 Good morning, and welcome to the 38th meeting of the Health, Social Care and Sport Committee in 2022, in the last meeting of 2022 as well. I have not received any apologies for today's meeting. The first item in our agenda is to decide whether to take item 3 in private. Are members agreed? We are agreed, thank you colleagues, and the next item in our agenda is the final oral evidence session as part of the committee's stage 1 scrutiny of the National Care Service Scotland Bill, and we are taking evidence from the Minister for Mental Well-being and Social Care and Supporting Officials. I welcome to the committee Kevin Stewart, the Minister for Mental Well-being and Social Care. Good morning, minister. Fiona Bennett, the interim deputy director for NHS integration and social care finance. Ann Kyniston, the deputy director of National Care Service programme design engagement and legislation at Scottish Government. Good morning to you all. I invite the minister to make a brief opening statement. Thank you very much, convener, and good morning to the committee. Thank you for having me along today to give evidence to this committee. You'll be aware that I've given evidence on the bill to several committees already, so it's good to come to the lead committee, although I do have another two to come. It's fair to say, convener, that the National Care Service is one of the most ambitious reforms of public services. It will end the postcode lottery of care provision in Scotland and ensure that those who need it have access to consistent and high-quality care and support to enable them to live a full life wherever they are. The NCS bill sets out a framework for the changes that we want to make and allows scope for further decisions to be made. This flexibility enables the National Care Service to develop, adapt and respond to specific circumstances over time. I want to take time this morning to reflect on why change of this scale is necessary. Scotland's community health and social care system has seen significant incremental change over the past 20 years. Despite that, people with experience of receiving care, support and providing it have been clear that there remains some significant issues. We're not just changing to address the challenges of today. We must ensure that we build a public service fit for tomorrow. Today, about one in 25 people receive social care, social work and occupational health support in Scotland. Demand is forecast to grow. The NCS must be developed to take account of our future needs, and we will build a system that is sustainable and future-proofed to take account of the changing needs of our population. The principles of any new system will be person-centred with human rights at the very heart of social care. That means that the NCS will be delivered in a way that respects, protects and fulfills the human rights of people who are accessing care support and their carers. Improved carer support is one of the core objectives of establishing the NCS. As part of the human rights-based outcome-focused approach, carers and people with care needs will be able to access support, which is preventative and consistent across Scotland. Nationally and locally, the NCS will work with specialist charity and third sector providers of social care, as well as other third sector organisations in the field of social care to meet the needs of people. The NCS will bring changes that will benefit the workforce, too. The importance of staff in the social care sector has never been clearer, and we are fully committed to improving their experience as we recognise and value the work that they do. The NCS will ensure enhanced pay and conditions for workers and act as an exemplar in its approach to fair work. Our co-design process will ensure that the NCS is built with the people that it serves and those that deliver it. They have to be at the very heart of all of that. I have noticed that your committee has been out and about hearing from those with lived experience of social care across Scotland, and you have also heard from organisations who represent them. I was delighted to see that as it is vitally important that we listen to those people as we establish the national care service. We are committed to working with people with first hand experience of accessing and delivering community health and social care to ensure that we have a person-centred national care service that best fits the needs of the people who will use and work in its services with human rights at the very centre. Thank you for your reference in the amount of outreach work that we have done, and I thank everyone who we have met across Scotland in our outreach work and public engagement. I will put two very common queries that people have put to us to you. They have come up quite a lot from both the informal sessions that we have had and also the formal sessions. Over our weeks of evidence gathering, so many of the people that we have spoken to have said to us that, relating to care, there is already a lot of excellent legislation. There are already excellent policies that they were very excited about when they were announced. There are lots of frameworks and lots of strategies, but there is a big implementation gap. The question is that has been put to us, how would the national care service close that implementation gap? Do we need a national care service to close that implementation gap? Why cannot that be done now? That is the first question. The second question that has been put to us, or a certain comment that has been put to us, is that there is not enough detail in this bill for people to ascertain what the national care service is going to be. I will put those two questions to you in the winner. They are big questions, but they are ones that come out a lot. They are big questions, and they are questions that have also been asked of me over the piece, particularly about the implementation gap. I said in my initial statement that we have been on a 20-year journey of integration. Things have improved out there, but, quite rightly, you have heard from people around about implementation gaps, as I have too. You have heard quite obviously about legislation, which, let's be honest, in many cases has been very good legislation, but the spirit of that legislation has not been put into practice and that loopholes have been found to try not to implement in the way that was envisaged. Why is it that the national care service is needed and why will it make that difference? First of all, we will see the national high-quality standards come into play to end the postcode lotteries. Let's look at an example of good legislation and get implementation gaps. Some of the folk around the table, Ms Harper in particular, have seen that at first hand along with me. That is around about self-directed support legislation. Self-directed support legislation, Parliament came together and came up with what I think was excellent legislation. However, that has not been implemented in the way that it should have in many parts of Scotland. Over the course of the summer, I spent quite a lot of time speaking to folk around about SDS, including in Dumfries with Ms Harper. There are stark differences in terms of being able to access all four options of self-directed support. There are stark differences in terms of the amount of money that is given to folk for their self-directed support. There are vast differences in terms of the flexibilities that are or are not allowed. That is really frustrating for people, particularly for folks who know others in other parts of the country, who are getting more of a service than they are. Those are the kind of things that we need to change. Not all of that has to wait for the national care service and the national high-quality standards. Many of you will know that we updated at my insistence the self-directed support guidance just recently in order that we do this better. However, to truly end the postcode lotteries of care provision that exists across Scotland, we need to go one step further, and that is the national high-quality standards. The national care service will oversee the delivery of care, improve those standards, seek enhanced pay and conditions for workers, as I said earlier, and provide better support for unpaid carers. One of the key elements of all of that is that the national care service will support ethical commissioning of care. Acting and building up is an exemplar when it comes to our approach to fair work. On your question about detail, I too have had folk saying to me that they want more detail. Some people think that I am dodging questions at point when they ask me about detail about a particular thing. However, we have said, convener, that we will co-design how we move forward with the voices of lived experience. It is those voices of those who currently receive care and support, their carers and front-line staff that will help us to fill those implementation gaps. That will be bottom-up shaping of a service that will work for all. I am going to pass on to my colleagues a question from Emma Harper. Self-directed support stuff. You did come to Dumfries and we spent some time together, and I really appreciate that because it allowed me to see that some people were really happy with what had been offered as far as self-directed support. Other folk had not even been offered it and had never heard of it. Does the national training approach involve making sure that self-directed support and the ability to offer it would be delivered in a way in which people know what it means and what options there are so that that could be delivered by 32 local authorities in a more standardised way? Yes. Indeed, it has to be delivered in a way that suits everyone. Now, one of the things that I have heard time and time again is folk saying that they have never been offered self-directed support, they have been denied self-directed support in certain parts of the country or the offer that has been given to them has been very limited indeed. That is not the way that this was supposed to work. This was supposed to give folks the opportunity and the right to ensure that they could decide upon their own care and give them the flexibility and the independence to be able to do that. I am not saying that everything out there is bad because it is not and we know that there is some very good practice where some authorities are going above and be on the call of G to build in flexibilities to get it right for individuals and for families. Now, what I want to see is that thinking going on everywhere across Scotland. That is why the national high-quality standards are so important in all of this. Beyond that, we also need to look at where it does not go right, what is the complaint situation and what is the redress for the individual and for their family where we are not getting this right. That is why we have committed to establishing a complaints and redress service for the national care service that provides a fair, effective and consistent approach to complaints and redress. We will identify opportunities to improve how complaints are handled. It is not just the fact that folk are not getting access, it is the fact that when they complain about it, they feel that they are not listened to and we need to change that. We have had some interesting sessions with people that are assuming that the national care service is going to take away the assets of local authorities. Electronic cars were mentioned way back at the beginning of the evidence session. One of the things that might help us is to tell us what the national care service is and what it is not because there have been issues that have been brought up about transfer of staff and assets that belong to local authorities, for instance. Electronic cars is something that, for me, was interesting because I questioned that. Tell us how to dispel some of the myths that have already been created about the national care service. At the very start, I have got absolutely no want or desire to take folk's electric cars off them, to be honest with you. There have been some myths about assets and staff transfer. The NCS bill only gives Scottish ministers powers to transfer staff from local authorities to care boards or to the Government as part of the NCS. However, there is no desire for wholesale transfers of staff. We have many local authorities who are delivering very good social care services, and we see local authorities as being essential delivery partners as we move forward. However, in the bill itself, we have to have a situation whereby, because care boards will become the provider of last resort, there is the ability to transfer staff if a care board becomes the provider of last resort. What I am saying is that it is by no means a foregone conclusion that local authority staff will have to transfer their employment. It remains the Scottish Government's position that the new local care boards will work collaboratively even with local authorities, NHS boards, third and independent sectors, locally and nationally. It is our intention that local staffing decisions will be taken by local care boards as they are established. That is where we are at in all of this. I have heard rumour of 74,000 staff being transferred. That is not on our agenda. I will go to Tess. I am happy to move on, but I am sure that I will pick up on stuff later. People have given us evidence and said, why do not you fix it now? The national care service, we should not pursue it at this point because we really need to act now and fix it now. Why would we waste so much money at £1.5 billion on the national care service or this massive structural reform instead of just fixing it now? What would you respond to that? Whatever we invest in the national care services for the good of people, but we know that there is work to do in the here and now. This is not all about the formulation of the national care service. That is why we are also acting in the here and now, which will be for the good of the establishment of NCS2. I am pleased that COSLA has agreed the additional actions that we will jointly take across the next 12 to 18 months to bring about improvements in the delivery of social care support now. That is through our