Seòmar agus comataidhean

I am sorry—I am not moving amendment 125.

Amendment 125 not moved.

Section 37, as amended, agreed to.

After section 37

Amendments 46 to 49 moved—[Maree Todd]—and agreed to.

Amendments 126 and 127 not moved.

Before section 38

First, I place on the record my sincere thanks to the legislation team for processing my many amendments, which were lodged in such an unreasonably short time.

Across the Parliament, we all recognise the need for reform of our social care sector. We all know that our current model is unsustainable and we all want to see the change that is necessary to give social care in Scotland a sustainable and secure future. I question whether the rubble of the Scottish National Party’s National Care Service (Scotland) Bill is the best foundation for a sustainable social care sector.

I make it clear that we would support many of the actions that are proposed in the bill, but to deliver them through this cut-and-shut legislation, and through Government amendments that have been lodged at the last minute, would do them a disservice and would risk storing up problems for the future. Indeed, given the Scottish Government’s fondness for secondary legislation, I am unsure why, when that cross-party support exists, it does not intend to use that approach.

My amendments would give MSPs from all parties the opportunity to agree that legislation for serious social care reform should begin with a fresh sheet of paper, not with the half-shredded National Care Service (Scotland) Bill. Should members support my amendments and send the bill back to the drawing board, the Scottish Conservatives are committed to working across the Parliament on new, properly planned legislation.

If members choose to reject my amendments and continue to build this house on sand, we will seek to make the best of the legislation, but I do not agree that that approach will produce the kind of legislation that social care deserves. I hope that MSPs will agree to scrap the bill and build something better.

On amendment 158, the bill as it looks in February 2025 is very different from the objectives that it set out to achieve. Its name needs to reflect its contents, which now represent much more technical and specific changes rather than radical reform. In fact, it does not represent the kind of radical social care reform that was required by either the Feeley report or the Scottish Government’s ambitions for what was to be the national care service. Scottish Care has been clear about the need to use the language of social care distinctively rather than the often ambiguous terminology of “care” when detailing aspects of formal support planning and provision. The importance of that is increasingly recognised at Government level and should be reflected in the bill’s name, given that, in its current iteration, the bill focuses more specifically on elements of social care than on wider changes.

If the legislation was called the “Social Care and Support (Scotland) Act”, it would represent a clear and unambiguous approach to what the bill does and does not achieve. It would not take away from the need for progressing with urgent and radical social care reform, but it would acknowledge that the bill is now premised on more functional changes to existing practices and is no longer the key driver for transformative approaches.

I want to explore a little bit further the issue of palliative care that Dr Gulhane raised earlier. I hope that I am not putting words in your mouth, Mr McArthur, but I think that you would agree that the ideal scenario is for people to have access to palliative care as well as assisted dying. However, we know that that is not the case; indeed, one in four Scots is not getting access to palliative care. As you have highlighted, the bill is shining a light on the provision of such care, and I think that that is very welcome.

The other thing that we have heard about is the inequality of access to palliative care between Scottish index of multiple deprivation level 1 and SIMD level 5 areas. My question, then, is this: do you want the bill itself to guarantee access to palliative care alongside access to assisted dying?

You are absolutely right that palliative care is not for everybody and that, if the bill passes, the fact that someone does not access palliative care should not prevent them from accessing assisted dying. I fully understand where you are coming from with that. The concern is that if someone seeks palliative care and it is not accessible, the pressure towards assisted dying grows. That is the concern. If somebody speaks to their GP and requests more information on or to start the process of assisted dying, at that point, should the GP discuss palliative care options and what happens if they are not available?

Good morning, Mr McArthur. I have a quick supplementary around the vulnerable disability group. We had a round-table session in the Parliament with a variety of really excellent contributors, one of whom was the father and guardian of an adult son who had a learning disability. He pressed us really hard around the human right of his son should he request assisted dying—however, he has guardianship of his son. Where does the bill fit with that scenario?

I will move to the topic of unassisted suicide. Some people have told us in evidence that the bill might have a positive impact in reducing the number of unassisted suicides, although others have said that it will have no impact.

I have a practical question. Have you discussed that with insurance companies and do you know their take on whether assisted dying would be deemed to be suicide and might therefore make insurance policies unworkable or those deaths ineligible for insurance payouts? Have you had that conversation?

You highlight the issue of those who have a terminal diagnosis. That will inevitably have some impact on their mental health, and, as you say, the suicide rate among that cohort is about two and half times the norm. I will push again on the issue of access—or lack of access—to other services. Are you concerned that the lack of access to other services would inevitably lead people down a certain path?

No, I completely understand.

If coercion is not currently an offence, I presume that it would become an offence within the context of the bill. We would be asking members of the medical profession, who are not members of the legal profession, to make a judgment on something that might break the law. Is that a fair comment?

One of the big wins from this bill—if “wins” is the word that I am looking for—is that it is shining a light on palliative care provision and the need for it to be equitable across the country. If you look back at some of the evidence that we have heard, you will see the concern with regard to palliative care and the potential for some people to consider assisted dying because of inadequate palliative care in their particular instance. I ask you to have a look at that, because it is a big concern for me. I would like to think—and I am sure that you will agree with me—that, if the bill were to be passed, everybody who wished to consider assisted dying could also access palliative care, that the matter would be raised by a GP or whatever at the time and that provision would be equitable.