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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.

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.

It is challenging to achieve consistency across the board. We work not only with COSLA, but directly with chief officers in each local authority area. A few years ago, we updated the statutory guidance to make it clearer how we expect the policy to be implemented and to tackle the risk-averse approach that we see being taken in some parts of the country and the organisational or cultural barriers that might undermine the flexibility, autonomy and choice that are at the core of SDS.

My colleagues are probably best placed to comment on this, but we have funded Social Work Scotland to update the SDS framework of standards and to create the practitioners toolkit, both of which will help us to improve consistency across the country. However, I think that there is a strong case for a national care service. You would expect me to say that, but I think that it is really important that, in circumstances in which there is inconsistency and the situation is challenging for local areas, we will be able to provide national oversight and national support frameworks, and to ensure that different areas can learn from one another. At the moment, they are working in isolation, and we need to improve the learning that takes place across the country.

I think that everyone acknowledges just how challenging the landscape is at the moment, given the pressures that we face. This has been a long review of SDS, and some pressures were building before the pandemic. We have an ageing population demographic—it is great that people are living longer, but they are living longer with more complex health issues and are, therefore, requiring more social care support—and people with certain conditions are living independently in a way that they would not have been able to do in the past, so some pressures are built in.

There have been 14 years of austerity, which have, as nearly everyone acknowledges, challenged all our local services. All our public services are feeling stretched to the limit. Any changes that could be made to improve efficiency have been made, so any further savings have an impact on delivery. People are feeling like that across the board.

The pandemic has caused a real challenge. The health portfolio team has a meeting every week before the Cabinet meeting, and this morning we discussed some of the challenges that we face in relation to the stage at which people present with an illness, because people are presenting further on in their illnesses and when they are more acutely unwell. There is more complexity than there was before the pandemic, and there are also more Covid cases—there has been an increase in the level of Covid in our community.

All those issues still exert pressure on our health and social care system, so it is undoubtedly an exceptionally challenging time at the moment. In order to rise to meet the challenges and address the pressures that we face, we have weekly charging for residential accommodation guidance—CRAG—meetings where we look at the whole system in order to assess what is happening in health and social care in Scotland and to consider what can be done to improve the situation.

You will have heard from the First Minister that there is a real focus on delayed discharge, for example. The figure for delayed discharges used to vary by season—it would go down in the summer and up in the winter—but the pressure from delayed discharges has been relentless all year round for a number of years, since the start of the pandemic. Over the next few months, there will be a real focus on trying to improve the situation in order that we have some headroom.

From the letter that I sent to the committee yesterday about the national care service, you will know that we have paused our discussions on one or two amendments that have still not been agreed by me and COSLA in order to free up the space to focus on acute system pressures over the next few months, rather than on the systemic solutions that might be a little further down the line.

I do not know whether my colleagues want to say a bit more about eligibility options in the future.

In my casework as a constituency MSP, I certainly hear that concern. People think that option 1 is SDS, and that concerns me, because it suggests that people who are trying to access social care at the coalface are not being talked through the whole suite of options that are available to them, and that option 1 is being used as the default setting. That is a real challenge that we recognise.

As Rachael McGruer said earlier, we are working closely with NCS colleagues to ensure that the SDS principles are embedded within the creation of the NCS bill, and that the SDS improvement plan, which we are working through at the moment, is completed and embedded into the national care service, so that improvements in practice, that genuine offer of flexible choice and that change in practice are embedded in future social care delivery and available to everyone across the country.

Joanne Finlay, do you want to say a little bit more about that?

You are right. Everybody working in the health and social care system as a whole needs to have an understanding of how social care in Scotland works. One of the aims of our current work to tackle the acute issues that the system faces, as Ruth Maguire was alluding to, is working with healthcare systems to try to ensure that there is early referral, with early discharge planning for example. That requires an understanding of what is available in the community and who needs to be involved in the process of putting together a package of care post-discharge.

There needs to be a level of working knowledge in both the healthcare system and the social care system to ensure that things are operating efficiently and effectively across the board.

Certain professions are crucial, though. Social workers are crucial to the high functioning of the system—I am more and more convinced of this every day. From my perspective, as a general rule, it is really important that we support that profession and that we ensure that they are supported to make the professional and statutorily underpinned decisions that they are meant to be making to support individuals’ human rights as they access social care. We can do that by tackling both undergraduate and postgraduate support and training.

The work that we mentioned earlier to support and mentor newly qualified social workers and to ensure that there is a pathway in place for social workers who want to pursue higher qualifications—postgraduate qualifications—is really important. That needs to reflect not only the practical operation of SDS, but the culture and ethos of SDS, which is about flexibility, choice and upholding people’s independence. I joke with the SDS audience, “I’m all about independence.” I absolutely get how important it is to individuals that they have the autonomy to make decisions to have social care that supports them to work, for example, or to do whatever it is that they want to do. That is crucial.

For people who are working in the system, we have an opportunity, through NHS Education for Scotland and Scottish Social Services Council registration, to provide training packages that work in a multidisciplinary way right across the system. I think that that will be really helpful in tackling some of the barriers.