joint statement of intent. I have to say that we have heard repeatedly from people with lived experience that the current adult social care system must change to drive up standards to a consistent level right across our country. We need to tackle that postcode lottery of care, and a different approach is needed. We must have a system where high-quality community health and social care support helps to create thriving communities across Scotland. That is why we have brought forward a framework bill to support the collaborative design with people to ensure that we address that historic implementation gap that has already been mentioned. That implementation gap between policy and legislative intent and service delivery must be closed. That is top of the agenda for people. NCS2 is important, but the work here and now is important, too. That is why we will work with COSLA to ensure the additional actions in our newly-published statement of intent. Minister, I ask that this question has three hats. One is a member of this committee and is also a representative for a largely rural area, and I am a fellow of the Chartered Institute personnel and development movement we have experienced in TUPI legislation. Have you considered the cost of harmonising the terms and conditions? I accept that you say that not all the 74,000 employees will transition under TUPI, but a large chunk could. So, have you considered that? For example, even increasing mileage rates of 45 pence a mile to 65 pence a mile, and that was a figure that was given to us by some of the witnesses, will cost millions of pounds, and not to mention harmonising sickness and pension benefits, which will go into the billions. So, are you really serious about wanting to transition to a central service for what you say in your opening, or is this plain and simply a power grab to centralise services and with the view of taking budgets away from the local council? No, that is not a power grab, but it is responding to what we have heard from people right across the country. They want to see ministerial responsibility for social care, and it has come as a shock to many of them that, while I can, as a minister, help legislate to bring about policy that I have no direct influence over service delivery. It comes as a shock to many members in this place who write to me all the time asking me to intervene in situations that I cannot do because I am not responsible for the delivery of community health and social care. We are responding to people who believe that ministers should have accountability for the delivery of social care. We are also responding to people in the fact that they think that accountability at a local level should be enhanced, which I agree with too. So, this is not a power grab, it is a response to people. In terms of the work that we have done around about staff transfers and pensions, as I said, the NTS bill only gives ministers powers to transfer staff from local authorities to care boards. However, as I said earlier, I am a response to Ms Harper. It is by no means foregone conclusion that there will be wholesale transfer of staff. The Government is, of course, as always, very well aware of repercussions of transfers. That is why we have done and are continuing to work on all of this to ensure that we get it right. If we see transfers, we will engage and consult with trade unions on transfer of staff. If it is agreed that any staff will transfer to the national care service following discussions with local authorities, cheapy regulations would apply as set out in section 3114 of the bill. The Government would engage with the recognised trade unions in line with Tupi and Cawsop at Cabinet Office's statement of practice regulations. Tupi and Cawsop place requirements on both sides to consult with trade unions in good time, and we would ensure that such consultation takes place. Our intention would, of course, be ensuring that we avoid any detriment to staff, including in relations in line with pensions. However, I reiterate the point that I made to Ms Harper that there is no intention to see a wholesale transfer of staff. I can just press you on this point, minister. We have heard that part of the issue with the current staffing issues is that social carers cannot be recruited. One of the issues is the mileage rates, 45p, and they are looking to have their mileage rates equivalent to 65p. That might seem small to you, but to many of these carers, the difference between 45p and 65p in a mileage rate can make the difference between surviving in a job and not surviving in a job. Now, the harmonising just the mileage rates will be millions of pounds, and you might say, well, we're not going to do it, and we're not going to think about it and Tupi legislation and all that sorts of things, but I'm just thinking in terms of fairness, if you're working doing the same job as somebody else and they're on 65p a mile and you're on 45p a mile, that could lead to employ relations, industrial and rest. Do you have a comment about that? I have a lot of comments about that, convener, because I know that some folk out there are not even getting 45p a mile for their mileage rates, and I declare an interest, convener, because I have two nieces who work in social care, one of whom works in rural Aberdeenshire, so I know how hard those mileage costs have hit. That is why I've written to the UK Government, not once but on a number of occasions, a roundabout them changing the rates that they set in order that we can do better for folk out there. I also urge the UK Government to find additional resources to deal with those increased fuel costs, which are taking much more money in terms of fuel duty and VAT because of those. Let's use some of that money to pay social care and other vital workers across the UK better mileage rates. Unfortunately, I have yet to hear from the UK Government on that issue. I wish that they would take a nice sense of what I have laid out for the good of social care and other vital workers not only here in Scotland but across the islands. In terms of the future, convener, at the heart of the bill is ethical procurement and fair pay and conditions. Do we aspire to do better in all of this? Absolutely we do. We need to do that for the simple reason that if we don't, we will be unable to grow the social care profession, which has taken a huge hit in recent times. We have lost lots of people because of Brexit and we need to replenish that staffing core. In order to attract young people to the social care profession, we will have to do much better in terms of paying conditions but also in terms of providing career pathways so that they see that the profession is being the right one for them. That is the only way that we will make that workforce sustainable for the future. Questions from Paul O'Kane. Thank you very much. Good morning to the minister and to his team. I wonder if I can just return to the point about potential transfer of staff and that 74,000 number, which I think you described as a rumour minister or rumours to that effect in your contribution. I think that trade unions, local authorities and my staff would contend that there is a legitimately held concern that 74,000 staff might be transferred. However, I appreciate what you have said in terms of your view that wholesale transfer is not envisaged and that it could be, for example, the provider of last resort. My understanding currently is that a council would be a provider of last resort anyway and currently fulfills that function, but I wonder if we are in the business of trying to clear up rumours and dispel rumours. Are there any other reasons that you would see that staff might transfer to a care board? There may be other reasons that staff may transfer to a care board. It may well be that a care board, for example, puts in some specialist provision in terms of the flexibilities that they are allied with in their area, and they may want to transfer staff to fill those positions. Of course, that would have to come with agreement of all in that regard. I come back to the point. Why would we transfer huge swathes of staff if the employer is currently a good one and is delivering good, high-quality social care? I have made no bones about that during the course of those discussions. There are folk out there who continue to say that I want to grab and transfer 74,000 people to the national care service because it is a bit of empire building. That is not the case. I hope that local authorities across the country will continue to be prime delivery partners—good delivery partners—serving people in their communities. If we take that as read what you have just said and take you on your word there, why in the bill have you not spelled out that that is what you are intending to do, that it is a provider of last resort, or that you referred to specialist provision? I do not know whether you can expand on that, but I presume that specialist learning disability services or something like that. I wonder if you can say why you have not spelled out what you have just said on the face of the bill to give confidence to people who are clearly very anxious. We heard in evidence from trade unions, local authorities and front-line staff that there is anxiety, not least about the implications potentially of TUPI and the implications for things like pensions. I appreciate that you have written to the committee in that regard, but it is about dispelling the anxiety for people. I do not know if you want to take the opportunity just to clear some of that up. I suggest, convener. I have said that at other committees as well. Alongside the draft bill, there is a suite of documents that includes the policy memorandum. In paragraph 48 of the policy memorandum, it spells all of that out. I would direct the committee to look at that in-depth. I would ask others to look not just at the draft bill itself, but also to look at the policy memorandum and the other suite of documents that we have published. Beyond that, convener, in terms of all those issues, I continue and will always listen to what folks have got to say. I want to allay fears and concerns. I want to ensure that people are infused by what we are trying to achieve here. The key thing for me, and I declare an interest, is that I want to ensure that we have a workforce that is bolstered by fair work and has that ethical procurement guarding its back in terms of fair work and paying conditions. I turn to some of the financial implications and the financial memorandum. Last week, we heard from Kathy Russell, who is in terms of care for relative Scotland and the social covenants training group, who said that, to some extent, what worries me is that we hear figures such as the £500 million cost of the new structure. Audit Scotland thinks that it could be more than £1 billion, but we will not get an extra hour of care for that. None of that will be spent on the front line. Can the minister explain why existing government commitments on the reform of social care, as listed in the financial memorandum, were not included in the bill? Can he give any progress in terms of the worst-fulfilling of such commitments? No financial commitments are being directly made from the financial memorandum. The process of co-design will continue and detailed work done on the preferred options will be done through a business case before the spend is committed to. A number of things have been said about the financial memorandum, which are not quite correct. For example, in the financial memorandum, it is clear that more than 40 per cent of the projected costs relate to improved pay in terms and conditions for front line social care workers, not bureaucracy costs. The estimated costs in the financial memorandum are largely represent investments in service improvements and terms and conditions for front line staff. Any suggestion that the figures relate exclusively to administration or bureaucracy costs are totally false. Additionally, investment in areas such as support services will directly improve areas such as data analysis, planning and reporting, allowing us to better understand outcomes and tailor future investment to have the biggest impact on our citizens. We, as a Government, have said that we will increase social care spend by 25 per cent, some £840 million by the end of this Parliament. That is in our manifesto, and we shall do so. Again, convener, I recognise that there have been some criticisms of the financial memorandum, which was done before the current financial economic crisis. We will consider what has been put to us and come back with an enhanced financial memorandum, but not all social care spend, which is going on at this moment and will continue to do so, is covered by a financial memorandum, which covers bill aspects only. I appreciate what the minister just said. Everyone would welcome an enhanced financial memorandum. That is very important, not least because of the significant concerns that were raised by colleagues in the finance committee. If that enhanced financial memorandum will include consideration of the vat liabilities that are involved in the process? The financial memorandum will cover all aspects that pertain to the bill. As the committee knows, we are working at this moment to ensure that we cover all bases when it comes to any liabilities, including vat. The best option here would be for the treasury to rule that there would be no vat liabilities, and we will continue to push and prod the treasury in that front. I will pop both of my questions into one to save some time. We have heard from witnesses a difference in opinion of what the bill could achieve in the medium term. Could you provide some practical examples of what impact the bill could have on some of the current issues that are facing social care? Obviously, this is a large piece of structural reform, and a lot of the issues that we are covering today are quite rightly technical, but for many in the general public that will be difficult to digest and follow, but will potentially have a large impact on how they or a loved one receives care. So what differences do you hope that workers and those receiving care will see as a result of this legislation? We have had a fair amount