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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 17 August 2025
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Displaying 775 contributions

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Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 26 September 2023

Maree Todd

That might be an easier way of doing it, but we can deliver both. We can have co-design at the heart of our development of legislation and ensure that this committee and others are comfortable with the financial scrutiny.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 26 September 2023

Maree Todd

Co-design is a core part of the national care service. I do not expect it to finish by Christmas; indeed, I expect it to continue throughout the bill鈥檚 development and to be a fundamental part of the national care service in future.

Donna Bell can give you a little bit more information.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 26 September 2023

Maree Todd

What I have been trying to describe is a dynamic process in which we take on board the co-design and then come back to the committee with more information. The business case is iterative, so we will have lots of opportunities for you to scrutinise and examine what is going on. The use of co-design in developing the legislation is fundamental to the type of change that we are delivering. As I say very regularly to people, if we have lived experience at the heart of our policy and legislation, we are much more likely to get them right. The challenge, though, always lies in implementation, so we also have a built-in mechanism for holding our feet to the fire in that respect to ensure that we not only deliver our ambitious policy and legislation but implement them appropriately on the ground.

What I am trying to say is that co-design is a core part of the national care service. I would expect that, once we have delivered it, it will continue to evolve, much like the NHS has. It will not be fixed in stone, just as the NHS was not fixed in stone when it was introduced in 1948. Having co-design at the heart of the development and at the heart of the service itself means that the voice of lived experience will continue to be involved in its evolution, even after we deliver the legislation. However, I agree that the approach makes it more difficult for you to scrutinise costs.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 26 September 2023

Maree Todd

Yes.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 26 September 2023

Maree Todd

I will ask Fiona Bennett to answer that question.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 26 September 2023

Maree Todd

As you will know, we set out a financial memorandum this time last year. That was the envelope that was put forward with the original draft legislation, but it is changing as we develop the legislation. We are determined to develop a system that meets the needs of the population. You will be aware that there is a commitment at Government level to do that. I will continue to work closely with the Deputy First Minister to ensure that we are able to afford and deliver a national care service that works.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 26 September 2023

Maree Todd

You are absolutely right鈥攜ou have picked out one of the real tensions in the bill and in the idea of national oversight of the social care system. You are preaching to the converted on that. I come from the rural west Highlands and I represent the northernmost and biggest mainland constituency in Scotland, and I absolutely recognise that care cannot be delivered in exactly the same way in every part of Scotland. NHS Highland, which is the health board in the area where I live, has its own model of integration鈥攚e have the lead agency model and the rest of the country has a different model. In Ullapool, where I live, accessing care is a very different experience from accessing care in Inverness, which is a city and is much more like Edinburgh.

There are fundamental differences throughout the country, but we are focused on the unnecessary variation. The thresholds of need should not vary quite as much throughout the country, and there should not be a variation in quality throughout the country. It is not acceptable that people in one part of the country have to accept a lower quality of care. We want the standards to be high everywhere. There are variations in pay and conditions, which are really challenging and threaten service delivery in parts of the country. For example, the social work profession, unlike nursing or teaching colleagues, do not have a standardised approach to their pay and conditions. Working through the national social work agency, we will be able to improve that.

I will use Shetland as an example, because I really enjoyed visiting there as I had not been back for a number of years鈥攕ince pre-pandemic鈥攁nd it was a pleasure to go back to an area that I used to represent. Shetland has integrated health and social care very well, so was fairly healthily sceptical that the national care service would offer it anything. It is doing things pretty well as things stand, but we were quickly able to identify certain areas in which a national approach could support local delivery, including support with social work training and legislative changes to information sharing, which will vastly improve the experience for people on the ground. I agree that there is tension and that it needs to be done very carefully, but it is possible to raise standards generally and to reduce unnecessary variation without impacting too much on the way that people do things locally.

It might be down to the part of the country that I represent, but another very important thing to consider is that young people with disabilities who access care packages can find it impossible to move freely around the country because their care package does not follow them. We need to improve the system to make it more straightforward for them. I want young people in the Highlands to be able to go to university, and that almost inevitably means going away. I want them to be able to access education and to be able to choose employment that suits them. They need to be able to move around to do that. The national care service could definitely improve the situation with transition across the boundaries that we currently have, which are impossible for young people to navigate.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 26 September 2023

Maree Todd

Absolutely.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 26 September 2023

Maree Todd

There will be a decision on that point towards the end of the year.

Finance and Public Administration Committee

National Care Service (Scotland) Bill: Financial Memorandum

Meeting date: 26 September 2023

Maree Todd

No.