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Chamber and committees

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 12 August 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

Absolutely, and I will be looking for allies who will work with me on the things that we agree on鈥攁nd we agree on a great deal. I will be looking for allies across Parliament who will help me to progress the changes that we all want to see. I rarely hear from parliamentarians here that they want things to stay the same. I think that everybody acknowledges that the system needs fundamental change, so we need to work together on what that change will be.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill

Meeting date: 26 November 2024

Maree Todd

Given the complexity of social care and the number of stakeholders involved, it was very likely that no single stakeholder view would be reflected in the bill. However, each of them was heard and the bill was developed with their collaboration. We worked hard to bring to life what people were telling us.

Do you want to say more, Donna?

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill

Meeting date: 26 November 2024

Maree Todd

Anne鈥檚 law will be implemented as soon as is practically possible. I think that the care home relatives know and understand the challenges that we are facing. Anne鈥檚 law will engage the European convention on human rights, and when we are balancing human rights, it is always tricky to get the legislation correct. They understand the complexity, the sensitivity and the challenges that are involved, and we are working very closely with them to get the balance right on those rights. I assure them that we will deliver Anne鈥檚 law. We need to take time to get it correct. As I said in my letter to the committee, I will come back with a new timetable for the new year, so I do not think that they are going to be waiting terribly long. I do not think that there will be a long delay.

There has been lots of discussion about how long it will take for the national care service to come into being once the legislation has been passed. There have been quite a lot of headlines in the newspapers about how many years it will take for that to happen. Anne鈥檚 law could be implemented immediately, as soon as the bill is given royal assent. As soon as the bill becomes an act, we could see rapid implementation from that point on, and we would be working to deliver it as soon as was reasonably practicable. I am remembering my Government jargon: as soon as is reasonably practicable and as soon as the bill becomes an act, we will be working hard to deliver it for them. There is no reason to wait.

Health, Social Care and Sport Committee

National Care Service (Scotland) Bill

Meeting date: 26 November 2024

Maree Todd

As I said, we meet weekly with local systems鈥攅very one鈥攁cross the country. The Cabinet visited Ayrshire recently to meet system leaders and had detailed discussions about some of the challenges that they face.

We very regularly meet people in some of the areas that face particularly difficult challenges, in order to drill down to find the explanation for local variation. For example, as part of my ministerial role I have regular meetings with Highland systems to look at why their delayed discharge rate is so high compared with rates in the rest of the country. There are some reasons for that鈥攆or example, rurality and poverty have an impact. However there is undoubtedly a level of variation that is not explainable only by those factors. The challenges that are faced in Highland in delivery of social care鈥攖he geography, topography, sparse population, labour market shortages and competition with hospitality in the labour market鈥攁lso apply in Argyll and Bute, for example, which does not face the same challenge in respect of delayed discharges.

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鈥檚 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鈥攖hey 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 拢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鈥攖he 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 拢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鈥檚 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鈥攕o they are not part of the bill鈥攁nd 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鈥攚e 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.