of discussion already this morning about implementation gaps and the postcode lottery, and the fact that folk often feel that their complaints and concerns are not addressed properly. We want to ensure that those implementation gaps are plugged and that we end those postcode lotteries. It is galling for some folks to see people who often live not that far away from them getting better services for a condition than they are. That is why the national high quality standards are important in ensuring that we end those postcode lotteries. We also need to garner the knowledge of people themselves in order to help us to fill those implementation gaps. In all of that, two preventative approaches have to be at the heart of all that we do. We talk a lot about person-centred care and lots of folk get person-centred care, but we need that to apply to everyone, and that is why getting it right for everyone is at the heart of all of that, too. Crisis costs a lot of money, and it would be so much better in terms of the public purse, but also for the human cost when we get it wrong to move to more prevention, rather than deal with crisis. In terms of delivering that, ethical procurement and fair work are so important. We need to ensure that we move forward in this front to improve recruitment and retention, which we know is a problem. However, more than that, as I said earlier in an earlier answer, we need to attract new folk to that profession. We need to attract young people into what is vital work. In order to do so, we have to show folks that they are valued not only in terms of the paying conditions, but also in terms of career progression. We have a situation at the moment, convener, where we have 1,200 employers. It is often difficult to deal with that situation, but with every single contract having ethical procurement and fair work at its heart, we can do much, much better. I want to pick up on things that the minister has said in this theme, and I am going to take them individually just to ask your one question on this, because we will need to move on to talk about co-design and implementation in detail. First on my list is Sandesh Gohani. You said in response that you have a joint statement of intent with Cozzler to make improvements now. How many meetings have you had and your officials had with Cozzler once the statement has been made? Can you name one change that you are going to make? We published a new statement of intent yesterday. I have to say that there are constant meetings between officials and Cozzler officials. As you can imagine, I see the Cozzler health and social care spokesperson, Paul Kelly, on a very regular basis, because he is involved in many of the groups, including the ministerial advisory group, which he co-chairs with the cabinet secretary in terms of dealing with the hearing now. I will give you one example of where I want to see improvement and improvement quickly. I am quite sure that Cozzler officials would agree that it is scandalous that many women working in social care at this moment have no maternity pay entitlements. It is absolutely scandalous in the 21st century. That is one of the first things on my list for improvement. The statement of intent will help us to move forward on that front and get rid of some of the antiquated employment situations that exist. We heard from Derek Feeley in evidence that he felt that the national care services needed to be progressed at pace. However, we have also heard in evidence from many that they want to pause. What would you say to that? We cannot afford to pause. We need to change the system. We have to do that carefully, and we have to do that incrementally, and we have to do that ensuring that, as we move forward, we are getting everything right. That is the dilemma for me, because I know that there are many folk, such as Derek Feeley, who want things moving at a pace. There are many folk who actually want change yesterday. Let us be honest, there are activists out there who have been campaigning for social care change for decades. They have seen some change, as we have spoken about earlier, but all of that does not go far enough for them. We have got a job to do here in terms of getting this right. That means that we have to take people with us, and we have to have people at the very heart of the co-design of the service. That will take a bit of time. We also have a situation in which Parliament, quite rightly, wants to scrutinise what we are doing. That is right, too. That is going to take a bit of time. We have to build the confidence of all as we move forward, and sometimes that takes a bit of time. While I very much understand Derek Feeley wanting to see change at pace, and I understand those activists who want to see change yesterday, I, the Government, the committee and the Parliament have to recognise that there is work to be done, and sometimes that work takes a little bit of time. There is a fine balance to be struck here, is what I am saying, basically. The question from Carol before we move into talking about co-designing in more detail. I want to start by saying that pausing the bill does not mean pausing some of the urgent changes that are needed to social care. We have plenty of evidence and quotes from professional organisations, trade unions and third sector, indicating that there is a lot that we can do now. The specific question that I have for you now is about collective sectoral bargaining. I want to know whether the Government considered that, have you had any advice on that, and will you commit to talking to the trade unions now about that, because throughout the evidence sessions that we have heard and mentioned at yourself, we can sort pay terms and conditions for social work staff, and that will make the biggest difference that we possibly can to getting quite rightly the care and support that individuals need in their day-to-day life. National sectoral bargaining at this moment is nine-year impossible because of the current setup. As I have said earlier, dealing with 1,200 disparate employers is difficult. As the committee knows in the past year, the Government has increased pay twice for adult social care workers, but it has not been easy to get that money into the pockets and purses of those folks on the front line. Through the national care service, we want to see improvements in terms of terms and conditions, as I have stated many times this morning. That includes improvements through national sectoral bargaining for the sector. However, our work on introducing sectoral bargaining is progressing ahead of the national care service, in line with the recommendations of the fair work convention. In August, the Government officials held a session to start the initial exploratory work on the sectoral bargaining with key members of the fair work in social care group. That meeting, of course, was attended also by COSLA, trade unions and by provider representatives. Regular meetings with those key stakeholders are now taking place to move this work forward and to establish a set of recommendations. It would be fair to say that I have spoken with and listened to a number of trade union colleagues over the peace, and I will continue to do so. I have had a number of separate meetings with the GMB. The last big meeting that I had with trade unions was in the company of the First Minister and Mr Lockhead to talk about trade union issues across the peace. Obviously, the national care service played a major part in those discussions. We will continue to listen to trade unionists as we move forward, and we will continue to try to make improvements in the here and now through our fair work in social care group. I want to put on the record the letter that we received from the minister yesterday, and to let everyone know that that is on our committee section of the Scottish Parliament website for anyone to look at it, but I know that members have read that, where we wrote to the minister about terms and conditions, pensions, the workforce and the inclusion of fair work in the bill, so it is quite a comprehensive letter and it is publicly available now. We move on to talk about co-design, timing, implementation and evaluation. Emma, you have some questions on that. We have heard people talk about co-design and co-production, but they are often used the same interchangeably, but we know that co-design is actually different. Tell us, minister, what co-design is in terms of shaping the national care service bill? That is a very good question and sometimes there is some confusion. Co-design is working with people in an equal and reciprocal partnership in the design of services, policies, frameworks and interventions. Involvement starts from understanding the present to deciding what the future should look like and how we all get there. There are three key clear phases to the national care service collaborative design. The first one is understanding, building on the shared understanding of the current challenges that I mentioned. The second is sense making. How can we deliver the improvement that we all want to see? The third is agreement. Do the proposed changes address the issues that are raised by people? The initial co-design themes were launched at the national care service forum in October. It will focus specifically on the information that is needed to develop policy directly associated with the passage of the bill. Those are information sharing to improve health and social care support. That includes data sharing, realising rights and recognising responsibilities. That is the human rights work and the charter development. Keeping health and social care support local. That will look at care boards, geography and board representation, for example. Making my voice heard, looking at things like advocacy and complaints, and valuing the workforce that will look at issues such as ethical commissioning. I hope that that helps Ms Harper and the committee. Part of the co-design process is how will the Government ensure that national accountability allows for local implementation and flexibility? We know that there is a big difference in developing a care to be delivered in the city of Glasgow versus rural Dumfries and Galloway, for instance. I am assuming that co-design will be on-going rather than have an end point in designing the whole services as we go forward. While we need everyone to adhere to the national high-quality standards in terms of delivery, we also have to have the ability and flexibility to create the right thing for places in terms of delivery. That will also allow for innovation. To give an example, I have had discussions with folks from our island communities, and it may well be that we need to do things differently there. We will listen and react accordingly. Ms Harper is right, because delivery may be somewhat different in rural Galloway compared to Glasgow, and we have to allow for those flexibilities. Let us give an example of what I see as an opportunity. During the course of Covid, many community organisations step up to the plate and provide help, care and support when others were unable to do so for some of our most vulnerable folk. Some of that work has continued in some places, but ethical procurement gives an opportunity for community wealth building. It may well be that some rural communities and urban communities choose to try and deliver care in their own locales. Often, the current procurement practices have been a barrier to those kinds of things. Ethical procurement can open up the door here, so it may well be that we will see in rural Galloway or in Orkney or maybe even in Glasgow others coming forward in terms of providing care and support, and we will be able to do so through that ethical procurement method. Just a question on the monitoring and evaluation of the implementation of this framework bill and then the delivery. How would you perceive that we monitor and evaluate the implementation and then the success, assuming that it will be a success of the bill? It is not just about the bill. The key thing here is that implementation and ensuring that the implementation gaps that we have talked about so often today are plugged. I will say to the committee, and I have been honest about this previously, and I will be honest again, it is often very difficult for us to gather up data around what was going on out there. That is one of the reasons why data is so important as we move forward. Now, there has been a lot of chewing and throwing around about certain aspects of social care delivery and costs, etc. It is very difficult for me, as minister, to gather up some of that information. We need to change that. We also need to look at much more outcomes and what is working for people and what is not. Although we have a fair amount of information on that, it is still not enough. As we move forward, we have to become more adept at gathering data in order to be able to monitor properly. Beyond that, we also need to continue to listen to the voices of lived experience as we continue on this journey. That is why I have not really talked about the make-up of local care boards, but one thing that I have said is that I am absolutely adamant that the voices of lived experience should be at the table at local care boards and should have voting rights. In terms of monitoring what is going on and ensuring that we plug those implementation gaps, they are the experts. I will pass on to Paul Cain. Before I do, because the minister has mentioned outcomes, I was just wanting to raise something that seems to be a really good point to make it. We have heard, particularly from people who work in social care, that the timing task model does not focus on outcomes. I want to ask the minister directly how we are going to have systems in place that prioritise outcomes for people, rather than systems dictating the amount of time that a home carer comes in and spends with them when they might need more than the 15 minutes of the day. Do you know the scenarios that have been mentioned to us, people's outcomes, rather than a system dictating what they get in terms of care? That is an extremely important question. It cuts to the crunch around prevention, rather than crisis, that I was talking about earlier with Ms