a national care service that meets the needs of the people of Scotland.

I agree with Mark Ruskell that now is not the time to dampen our ambition. As I laid out in my opening speech, we will drive enhanced oversight and support of the care system, through the national care service advisory board, to provide a level of independent oversight that has been missing for too long. However, in order to unlock the full potential of the national care service, we must pass the vital changes that the Care Reform (Scotland) Bill will bring.

I confirm that I encourage members to support my amendments 40 and 41 and Jackie Baillie’s amendments 42 and 43. I was pleased to hear that Brian Whittle does not intend to move amendment 64.

Amendment 40 agreed to.

Amendment 41 moved—[Maree Todd]—and agreed to.

Amendment 64 not moved.

After section 41A

Amendments 42 and 43 moved—[Jackie Baillie]—and agreed to.

First, I will speak to the amendments in my name, which are simply technical in nature and will, I hope, be uncontroversial. Amendments 44 and 45 split section 13 into two sections, so that what will be left in section 13 will be a regulation-making power in relation to independent advocacy, with the regulation-making power in relation to independent information and advice appearing in a separate section. That will make the provisions easier to follow.

As a consequence of that change and the fact that section 13 was moved in the bill at stage 2, my amendments 47 to 50 reposition the order in which section 13 and the new section that will be created by amendment 45 are referred to in section 46, so that the list of section numbers will run in the right order after the bill is passed. The amendments will not change the legal effect of the provisions.

Turning to the more significant amendments from other members, I welcome Brian Whittle’s amendment 71 and encourage members to support it. It will provide for advocacy service standards to be introduced by regulations. I am committed to ensuring the delivery of high-quality independent advocacy across Scotland, and amendment 71 will help with that, allowing us to develop the standards and regulations by engaging with providers in the sector and the people they support.

I also welcome Mr Whittle’s amendment 70, which would require the providers of independent advocacy, advice and information services to collect and anonymise data about those they help, and for Scottish ministers to review the data and publish a report on it. The lessons that we can learn from data on why people access those services could support improvements in the social care system. However, it is important that the collection and processing of anonymised data do not become overly burdensome for the relatively small organisations that operate in the sector. We need to consider that before laying the regulations.

I welcome Mark Ruskell’s amendments 72, 73 and 82, which would put a definition of independent advocacy services into the bill, and I ask all members to support them. As I have touched on, I encourage members to support Mr Ruskell’s amendment 78, which would put ministers under a duty to review and report on the provision of independent advocacy funded by them.

The Feeley review recommended an increase in the independent advocacy provision for people accessing social care support. I understand how important independent advocacy is in helping people to have their voice heard and in realising their rights, which is why we are providing £500,000 for the financial year 2026-27 to increase provision of those vital services. Stakeholders such as the Scottish Independent Advocacy Alliance support our taking an incremental approach to increasing provision in order not to overwhelm the sector.

Going forward, by reviewing and reporting on our independent advocacy provision in the first two years and then every four years thereafter we can ensure better planning and give more clarity to providers.

I move amendment 44.

This group of amendments on Anne’s law is particularly important. It is everyone’s job to ensure that Anne’s law is delivered in practice. That is why the amendments focus on ensuring additional oversight and support around decisions on visiting, and on ensuring that the vital role of the essential care supporter in supporting wellbeing is fully recognised. I am grateful to Opposition members for lodging the amendments and for working with me to get them right. I thank members of care home relatives Scotland and many others for their constructive engagement with us to get the bill right.

I welcome Jackie Baillie’s amendments 30, 31 and 32. I recognise the role that essential care supporters play in providing their loved ones with regular care and support. I agree that it is only right that the identification of the individual is undertaken in a consultative manner and that it involves the resident and those closest to them. I also agree that there is a need for limited exceptions to the requirement to identify such a person. The amendments provide the appropriate flexibility.

I also support Jackie Baillie’s amendments 35 and 36. Based on our learning from the pandemic, there is general agreement that more should be done to ensure that there is greater oversight of decisions on suspending visiting. The amendments provide a requirement for care home providers to review a decision about the suspension of visits and notify the Care Inspectorate when it decides to suspend. The amendments will ensure that there are appropriate checks and balances in relation to providers’ decisions.