People with learning disabilities are one of the communities that struggle to have their rights upheld. There are good training opportunities for everyone who works in the system in how to engage with people with a learning disability. NES offers multidisciplinary, postgraduate and post-qualification or post-registration training to everyone who might come across such people so that they can help them to engage fully in the process of decision making and make good informed decisions that suit them, that uphold their rights and that fulfil their dreams and ambitions for their lives.

I am going to ask Joanne Finlay to come in on that.

On the need for flexibility, we are doing work around the country to try to ensure that SDS is delivered as flexibly as possible. At the moment, we have a request in from Highland Council to clarify some of the flexibilities that it might need in very remote communities where everybody is related, frankly. That is a challenge that I have in my constituency.

We have to ensure that there are tight controls on the possibility of exploitation of vulnerable people, but we also need to recognise that family support might well be the only option that people who live in very remote and rural communities have. We are working with the council on ensuring that we can deliver those flexibilities while safeguarding individuals’ human rights, and also on ensuring that it works for people, because saying, “We are not going to do that” is not an appropriate answer.

We also have work going on across all parts of the country on exactly the same challenges. One of the challenges that we have, and one of the reasons for variation across the country, is the level of risk averseness that individual local authorities and integration authorities have. We are trying to support them with that to ensure that they know that they are empowered to be flexible.

Rachael McGruer, do you want to comment on that? Were there plans to measure it before 2013, or were there plans in place on metrics when the legislation was introduced to measure whether the vision had worked?

I agree that it is not always recognised that it is the primary delivery mechanism. I meet constituents on a regular basis—as you all will—who say, “I’ve been put on to this SDS,” and they do not realise that that is the way that we deliver social care. For example, they think that option 1 is the only option with SDS.

As well as the geographical variation, which reflects culture, delegation practices and the levels of integration in each area, we operate in a system that has different external pressures. The pandemic has undoubtedly been a huge pressure on our systems, as is the financial situation in which we find ourselves. The post-Brexit challenges of immigration and the labour shortages that we have across the country are another pressure.

Even in the geographical area that I represent, I have seen real changes. When I was first elected, I met local representatives in the Highlands who blew me away with their description of the amazing opportunity that people had to live their lives to the full and avoid being institutionalised in any way, and I met young people who were using their SDS to follow their dreams. It was magical to hear about.

Now, I more commonly hear concerns that—this is probably common for every representative around this table—when there is market failure, when the local authority has struggled to provide care, people are being told, “Don’t worry, you can have this budget and find care for yourself.” That is not the intention. People are meant to be able to choose the option that works for them. Option 1 is not meant to be the final stop when market failure has occurred.

We are well aware of those challenges. I suppose that the way to avoid those challenges for people who are trying to access care is to focus our work on improving workforce planning and ensuring that sufficient funding is going into the system. We have a lot of work going on across the piece to do that. We committed to increasing the funding of social care by a quarter during this session of Parliament. We have delivered that two years ahead of schedule, but we are often not feeling that at the coalface.

We need the national care service to provide some grip and assurance in relation to following the money and making sure that the money is getting where we need it to be. The workforce issues are undoubtedly challenging. We will improve those by not just tackling pay, although that is really important, but social care conditions and the level of support for social care staff, so that they feel well supported and can flourish in their vital professional role.

Work is under way right across the piece to do that, but it is not as simple as flicking a switch, and it is exceptionally costly, so it must be done carefully. I would like us to go further and faster, but I think that we are on the right path. Each social care worker in Scotland is paid £2,000 more than they were paid last year. Their wages are going up substantially each year. Social care workers in Scotland are paid more than, and pay less tax than, their counterparts in the rest of the United Kingdom.

We are on the right pathway. We are not where we want to be, but, as a Government, we have set out our stall and are making incremental improvements in social care that will help us to solve the big-picture problems.

We are working on accurate data. It is not as simple as saying that we should put in extra money. If it were that simple, we probably would just throw money at it, but most people would recognise that a change in approach is required as well as extra money. There are challenges in following the money across the system and in seeing where the money goes within social care. It is quite complex to follow it.

There is a general acknowledgement that we are not getting in early enough. If we go back to data, one of the problems with data is that we focus very much on the things that are easy to count, such as delayed discharges—what we call the back door of the hospital. It is less straightforward to measure unmet need in the community. If we could get that fixed, that would help us with early intervention and prevention and mean that money was spent more efficiently. Some of the calculations on early intervention and prevention suggest that we could probably help twice as many people if we were able to get in earlier, rather than waiting until somebody reaches crisis and is admitted to hospital. A frail elderly person being discharged from hospital is likely to need twice the package of care than they would have needed if we had got to them earlier.

It is not an easy thing to do, but morally, ethically and economically, we have to get in earlier, higher upstream, and we have to have more grip and assurance across our system. We have to understand what is going on and make sure not just that money goes into the system, but that it goes to the right place. I think that there is general agreement in that regard. People have concerns about the national care service and about the Government’s delivery of social care, but very few people are arguing for the status quo and more money to do things the way that we do things now.