Mackay. In some areas already, we are seeing freedom and autonomy given to front-line staff. Who are the folk who recognise if Mrs Smith is becoming frailer or if Mrs Smith is improving? In the home city of Aberdeen, the Granite Care consortium, the front-line staff have the ability to step up and step down care. Obviously, that has to be done in consultation with the person who is receiving care and support in their families. Obviously, there is more stepping up of care than there is stepping down. However, their ability to do that puts the person front and centre. Beyond that, if we look at delayed discharge, for example, the best way of stopping delayed discharge is stopping folk from going on the front door of a hospital in the first place. By stepping up Mrs Smith's care, are we saving a journey to A&E and maybe a lengthy stay in hospital? I reckon that, in a lot of cases, we are. That autonomy, freedom and independence for front-line staff, which largely does not exist in many places because of contracts, we need to change. We are trying to change that in the here and now. I do not want to wait for NCS if we can get some flexibility about that in the here and now. That would be brilliant. That would be good not only for health and social care partnerships and local authorities. It would be very good for people at this moment in time. We will continue to try and persuade and give comfort to local authorities, health and social care partnerships around trying to change contracts at this moment. That is clearly working in Aberdeen. There have been changes implemented in Fife 2, which I think are benefiting people. We need to see more of that. I want to see more of that before NCS, but NCS gives us that complete opportunity with ethical procurement. I ask what the minister's rationale was for a promise of co-design after the bill was passed, rather than in the preparation of the bill. Is it your view that co-design after the fact is better than co-design before we get to legislation? Who decided that the bill should proceed in that manner? We have to have a framework before we can move to co-design. We had to show the people who we want to help us to co-design all of that with us. There was a framework to blanket that co-design around that. Why did we come to that decision? We came to that decision because that is the logical way. We came to that decision because we looked at what has happened previously. I remind the committee that, in terms of the formulation and the formation of the national health service, it was a framework bill. I think that the national health service has been a wee bit of a success, has it not? I am not sure that we are comparing apples and oranges there. I wonder, though, if I can move that on slightly and just quote to the minister some of the evidence that we have heard. He said that he feels that it is a logical process that he has adopted, but we have heard that. At the moment, it feels like it is a one-size-fits-all system, and I do not think that that will work. So much is left to second realisation and co-design. We do not feel that we can have the detail to be able to comment. We are talking about a substantial bill on a national care service that has been introduced without clear detail. The bill does not deliver the changes that are required. Finally, it is like buying a house without ever having seen it or knowing how many rooms it has or where it is located. That is across a section of the evidence that we have heard from legal experts, common wheel care providers, local authorities and trade unions. I think that those are very serious concerns about the way that has been done. I wonder if the minister would like to comment on some of those quotes. I could also provide quotes from people with lived experience who want to be at the heart of shaping the national care service, which is, after all, delivering for them as we move forward. I recognise that some people are worried about change. I get that, and change is often of concern. However, I will continue to say that we will be open and transparent as we move forward on this journey and continue to listen to people and allow the opportunity for scrutiny. Let me give you the example of secondary legislation. I know that there are many people out there who always feel that everything has to be in the face of the bill, everything has to be in primary legislation, but that does not allow for the flexibility that we often need in terms of change. I give you the example of self-directed support in the legislation that I mentioned earlier. Most of that, almost all of that, is in primary legislation. We know that there are loopholes that folk are using to avoid the spirit of the act. In order to close those loopholes, you have to go back to primary legislation. It would be so much easier if we had things in secondary legislation, and if we find loopholes, if we find an implementation gap, we have the ability to change that pretty quickly in order to get that right for people. I recognise that some folk do not like that, and if we were to make change, we would consult and listen to people. However, that is a major way of ensuring that we have the flexibility of getting all of that right as we move on in the future. The significant gaps highlighted throughout a report in combination with the Scottish Government's approach to introducing the primary legislation prior to the completion of the co-design process has frustrated the parliamentary scrutiny process. That was from the finance committee's report on the bill. Given everything that I said in my previous question and the concerns of other committees of this Parliament, does the minister not recognise that there is an opportunity here to pause and to get back around the table and to listen to those concerns and to try to address them before we move to legislation? What I said at the finance committee was that if we had done it the other way around, there would have been detractors that way, too. That approach allows for the scrutiny of the principles before the co-design starts. That provides reassurance for people in the co-design process and gives them reassurance that their contributions matter. Gillian Mackay Minister, you raised the issue of sustainability of co-design with Derek Feeley. Given the number of work streams that are currently under way and the length of time that co-design could take place over, what work is being done to ensure that those contributing, particularly those with lived experience, can continue to do so and can do so in a way that is not unduly taxing? I am not going to dodge Ms Mackay's question, but I want to start off with something that I should have maybe said in terms of my response to Ms Harper earlier. Some folks have talked about co-design. One of the key elements, first of all, is that we have a job of work to do in terms of the introduction to co-design sessions, many of which are now complete, which demystifies the process for people. Over 200 folk have taken part in those so far. That gives them a fair grounding of the task that they are going to embark on. Ms Mackay is right. We want to ensure that we have all the voices that we possibly can at the co-design table. We have gone out of our way to try to attract folk with various conditions from various parts of the country. We also have to take a license of the fact that some folks may require help and support, and that may mean financial support in order to take part in that process. We will continue to listen to that and provide support that we can. We also have to ensure that we, along the way, continue that listening process and that we continue to encourage people to come forward. We also have to look at the activities around co-design, which will vary. There will be a number of things that are suitable to meet the needs of individuals, so that might mean one-to-one sessions, surveys and group sessions. The recruitment for the lived experience panels, of which we now have more than 400 folk in, will continue throughout national care service development. When I say more than 400, I should probably say 450, because I think that that is the latest number. Through co-design and evidence gathering, you will likely, as we have heard, examples of good practice in different parts of the country. How are those being incorporated into the plans for the bill and for the implementation afterwards? Earlier, we were talking about the gap between implementation. How does current work on the bill ensure that that will not happen with this piece of reform? In terms of picking the best that is out there, I have made no bones about it. I have said it to this committee previously in terms of other appearances. It is absolutely vital that we pluck the best work and export it right across the board. Informing the national high-quality standards, we must look for the best—the best of the best. That is the aspiration in all of this. However, again, as we continue on this journey, we will not wait for NCS for some of that. We are already trying to ensure that we are exporting best practice across the board. At the moment, of course, we do not have the power in terms of the national high-quality standards to make sure that that becomes a given across the board. In terms of the implementation gaps and plugging them, why should we have more confidence on this occasion rather than on another part of our integration journey? I am confident that we will be listening to the voices of lived experience. They know where the gaps are. They know where the difficulties lie. They know the barriers that have been put up from stopping them from getting the care and support that they need. They are going to be the key in plugging the implementation gaps. Of course, in the future, once this is up and running, if we find that there are gaps or if we find that there is practice that is not working right for people, we have the ability to change the standards in order to ensure that that is fixed. A lot of witnesses have raised their concerns about co-design processes that you have been hearing. Colin Pullman of the RCN said, I think that I have been quite clear in saying that the problem is that we do not know. It is absolutely not clear how the co-design process will work and that has led to anxiety in the workforce. How can you guarantee that all relevant parties will be adequately consulted? We continue to speak to and to listen to, more importantly, everyone. I have given out this morning to Ms Harper an outline of how the collaborative design will work. I realised that that was a fairly lengthy contribution, so I will not repeat it. We will send all that to the committee in letter form so that they know exactly what was said this morning. We will also outline to you the work, the on-going work, that there is with my officials, with myself and others around about all that we are doing here. I am more than happy to outline to the committee who we have been speaking to, who we have been listening to, the meetings that we have had, who has applied to come on to the stakeholder groups. All of that I am willing to share and be open and transparent about. I will set all of that out in writing, if that is what the committee wishes. It would be helpful, because you cannot outline a whole list just now, but it would be really good information for us to have. Sandesh, do you have a follow-up question? I must move on to Tess. I do, yes. In the letter that you write to us, will you also set out exactly how the co-design process will work, including, but not limited to, how the voices you hear are weighted? How do you resolve conflicting views? Who and where will the decisions be made and what transparency there will be on those decisions that you make? What I will do in terms of the letter to the committee is for transparency. I will write to you and give you full detail of all that I have outlined already, but I will also outline how we are running public workshops on co-design, which all is available on the Scottish Government website. There are two registers promoting that heavily, as I have outlined already. All registrants will have detailed training around about co-design itself. I am more than willing to be as open and transparent here as possible. I know that co-design is new for many folk. Some folk see that as being very brave. I see that as being necessary in terms of us getting it right. We will outline all that we are doing here to the committee in letter. Sandesh, can you really be quick? We are getting at 90 minutes and we are not even halfway through all our questions, so quick question in the context. I mean, just back on that. My question was really focused upon what happens once that information has been received. My question was all about once you have that information, what will happen with that, what happens after the public consultation process, and it is that that I am asking you to set out. After the co-design? Yes. We will set all that out in the letter to the convener. Obviously, as part of the co-design, we are going to have a discussion around about the end product to you, so we will outline all of that in the communication to the committee. Thank you. Do you have a quick follow-up question before I move on? Thank you, convener. Minister, welcome the fact that you say that you are being open, transparent. The adult social care independent review that was published yesterday does not mention your desire to improve maternity benefits for social care staff. If it is so important to you, why is it not mentioned and has it been costed? Is it on top of the £1.3 billion estimate for the NCS? Thank you. One point four billion, as Ms White mentioned, covers the bill. That is not on the bill, that is action that we are taking now. That statement of intent covers a huge amount of things, including pay and conditions, maternity pay being a condition. Now, not all of these things are spelled out individually in that statement of intent. I picked one off the top of my head, which is one that is extremely important to me. The cost of that, again off of the top of my head, and I will correct myself if I am wrong in writing, is around about £4 million, if I remember rightly. I am just looking at the