The Health, Social Care and Sport Committee has published its Stage 1 report on the National Care Service (Scotland) Bill following months of scrutiny.
The Parliament Committee has made a majority recommendation that the general principles of the Bill be supported.
However, they highlight a number of concerns in their report and say their support remains conditional on the Scottish Government addressing these concerns and agreeing to facilitate significant further scrutiny of the Bill at Stage 2, ahead of formal Stage 2 proceedings.
A majority of the Committee say they recognise the need for wide-ranging reform of social care; to address existing inconsistencies in access and delivery across local authorities, address ongoing workforce challenges, improve commissioning and procurement, and most importantly, improve outcomes for those in receipt of social care.
However, the Committee’s detailed 183-page Stage 1 report highlights a series of concerns with the proposals and the process, and calls on the Scottish Government to take a number of actions ahead of stage 2.
Committee concerns include the Scottish Government’s inability to articulate and communicate a model of how the proposed National Care Service would operate. The Committee say they are looking forward to receiving further detail from the Scottish Government on this ahead of the Stage 1 debate next week.
Following the Scottish Government’s announcements that they plan to revise the original proposals, and the partnership agreement reached between the Scottish Government, local government and the NHS in summer 2023, the Committee say they are seeking further details of amendments which the Scottish Government intends to bring forward to clarify its revised proposals.
The Committee say they understand that this is a ‘framework Bill’ but describe the lack of detail at this stage on what that framework will look like as concerning, arguing that this has limited the Committee’s ability to scrutinise the proposals effectively.
Prior to Stage 2, the Committee is calling on the Scottish Government to explore the possibility of establishing an expert legislative advisory group for the Bill to help guide the proposed co-design process.
Assurances are also sought that a full list of Stage 2 amendments will be made available to the Committee as soon as possible and well in advance of formal Stage 2 proceedings to allow for significant further scrutiny.
The Committee has also given due notice to the Scottish Government that it will require additional time to take further oral and written evidence from key stakeholders on the content of these amendments, prior to commencing the formal Stage 2 process.
In the report, the Committee concludes: ‘Subject to these conditions, the Committee recommends that the general principles of the Bill be agreed to.’
Speaking on the publication of the report, Clare Haughey MSP, Convener of the Health, Social Care and Sport Committee, said: “A majority of our Committee welcomes the intentions underlying the Scottish Government’s proposals for the creation of a National Care Service.
“Our Stage 1 scrutiny has undoubtedly been affected by changes to the original proposals, meaning we will have to reserve final judgement until we have had an opportunity to scrutinise the detail of those changes as part of a reinforced Stage 2 process.
“We welcome the Scottish Government taking on board the views and concerns of stakeholders and its plan to revise the original proposals, but it is essential details of these revised proposals are shared with the Committee in a timely manner and sufficient time is allowed for the Committee to undertake substantial further scrutiny ahead of formal Stage 2 proceedings.
“It is on this basis that that a majority of our committee has concluded that it recommends that the Parliament should agree to the general principles of the Bill.”
“We’d like to thank all who have engaged with us during this process. Their insight and knowledge have been invaluable in helping us to consider and scrutinise the Scottish Government’s proposals.”
Some of the other key conclusions in the report include:
- While acknowledging the Scottish Government’s intention to utilise co-design as a key mechanism for developing the proposed National Care Service once the framework legislation is in place, the Committee has heard evidence from multiple stakeholders that there appears to be an ongoing lack of clarity regarding the definition, the precise scope and key areas of focus of codesign or the anticipated outcomes of the co-design process.
- The Committee calls on the Scottish Government to acknowledge concerns from many stakeholders that the consensus agreement between it and COSLA and the way in which this was arrived at has undermined the confidence of many of those who have participated in co-design so far that their input is being taken seriously.
- It remains unclear to the Committee at this stage whether the Scottish Government intends to transfer those powers currently conferred on Scottish Ministers under Chapter 4 to the newly proposed National Care Service Board. Nonetheless, the Committee’s report highlights widespread concerns it has heard during its scrutiny of the Bill regarding the nature and extent of those powers.
- The Committee welcomes confirmation from the Scottish Government that, under the new consensus agreement with COSLA, local government will retain control of functions, staff and assets following concerns raised by multiple stakeholders.
- The Committee believes that a single electronic health and care record is fundamental to the success of the proposed National Care Service and calls on the Scottish Government to complete this as a matter of urgency.
- The Committee welcomes indications from the Scottish Government that, as a consequence of the consensus agreement with COSLA, rather than being transferred to Scottish Ministers, legal accountability for the proposed National Care Service will be shared between the Scottish Government and local government.
- The Committee says the Scottish Government should mandate a review of the regulation-making powers of the Bill and of any regulations made using these powers, within 3 years of each of the corresponding provisions coming into effect.
- The Committee welcomes the commitment to Anne’s Law and considers it should be fully implemented as soon as possible to ensure a human rights-based approach to care.
For info: Dissent
Tess White MSP and Sandesh Gulhane MSP dissented from many of the recommendations in the report. More details of this dissent can be found in the report.
Paul Sweeney MSP and Carol Mochan MSP dissented from certain of the Committee’s concluding recommendations on the general principles of the Bill. More details of this dissent can be found in the report.
Alternative wording of a number of the report’s concluding recommendations on the general principles of the Bill were also proposed by certain Members of the Committee. These were all rejected in votes by a majority of Committee Members.
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