I cannot support amendment 55, which has been lodged by Brian Whittle. However, as he said, the amendment is not necessary, because it broadly duplicates the notification process that is provided for by amendment 35. I appreciate Mr Whittle’s confirmation that he will not move amendment 55.

I will also not support Sandesh Gulhane’s amendment 56. The code of practice will be primarily for care home providers to have regard to in fulfilling their duties under Anne’s law. The code of practice cannot be used to create a new complaints process. There is an existing legal framework for complaints, which would include decisions relating to visiting. The code of practice will also set out how the requirements to review and notify that are imposed by virtue of amendment 35 are to be met.

I welcome amendments 37 and 38, which are in Jackie Baillie’s name. I agree that Anne’s law will work in practice only if care home providers work collaboratively with residents and their friends and family. By having guidance in the code on how staff should do just that, residents’ care plans will fully reflect their needs.

I turn to Brian Whittle’s other amendments in the group. I am pleased to support his amendment 57. I agree that residents and families should always be informed timeously about any changes to visiting.

I welcome amendment 59. From my experience of working with groups such as care home relatives Scotland during the preparation of the bill, I know the value of lived experience in developing and reviewing legislation and policy. Therefore, I recognise that gathering their feedback is vital in order to ensure that any review of the code is meaningful.

I support Brian Whittle’s amendments 58 and 60. I agree that it is essential that the code of practice can be understood by the widest possible range of people, including people with learning difficulties or other conditions that affect how they process information.

On amendment 62, I agree with Brian Whittle that reviewing the regulations’ operation after two years will provide an opportunity to check and follow what is working as intended. That will sit alongside other mechanisms for sharing, learning and best practice, locally and nationally, such as our national oversight group for Anne’s law, which brings together relatives, care home providers and health and social work professionals in order to share learning in a collaborative way.

However, I am unable to support amendment 61, in the name of Sandesh Gulhane. Amendments 59 and 62 will provide sufficient mechanisms for reporting and feedback on the delivery of Anne’s law. When carrying out a review of the code of practice, Scottish ministers will be required to consult the Care Inspectorate on all the points that are specified in amendment 61. The Care Inspectorate will naturally be significantly involved in the report on the operation of Anne’s law. I consider that imposing a further requirement—the production of an annual report on Anne’s law—on the Care Inspectorate would be excessive and not the best use of resource.

I turn briefly to my own amendments. Anne’s law will mean that, even when general visits need to be suspended due to risks to life, health or wellbeing, some visits should always be supported. That would include end-of-life situations, as they might be the last chance for family and friends to see and interact with the resident. Amendment 33 provides that visits should also be supported for people who have undergone, or are expected to undergo, a significant deterioration in their physical or mental condition, which can be very frightening. It is reasonable to expect that any such resident would want or need the support of their family or friends. Although the resident’s death might not be anticipated in that period, it might be the last opportunity for them to interact with their family and loved ones.

Amendment 33 is based on feedback from a number of stakeholders, including care home relatives Scotland. It is vital that care home residents can spend time with their loved ones outside of the care home and engage in the community if that is their wish and it is appropriate for them to do so, which is why Anne’s law will include a duty on care home providers to facilitate visits, both in and out of the home.

I have listened to stakeholders, including Scottish Care, that have highlighted a concern that a duty to facilitate visits might be taken to impose a positive obligation on care home service providers to physically take residents out on visits or arrange or pay someone else to do so. That was not my intention, so to address that concern, the limits on facilitating external visits are now clearly expressed by amendment 34.

In summary, I support and welcome Jackie Baillie’s amendments 30 to 32 and 35 to 38. I also support Brian Whittle’s amendments 57 to 60 and 62. I urge members to support my amendments in the group—33 and 34—and reject Brian Whittle’s amendment 55 and Sandesh Gulhane’s amendments 56 and 61.

The provisions in amendment 65 were in an amendment that was lodged at stage 2, which I was unable to support in the end because it required ministers to make regulations dealing with matters that are already dealt with by primary legislation passed by this Parliament.

I am grateful that Sandesh Gulhane is not going to press amendment 65, and I suggest that we all breathe a sigh of relief.