clock. The minister has been sat there for nearly 90 minutes, so we are going to have a break in about 10 minutes time. I want to get another theme under our belt before we do that, because we have still got an awful lot to discuss. Questions from Steff and then from Caroline Walken, before we take a break. Thank you, convener. I have got three questions. The first of them, you have touched already on monitoring, evaluation and outcomes. The bones of it seem to be that we are really good at asking people what would you like to see, we are maybe not so good at asking people how was it for you, and that is what really, really matters to people. It has been suggested, for example, that we could adapt the Northern Ireland England and Wales national audit in national survey of bereave carers, but I am wondering if you can ask you to be quite precise about how successful we were measured and evaluated, and perhaps divine consistency and quality. That is a big question. I do not know about... I have got another two, so just not too long. I think that we have a long way to go on data. I will have a look at the English Northern Irish and Welsh situations, but there is some data that I would like to get my hands on, which is not so easy to obtain. We have got to do better on that front. We also need to do better in terms of individuals' data as well. That is why the national health and care record is important moving forward. Depending on the data sharing agreements from that, we can get much, much more accurate data about what is going on. I really do get your point about consistency and quality of data, because you will know that you will have seen it at this committee. Some of the data that we receive is often caveated and quite heavily caveated to boot, so it does not necessarily give us the true picture. Mr O'Kane talked earlier about comparing apples with oranges. I often feel that that is what we are doing when we are looking at some comparative data. We absolutely need to get better at that. I think that the national health and care record will go a long way in helping us in that front. I would say again that, even before our NCS, we must continue to refine what data we are collecting, how we are collecting it and the impacts of that on people. I appreciate the committee for taking a look at that as well. I am also interested in your vision for community health services. Can you provide some clarity? Certainly, we have heard in evidence that people have concerns around that, because it is truly really central. Can you provide some clarity on where that will sit? People have felt that it is missing from the bill. Clearly, that is vital if social care is to be viewed as an investment rather than a cost. Community health is one of the foundations of the national care service that we need to get right. We have learned through early engagement with stakeholders that it is imperative that we continue to engage people with experience here. Community health, as it currently stands, as those services are based in the community that provide the first point of contact diagnosis and treatment comprises more than 90 per cent of all interactions in health. Many problems are identified, managed or resolved within the community, making one of the largest areas of healthcare and one of the most crucial. Community health, community social work and social care services are the front line. They are accessed in a variety of ways through many of our health and care sites, or even in people's homes or remotely supported by technology. Again, we need to look at the best practice here as we move forward in terms of getting it right for NCS. I should say for clarity that community health staff will remain within the NHS. Commissioning and planning of community health will be the responsibility of the national care service. That will build on the current integration arrangements that are in place under integrated joint boards. I have a concern that seems to be about the fact that there is not really many mention of it in the bill. Is that something that maybe needs some further consideration or where exactly we are at with that? I do not think that it needs to necessarily be mentioned in the bill, but what we all have to be cognisant of is making sure that in the co-design that we get all of that absolutely right and that we get integration absolutely right. One of the things that has been strange for me is that many folk have said that various things should not be in the bill. Criminal justice should not be in the bill according to some. Children's services should not be in the bill according to some. There are numerous arguments around that. I should say that in those two areas, the Government has not taken any decisions yet about whether it should be in or out of national care service. At the local government and housing committee the other week, there was a suggestion from a member that housing and homelessness services should be in the bill and should be in the NCS. That is not going to be the case. However, we have to make that the linkages between the national care service, no matter what is in or what is out, has the linkages with other services across the board, including housing and homelessness. There are areas that might not be being discussed or are not seen to be being discussed by you folks as much as should be, but those are conversations that are being had right across the board. It was raised by Alston Care, Royal College of Occupational Therapists, by Finchay Akely, Blackwood's Homes and then a session by Henry Simmons from Alzheimer Scotland. It is round about rehabilitation and the rights of people to see part of the national care service as rehabilitation. Those experienced people indicated that the authority should be on the face of the bill, and I wondered whether the minister would commit to looking at that. I will consider anything, but again I would come back to the point. If we put too much into primary legislation here, we may end up in a situation where it is difficult to change what is there. In terms of rehabilitation—I do not really like the term reablement, so I am glad that you have used rehabilitation. We are seeing advances as we move forward. We do not want to set everything in stone, so secondary legislation is probably the right place for that. Obviously, I want those very good folks, some of whom I know very well, including Finchay Akely for my previous role in housing. I want them to be at the table helping us to shape what is required as we move forward. Blackwood itself has made some immense advances in terms of the technology that they have put in play in order that folk can live free and independent lives, including a washing machine that Irons convener, which was something that took my eye—hadn't I got him yet, but it's something that I've certainly been considering over the piece. We need those folks at the heart. I will consider what they have to say. I don't think that it necessarily has to be in primary legislation on the face of the bill, but their voices have to be heard, and we have to get that right as we move forward. I would say that Ms Kiniston pointed that out to me. If I don't say that, she will be giving me into trouble. Again, I refer the committee to the policy memorandum around this particular area. Parah 38 has that commitment to improve outcomes through prevention and early intervention, and I think that that fits in there. It is also in part 1 of the bill. Last question before we take a break. Thank you. I'm grateful for you allowing me to come back in. We had Mark Hazelwood here last week from the Scottish Partnership for palliative care, and he was talking about the fact that not everybody is going to recover, and that one in three hospital beds are actually used by someone in their last year of life. There were two things, quite specifically, that they would like to see included in the bill. They are talking about putting down in the bill about irreversible health conditions through illness at old age, people who have got their end-of-life approach in, and secondly, around interventions about them preventing or delaying the development of care needs and reducing care needs in support for those with irreversible health conditions. The kind of felt that end-of-life wasn't included in the bill, even though it's something that we're all going to face at some point in time, and it's becoming a larger and larger proportion as the demographics change. I'm really interested in those changes to the principles of the bill to include end-of-life. Is that something that you can take away and consider, or what's your response to that? I will look at what Mr Hazelwood has said, and Mr Hazelwood has engaged with us a fair amount. If I remember rightly, he was at the Charter of Rights and Responsibilities co-design the other week. Again, I would come back to the point of not everything has to be in that primary legislation. While that end-of-life care is absolutely vital in getting it right, if we put too much into primary legislation, that does not allow us the flexibilities to change. I rule nothing in or nothing out, but probably the best way of getting this right is doing so in secondary legislation, with the flexibility to change in the future as care in this area changes, as it has done to a huge degree in recent years. In terms of the points that Mr Hazelwood has made elsewhere and others have made too, we have to do all that we can to try and meet the needs of folks at the end of life. I have experienced loved ones' friends who have passed at home and who have had much better experiences because of that. We recognise that there is work to be done there, but it is whether that needs to be in primary or secondary legislation. I know that I said this was the last question before we gave you a break, minister. If the bill is too prescriptive, people involved in the co-design process will not have the agency that they would otherwise be doing what they want to do with the national care service. I revert back to my point about SDS. It is a fantastic piece of legislation, we all thought, but some folk have found loopholes that have not been challenged, they have not been easy to change, and I have tried to change some of that through guidance. You know yourself in terms of vehicles for primary legislation, sometimes they do not come along very often, whereby if you find a flaw, if you find a loophole, or you know something changes in terms of the way that we deal with an illness or a condition, we can change secondary legislation quite easily or easier. That does not mean to say that we do not have folk scrutinising and being open and transparent about it, because I would expect if and when secondary legislation is required to be changed, that we continue to have the voices of lived experience guiding us there too. We will give everyone a break for 10 minutes and then come back. We will continue with our question to the minister on the national care service bill and on the charter of rights, responsibilities, complaints and independent advocacy, and we have questions from David Torrance. Thank you, convener. Good morning, minister. The committee has heard evidence that there is a wide support for a charter, a complaints process and access to independent living, but there is also a previous briefing that says that a model for a charter is not clear. Minister, will the charter of rights and responsibilities provide a clear understanding of what people can expect from a national care service in terms of the rights? Will the reference to rights be explicit and will we be enforced, and if so, how? A big question, a big set of questions. I should probably start at the very beginning of that, because the national care service consultation demonstrated, without a doubt, strong support for a national care service charter of rights and responsibilities so that people know what to expect. Therefore, we have commenced the work in developing that charter of rights and responsibilities. The design and the development of the charter will set out the rights and responsibilities of people accessing national care service support. It will set out information on the national care service complaints and redress system, which will provide recourse if the charter rights are breached. It will also set out information about how to access further information, advice and advocacy services. The charter will support people accessing NCS services to better hold the system to account and to receive the services that they need to thrive rather than just survive. One of the things that has been at the fore in discussions that I have had with folks with lived experience is that many people who have had poor service delivery, who have not been cared for in the right way and who have found it very, very difficult to get all of that sorted. Often, I hear the same tale and I have said that if I did a pound for every time I had heard this, I could probably go in and I would ring the world cruise but not something that I really want to do in a pandemic period, I have to say. Folks saying that I complained about this and was told by the health and social care partnership that that is not the local authority or the health board. It goes on and on and on and that is just not good enough. We have also come across on numerous occasions in terms of the work that we have done, situations where there had been arguments between health and social care partnership local authority health board about who is paying for something and then the person not getting it for a very long time, which actually leads to some real difficulties. We have got to get that right in terms of the rights and responsibilities. I want people to be empowered and as I hinted earlier on, one of the first co-design sessions around the charter of rights and responsibilities to hear what folk have to say. There are some polarised views that we are going to have to work our way through but we have to get that right for people. We have heard that co-design is limited to the development of charter and complaints process and independent advocacy. Is that correct or can you expand on how you have engaged? Sorry, could you repeat that question? We have actually heard that co-design is limited to the development of the charter and the complaints process and independent advocacy. That is not the case. I do not know what has been said there. If I could get any quotes on that, we will have a look at that and respond accordingly. Thank you, minister. The other one is, what is the timescale for development of charter and independent advocacy and complaints process? Will the complaints process be independent of ministers as well as commissioners and care services providers? Again, in terms of the last point and the question, we are in about independence of this one, that one and the other. We have to work some of these things through. That has to be part of the co-design process itself, and we have to look at the accountability aspects around that too. Again, some of that will be worked through in terms of the co-design. What we do hope, convener, is that we have a skeleton, a draft of all of this by next summer, which is quite ambitious, but I am sure that, with the co-operation of the folks who are helping us to develop us, it is achievable. I am just looking at our papers in regard to the minister's question. We are asking that the co-design is limited to development of the charter, the complaints process and independent advocacy, or is the co-design going to do more aspects of the bill? Is the co-design going to be expanded beyond those three things? I outlined earlier on, convener, some of the main aspects of the co-design in terms of those areas that we need to look at in terms of co-design. I will repeat some of them again. I will not go into all of the detail, as I did earlier, and we said that we would try to… You did go through some of the co-design themes. Number two in my list was realising rights and recognising responsibility, which includes the charter development. The other things were information sharing, which we have touched upon already again this morning, to improve health and social care support, keeping health and social care support local, making sure that voices are heard and valuing the workforce. However, as I said, we will write to you in all of those things. I just wanted to give you clarity on what David was potentially getting. I was just looking at the papers and where you were coming from, just so that that is now on the record. We now want to talk about care boards, and I will hand over to Paul O'Kane. Very grateful, convener. I wonder if I can begin by asking more broadly about structures. I hear what the minister says about the need for national standards, and I think that there is a large degree of consensus around that. However we look at it, the national care service involves structural change—big structural change. Does the minister feel that there is a risk that structural change becomes an end in itself rather than a means to a greater end? Structural change is important, but that is not the be-all and end-all of what we are aiming to achieve here. What we have to do is to make sure that we have a service that works for people. There are quite a few arguments out there around structural change, but the focus of all that we do here has to be on people themselves. The committee will have heard some of the comments that I have made to the many other committees that I have appeared in front of around the purpose of care boards. I will go over some of that again, some of which I spoke about earlier to Emma Harper. The national care service will balance the need for local flexibility by having the care boards plan and commission care whilst providing national consistency through ministers being ultimately accountable. While local boards will have their own budgets and staff, they will be directly accountable to Scottish ministers. That will ensure that the standards that we have talked about are maintained across the country so that high-quality services are in place that are reflective of local circumstances as they are delivered. I am quite sure that Mr O'Kane might follow up with some of those around the amount of care boards, the care board compositions and all the rest. I will go through some of that just now. Care board membership will be examined in detail as part of the co-design process, as will the number of care boards. Based on responses from the consultation, we are obviously looking at how membership will include people with lived experience, which is the one point that I am adamant about, as I said earlier, so that we are making sure that lived experience is at the heart of decision making. For some people, that has been controversial. Some people have suggested to me that folks with lived experience and care boards will have vested interests, so they should not be there. However, the same argument is often used for local authority members and various things. We declare interests and sometimes leave if we have an interest, so I do not see that as a problem. We will also consider, through the co-design process, how we might include carers, other professionals, service providers and local authority elected members in local care boards. We are committed to ensuring that all the in-care boards will have full voting rights. The other aspect might be the numbers of care boards. That is another matter for co-design. However, let us be honest here, I have heard a suggestion from one person that there should be 250 local care boards. I do not think that that is possible, and we have to be honest around the parameters in terms of co-design. I can go back to understanding the point about ministerial control and the desire for ministerial control as opposed to that local control. The minister said that people have told him that they want to see ministerial control and accountability. I appreciate in previous answers that he has said that he is going to undertake to communicate to the committee where that evidence came from. 17 per cent of the folk in the consultation said that they wanted to control the Scottish ministers to have control and accountability over that. As he knows, people have raised issues around that consultation and how consulted they felt. We can go through the detail of that, and I am happy to do that. I speak to lots of people who have lived experience as well. Some people have raised concerns, but I want to get to the heart of what interest will local authorities have in the delivery of social care if they are not accountable for it? If they do not hold a statutory responsibility, what is the role of local authorities? Mr O'Kane has been an elected member in a local authority, as I have. Councils and local authorities do not just carry out functions that they are statrally obliged to do. They do other things that are for the good of the people, of the area that they represent. As I said earlier on, we want to ensure that local authorities remain as prime partners for the delivery of high-quality social care in their communities. That is for the good of the people that they represent and whether they are accountable by law for that or not. I am sure that the altruists who serve on local authorities will see the huge advantage of ensuring that their people are cared for appropriately and to the highest quality standard. Beyond that, as I pointed out, in terms of local care boards, as with IJBs at this moment in time, local authority members will play a part. The minister does not recognise that there is a principle here about decisions being taken as close to people as possible and the role of local government in doing that. He is right to say that him and I have both served as other colleagues in committee on local authorities as councillors. I am keen to understand why he feels that it will be more accountable by virtue of 129 MSPs and the minister having that control as opposed to local councillors. Does he feel that local councillors are not accountable enough just now and do not represent their constituents in those issues? I will refer back to the policy memorandum again. At the end of the day, the national care service will be there to provide leadership, oversight and accountability for community health and social care, including by providing strategic direction and planning at a national level and regional level, and performance management and monitoring of care boards to ensure that national standards and expectations are achieved, albeit in a way that suits local circumstances. I have pointed out again and again this morning that local accountability needs to be strengthened, too. That is the purpose of this bill. That is what we have heard from people, but that does not stop. None of that stops local decision making. None of that stops local flexibility and innovation, and none of that stops flexibilities around about delivery of services in particular areas. However, those national high-quality standards must be met. That ends the postcode lottery of care, which again folk want to see, but it does not stop flexibility. You have stated to various committees over the past weeks and to us as well that local authority function staff may not be transferred to care boards at all, and that care boards merely act as a provider of last resort to ensure the continuity and quality of service. In what circumstances would you deem that transfer to be necessary? If there was service failure, let me give you an example in terms of provider of last resort scenarios at this moment. It may well be that a care home in a particular place collapses. The company may go out of business. The local authority would move in in some circumstances as the provider of last resort and take that over and ensure that there is continuity of care for people. Those things happen on a fairly regular basis, unfortunately, not just in terms of care homes but also in terms of some care at home and provision and other things. There is a feeling that the centralising agenda of the national care service will negatively affect rural and island communities disproportionately. Nick Morris of the NHS chairs group in Scotland said that the logical conclusion that is suggested by the NHS proposals at the moment is that the island communities would have less control of NHS elements of care because it would all go to a care board. Do you agree with Mr Morris' interpretation and how are you going to mitigate powers being taken away from those local providers? I do not see this as centralisation at all. I should say to the committee and some of the folk around the table will be aware that I was the First Minister to island proof a bill, the fuel poverty bill, before the island's bill had passed. In all the work that we are doing here, we take a licence of the different arts and parts of our country and how we need to get it right for everyone. We have a separate work stream at this moment looking at islands and what we can do there and looking at some of the suggestions that have been made by some authorities about how they can deliver in all of this differently. I have been in Shetland over the peace a few months back to listen to their views. I am due to go to Orkney at the beginning of the year. There have been suggestions from some island leaders—not all, I would hasten to add, and that needs to go on the record, not all—but there have been suggestions around about single island authorities. That is something that the Government will look at. In terms of our more rural areas, particularly remote rural areas, as I said earlier, there is an opportunity here with ethical procurement to change the way that we do things. I hope that those opportunities will be grasped. We have to look at how we deliver across the board. I will do that. My officials know what needs to be done in that regard. Again, we have gone out of our way to find voices of lived experience from our more remote rural and island areas, whose difficulties are often much different from those folks in my own community in Aberdeen in order that we get it right for everyone. We know that integration joint boards are not always delivering, and that voices are sometimes not heard on integration joint boards. Clearly, there are some concerns with some people that recreate a system that moves people around when we talk about care boards. It sits them in a different seat, if you like. Are you able to give us an example of any area that is working like a care board just now? I am thinking of Granite Care Consortium, where it has health, health and social care partnerships, lived experience providers who have a different range of expertise. They are all very much sitting around one table and collaborating together and everybody has a voice. I would be really interested if that is the vision that you have in mind for it. Secondly, we have heard a few times from different people about the suggestion of having a national care board that is a kind of overaction, if you like, of local care boards. I think that Ms Callaghan is enticing me to be naughty here, which I am not going to do. I am not going to name where things are good or where things are bad. It is very clear that those areas in which there is increased delegation to IJBs, to health and social care partnerships tend to perform better. I think that there are other aspects of that in terms of the scrutiny agenda. I do not know how many of you around the table are as anorakish as I am, but I have gone out of my way at points to dig a little bit deeper, as always, which I am prone to doing. You look at some IJB agendas in minutes and you can see quite clearly that they are taking their scrutiny responsibilities very seriously, and they are making some really key decisions. The frustrating side of the coin is that some IJBs look at the agenda and the items in the agenda, often which are pretty serious items, but are for noting only. It does not look like that there is a level of scrutiny in our decision making that there should be. Do not take my word for that and have a look at them. What we actually need to get to is a position where local care boards are scrutinising and taking the decisions and being accountable to the populace at large for the decisions that they are taking. In terms of the suggestion of a national care board, I have heard that suggestion from some. I am not entirely convinced that it may just be another bureaucratic layer and I am not really one for bureaucracy, as you well know, but my ears are still open on that one. There are just a couple of questions on the establishment of care boards. There are a number of sections in the bill that talks about establishment and abolition of care boards, directions of care boards, removal of care boards. I am interested to hear how we move forward in developing the care boards and who will be on the care boards and then will they be commissioning bodies or delivery bodies or a bit of both? That is a huge question, which may take a very long time to answer. Let me be as brief as I can and then I will fill in some of the other detail in writing to the committee. Obviously, in terms of the care boards themselves and some of that design work around about huge round-the-table all the rest, I have already said this morning that that is part of the co-design process. It has been thrown at me that the bill itself means that I could appoint and discard care board members at my will or my successor could do that. That is not the case. Many of the powers that we are talking about here are powers that are there in terms of NHS boards 2. Powers are used extremely sparingly indeed. However, that is an area where I probably need to tease out even more detail for the committee. If you are agreeable, convener, that is an area that I will follow up in writing. I will give some of the comparisons that I have made with other bodies if that suits you. In evidence, Karen Hedge from Scottish Care had concerns that care boards might just be recreating a system that exists already. I know that we have heard folk talk about moving the deck chairs around so I am just seeking clarity that this is about establishing a care system that will benefit the people on the ground who have been asking for better care and support for them personally. Absolutely. That is not about moving the deck chairs at all. I am not into that kind of game. What we need to do is to take cognisance of the views that we have heard from those who are in receipt of care and support, their carers and front-line staff around about the improvements that are required. I will also come back to the point that I made in my opening statement. We cannot tinker at the edges here. We have a changing demography here in Scotland. We need to expand the social care workforce, as I said earlier. We need to make real change and, of course, in so doing, people have to be at the very heart of all that. A number of members who want to ask questions about commissioning and procurement, I will start off with Carol Mochan. I am particularly interested to go back again to fair work. We have heard quite clearly from the evidence of people coming to the committee that there is so much that can be done now. I want to ask the minister if he can make a commitment to look at what has been achieved so far and push forward with that without having to have it rely on the bill? I have already given an assurance this morning that we are moving on many of these fronts. That is why we have the statement of intent with COSLA. There are things that I want to have seen done yesterday myself, and we will continue to try in advance in all of these. What I would say to Ms Mochan and others in the committee is that sometimes those things are not quite so easy, and what I would like to see is national sexual bargaining as envisioned in terms of our NCS proposals. Can you tell me what the key barrier is to that? All the evidence that we have heard from the trade unions, professional organisations and some of the third sector is that that should be happening. I am unclear what the key barrier that you find in government is to that. Key barriers are 1,200 disparate employers, as I said earlier, who are working to contract which government has no control over. Again, what I would say is that those two waders that I wanted, everybody here wanted, in the folks' pockets and purses as quickly as possible, is not the easiest thing to achieve. Again, we do our level best here, but there are things that we are reliant on others in doing at this moment in time, which often makes things not as easy as it may seem. It has been suggested that reinforced provisions on commissioning and procurement would be an important way of giving practical effect to embedding fair work principles in the social care sector. I appreciate that there are complexities to that, and that the minister has said that work is on going on. What provisions would the minister like to see in the bill? Would he work with himself and others on amendments ahead of stage 2 to embed some of those? As always, I am more than happy to work with anyone in ensuring that we get things right as we move forward. That is not to say that I will support every amendment, let us be honest, but if we can work in partnership together to get the most out of all of that, then I am more than happy to do so. Ms Mackay knows that ethical procurement is one of the top things in my agenda. I want to make sure that we do our level best to get all of that right and to embed fair work principles as much as we possibly can. However, I should highlight to the committee that you are all very well aware that employment law is not a power that this Parliament holds, so we have to do that, as always, with great care. However, it has been achieved previously in other bills—a forestry, if I remember rightly—that we need to do so again. If that means co-operation and collaboration with other members to get that right, I am more than happy to do so. The policy memorandum describes a new national social work agency that will be a department of government. Some witnesses have requested that the agency be independent. What is your view on that and what would you say to those who believe that the agency should be independent of government? The independent review of adult social care recommended the establishment of a national organisation for training, development, recruitment and retention for adult social care support, including that specific social work agency for the oversight of professional development. The policy memorandum again outlines the intention to establish that agency. There are a number of things that folk have come to me with around the social work aspect of this. We will continue to listen to what folk are suggesting. I think that, from our perspective, it should be part of the national care service, but we have listened as we have gone along and we will flex if need be on that front. If somebody can convince me the advantages of that being entirely separate, I will listen. However, we have to remember that there are huge linkages between community health, social work and social care, and what we do not want is to create a further fragmentation, if you like, in all of that. As the committee can well imagine, I have had a fair amount of meetings over the piece with various social work bodies. I should apologise, I had to miss one last week, because I was unwell, but we will continue to do that as we move forward to listen to their voices. However, I have to be cognisant of the linkages, and if there is something different, does that cause fragmentation? What does that do to service delivery for people? Concerns have been raised that, without a cultural shift, reform would replicate the same problems in a new setting, and some highlighted the need for retraining to ensure consistency. How can the Government ensure that there is going to be a cultural shift, and how can those issues be dealt with? That is the big question, because we can talk about legislative change, regulatory change and planning changes too, and often that has not led to real change. However, what we have discussed this morning around what is happening in certain parts of Scotland, if we could replicate elsewhere through ethical procurement, through fairer work, we would get that cultural change. At the end of the day, if we look at that Aberdeen situation again, I know that we keep picking on that, I know that the committee has been there, and I have been there, so it is one that we all know. Giving staff that freedom, that flexibility, that independence in the front line changes cultures dramatically. It is not just in terms of social care, it is also in terms of social work. Due to visit five shortly, in a couple of areas, they have given social workers a clean sheet about what they can do. Already it seems that there are some very positive outcomes from that. That freedom for social workers was embedded in the 1968 act. That has moved away from that. Many of the social workers I have talked to feel that they are not empowered to take the right decisions at the right time for people, because they feel that the eligibility criteria and budgets get in the way. We have to move away from that, and again that means a massive culture shift which can be achieved. Legislation regulation is fine, but in order to get that culture shift, it is about empowering the front line again. We can do that in terms of ethical procurement and fair work. We need to be trusting of a workforce that should be trusted. Minister, the convener for the Finance and Public Administration Committee, Kenneth Gibson, said that with the bill it seems that the Government is using a sledgehammer to crack a nut. With your own party and the finance committee raising concerns about the spending of this bill, how can you possibly justify the costs? I thought that it was £1.3 billion. You said this morning that it was £1.4 billion, and that is not including terms and conditions of employment and benefits. Some even say that it is an open checkbook. I do not think that Ms White has been listening to some aspects of what I said this morning about the financial memorandum and the fact that it covers a fair amount of costs in terms of staffing and conditions. We need to change. Folk recognises that change is required. We cannot continue with the same system. Derek Feely highlighted that in the independent review in adult social care. We need to plan and invest for the future in order that those of us—probably the bulk of us—that will require care and support in the future have the right care and support in the future. As for the analogy of a sledgehammer to crack a nut, there are many folk out there with lived experience that would have used sledgehammers long before now, it has to be said. I would be very naughty if I was to repeat what someone from the social covenants steering group said, but for many of the folk, the sledgehammer has not come out quickly enough. Social workers have been described as the GPs of social care. David Grimm contacted me about a letter sent to you in October by Lauren McNamara from Student Awards Agency Scotland, signed by 316 social work students and 20 lecturers. They are asking for a student social work bursary. Is that something that you are actively considering as part of your joint statement with COSLA, or is it something that the national care service might be able to provide? I cannot remember seeing the letter from Laura McNamara, but we will have a look at that and respond accordingly. We will now move on to talk about the continuity of the transition to community health, and I have a number of members. Members, if you have a follow-up question, can it be brief because we are getting to the point where we are going to start eating into other business if we take too much time. Questions led by Gillian Mackay? On the homelessness side of things, how do you envision the bill will engage with those experiencing homelessness, particularly through community health? How do we envisage the bill improving the lives of those who are experiencing homelessness and other things that might bring chaotic periods in people's lives? The subject is very close to my heart because of my previous job. Just because you changed jobs, you do not forget about things. The greatest breakthroughs that we have made in recent times in terms of tackling rough sleeping and those folks who are the most vulnerable has been the work that we have done in terms of housing first, which brings housing, care, health and others together in order to create the right environment for somebody to thrive in their own home. That has been immensely successful, more successful than any of us could have hoped to imagine with the last figures that I have seen and they may be out of date with 90 per cent tenancy sustainment. We need to ensure that services, no matter who or what they are, are wrapped around the individual in order to get that right for people. Some of our changes in homelessness legislation obviously will put duties on folk to do that. The national care service has a big role to play in all of that. I talked earlier on about the linkages that we need to create to ensure that we get that right. That is why I have met and will continue to meet folks from the housing and homelessness sector. That is also why Shona Robison and I have met a fairly regular basis with officials in order that we get that absolutely right as we move forward. There may be many people who transition through different tenures of housing during their social care journey, whether they be disabled people or whether they be people who are maybe approaching the end of life and who may move from, for example, a family home into either supported accommodation, sheltered housing, for example, or into palliative care or a care home. How can we ensure, through the national care service and through co-design, that we take on board some of the experience good or bad that people have had through those journeys and that we make those journeys and those transitions as smooth as possible for people? I think that Ms Mackay has taken me back to my own job here as well. It is often immensely frustrating when housing itself is causing a difficulty for somebody to live a fulfilled and independent life. There has been a substantial amount of investment over the past number of years in trying to get that right. If you look at where we are in Scotland, particularly with our social sector, but also in terms of some of the mid-market builds, housing for varying needs has been at the heart of that build. Again, my figures are out of date, so I probably will not quote them. The vast bulk of the social housing that we have delivered was to the housing for varying needs standard so that, if folk circumstances change, they could still live in the same home. However, we recognise that housing for varying needs standard was a bit old and a review has been undertaken. I am not exactly sure where we are in that review, but I will get back to the committee after liaison with Ms Robison. However, it is important that we recognise that there are changing circumstances in terms of people living longer and various circumstances. That design guide for varying needs had to change. We are also looking at changes to building standards as well to underpin as Scottish accessible home standards, which all new homes must achieve. Again, convener, there has been a lot of discussion about aids and adaptations, because sometimes a wee thing, a wee change in the house, can make it liveable. If it is not there, it means that somebody is unable to stay at home. Again, there is a lot of work and discussion between areas of government around aids and adaptations. Just to pick up on where you were at there already, I have to say that housing first was a revelation. You could see it really changing people's lives on the ground there. It was all about that wraparound care, that seamless joined up services there. I suppose that it is almost like a public health approach at population level. It is the bigger picture of that there. Clearly we have housing and homelessness, but we have also got all those other local services that are closely related to social care, mental health, drugs, alcohol issues, et cetera. Why is the NCS the way forward to get this seamless joined up care that people are looking for that matters to them? Let's take the example that Ms Callaghan gave around about drugs and mental health. Angela Constance and I, at points, seemed like we were joined at the hip in terms of getting it right for folks who have more than one difficulty. I have to be honest and say that services in many parts of the country are not what they should be when it comes to the like of dual diagnosis. That is why we are already changing standards. We have a number of pilots on the go around about getting this right. These things should become the norm. That is why we need national high-quality standards in order to get it right for everyone. We cannot have a situation where we are pushing folk from pillar to post. That is one of many reasons why we need to have a completely joined up approach. In terms of folks through housing first, where there has been substance use and mental health difficulties, we have managed to overcome barriers for those folks in housing first in many of the occasions. We should and need to be doing that right across the board for everyone who may have those kinds of situations in their lives. One of the barriers to that seems to be the idea of incorporating community health primary care services, etc. Can that really be achieved if we are saying that no health staff can be transferred into the national care service? Yes, it can be achieved. We are seeing changes now in certain areas in terms of how we are dealing with folk. Yes, it can. I wonder if I can ask the minister what will happen to health and social care partnerships as we understand them, given the process of integration that has happened in various local authorities? What will happen to them? What will happen to them? What will the status be of health and social care partnerships if we envisage them not existing in their current form and being redeveloped through the national care service process? As I have said, we intend to establish local care boards and the co-design around local care boards and delivery will be worked on with those voices of lived experience, with front-line staff, with stakeholders in order to get that right. I think that there is a huge amount of learning to be garnered from what has happened in health and social care partnerships. Mr O'Kane represented East Renfrewshire, a health and social care partnership, which has achieved a great deal. I came back to my point earlier about those areas where more services have been devolved seems to work better. I want to ensure that the learning and the good practice from health and social care partnerships, such as East Renfrewshire, are captured in terms of the delivery of our future services. I also want to look at those places where that has not worked quite so well and learn the lessons from that, too. The minister will hear no complaints from me about singing the praises of East Renfrewshire. He makes a fair point in terms of the length of time that integration has been part of the fabric of certain communities in trying to learn from that. I wonder if I can turn briefly to the social work element of that and the further consultation that the minister intends to undertake around children's services and justice, criminal justice and social work. I wonder if the minister can say anything about his intended timescales for that further piece of consultation. Convener, we were very well aware that, in terms of the work that we have done on adult social care, we had a huge amount of information, a huge amount of consultation that has been carried out. We have undertaken to do similar in terms of looking at children's services and criminal justice social work, which work is on going at this moment in terms of looking at all of that. We will continue to consult and listen to people on those fronts. I reiterate again that the Government has taken no decision on transferring children's services or criminal justice social work to the national care service at this moment in time. We move on to talk about Anne's Law, which is the final theme that we are going to cover. Many of those who gave evidence were worried that Anne's Law was ambiguous and did not contain enough assurance that visits would still be permitted in the event of another. Can you offer reassurance, minister? The NCS bill will allow Scottish ministers to exercise powers under section 72 of the Public Services Reform Act 2020 to require care home service providers to comply with any directions issued by ministers. The key issues that you have talked about that have been raised by stakeholders is that our proposed approach to delivering Anne's Law through their directions does not go far enough. The Anne's Law should be extended beyond adult care homes to cover additional settings, and we have talked to others about that and there is dubiety about that. We have also talked about the importance that is placed upon local decision making. Again, it is well understandable that the importance of human rights and a person-centred approach as we move forward. In the recent parliamentary consultation, some respondents indicated concern about the approach that we are taking. Whether that use of directions is the right approach, I think that it is absolutely the right approach to that use of directions. The most challenging issue in addressing all of that in terms of the use of the directions has been how to balance the views of some that endorse the occasional need to restrict, and that in the main is public health Scotland and others on health crimes. Although the directions themselves and visits continue visiting during outbreaks, we expect formal advice from Public Health Scotland that will highlight that this is at risk to outbreak management. At the moment, we have a piece of additional work going on looking at every single aspect of that, but as a minister, I want to ensure that people have access to their loved ones. We will have to balance some of that, but that is my expectation. Quite rightly, people will always be concerned and will think at the back of their mind about what went on during that Covid period. We do not want that to happen again, and that is why we are doing all the work that we can to ensure that we get this right for relatives, families and loved ones. People welcomed the legislation providing for outbreaks, but carers said that they felt really even if they were to get a break, they would find it really difficult to relax. Can you offer reassurance regarding a high level of replacement care and something that carers can trust? That is a key thing. I have not had the carers' Parliament events here and around about here in recent weeks. That situation whereby some folks are worried to leave their loved ones or that there are cases where folks just cannot leave their loved ones, how do we flex all of that to ensure that we are putting some support in place? We have in this bill the rights to breaks from caring, but one body argued with me the other week that that right could be there, but I am not going to get that break because my loved one needs me all of the time. What else can we put in place to ensure that we are giving somebody the time and the ability for some downtime, even being there? We have to work our way through this. There has been some really good stuff that has gone on in certain places, whereby folks have been unable to go for short-term breaks, but other things have been put in place. I swear to say this because I could identify people, but other things have been put in place which are beneficial to them and to their loved ones, which is maybe not as good as a break itself, but allows for some relaxation for some downtime. We are setting up a stakeholder working group, including carers, statutory services and carers centres to look at the issues that need to be addressed here. Again, we will continue to listen to what folk have to say, because some of the stories that I have heard even in the past couple of weeks are new to me. I wonder if I could pick up on your answer to Evelyn on Ann's law. Last week, we had a number of people in front of us who said that this lack of access to the loved ones was still happening. I mean that it could be Covid-related, such as infection control measures, which are understandable, but they go too far and people do not have access to them. What can be done now to make sure that that does not happen? I keep a very close eye on that. I have already used direction powers as folk are aware. I get regular updates from the care inspectorate around about any complaints that come in around about anybody being denied access. Those complaints to the care inspectorate have lessened dramatically. They are very few now. I would not want to give you figures, but we can provide you with that. I also get, on a fortnightly basis, a list of where there are outbreaks and what is going on there. It is rare to see a home closed for admission now. It is rare to see no-visits. I can provide you with much more detailed information on that, but I assure the committee that this is something that I keep a very close eye on indeed. Officials from here will challenge if they think that there is anything that is not working right for people. For the public, for people to find themselves in that situation, that is the care inspectorate that they should be going to. The care inspectorate in the first instance should be with the care home itself. Why is that happening? Why am I being denied this? If they do not get the right answer, if they do not get the access, then the care inspectorate. Those numbers have gone down dramatically, but we will provide you with that information for your reassurance. Final questions—I will be pleased to hear them from Emma. I am not saying that in the majority way to Emma. That is how it came out of my mouth, but I just mean final questions for this session. Emma. Just a quick question on the carers' breaks. Last week it came up about sufficient breaks, and sufficient breaks would be different for one person versus another. I was interested in following up on questions about that, but the bill talks about defining sufficient breaks. It says that regulations under subsection 2 may, in particular, make provision about the meaning of any reference to sufficient breaks in this act, and then standards and criteria in relation to the sufficiency of such breaks, including the nature of frequency or duration of breaks. Richard Mead presented at the health inequality cross-party group last week. We talked a bit about breaks. There is a lady called Susan Chambers from PASDA, which is an East Lothian support group for people with autism. I will be interested to hear your thoughts about sufficient breaks. I am not necessarily sure that there needs to be further information in the bill if it can be dealt with by regulation, but just to comment on sufficient breaks. We recognise, as you have done there, that caring roles vary in nature and intensity, and we recognise the fact that some folk feel more able to access certain things than others. One of the key aspects of that, which comes up time and time again, is the roundabout eligibility criteria. The bill aims to shift, in removing some of those eligibility criteria, for those unable to access sufficient breaks. The bill aims to shift the balance to enable more carers to access preventative short-break support, and those might have to be something different from what is currently in offer in particular places. However, the key aspect of all of that is to understand more about what sufficient is, and to recognise what those differences are in terms of the nature and the intensity of the care. We need to understand that better, and that is the reason why that stakeholder group has been established, convener, to work its way through that, including reaching a definition around about sufficient breaks. I thank the minister and all his officials for the time they spend. The extra time that they are given to answer our questions, no members have indicated that they would get any other questions to ask, so I am going to wind up our session now. That was our final meeting of 2022. Our first meeting in a new year will be taking evidence in the Scottish budget for 2023-24 from the Cabinet Secretary for Health and Social Care. I take this opportunity to wish everyone a happy and restful festive period. I reiterate my thanks for everyone out there in Scottish society that has helped us with our work over the course of this year. That concludes the public part of our meeting today.