 Ond dess i'r myndigll giantsg位 hract a'i dda g jewch chi'n defnyddio'r myndig gyfanol buseng? The first petition is Petition 1533 by Geoff Adamson on behalf of Scotland Against the Care Tax on the Abolition of Non-Residential Social Care Charges for Older and Disabled People. The petition was lodged in September 2014 and was first considered by the session 4 committee in November 2014. At previous consideration of this petition in October 2018, we noted the petitioners' concerns as set out in his submission of 11 September 2018. It is great to invite the cabinet secretary to give it evidence to address the petitioners' concerns and provide some clarification around the Government's approach to delivery and implementation of the extension of the free personal care policy. We received a written update on the issue from the cabinet secretary in November 2018, and that is included in our meetings papers. The cabinet secretary will be accompanied by officials who will be here shortly. I welcome the cabinet secretary to the meeting. I very much appreciate you taking the time to spend with the committee this morning. I do hope that we have a useful discussion on a number of petitions, but I understand that you have a brief opening statement before we take questions. I also wish committee members and others a happy new year. I thank you for the opportunity to be here. I also apologise for the current absence of my officials. I am grateful to you that we have begun on time. I would not want to hold a committee up for that reason. I thank you, as I said, for inviting me to attend the committee. As you said, I wrote to committee on 20 November, setting out our approach to the implementation of the extension of free personal care for those under 65 to ensure that it is consistent with the current approach for those aged over 65. We want to ensure an equality of treatment between adults under and over the age of 65. Legislation was passed by this Parliament in June 2018 to extend free personal care to all adults who are found eligible by their local authority, regardless of their age, condition, socioeconomic or marital status. That exceeds the original remit of the Amanda Capel petition, which focused on those with dementia only. The extension to free personal care will be delivered on time, as legislation comes into effect on 1 April 2019. That builds on previous action to reform the charging system. In 2016, we raised income thresholds, meaning that less income is taken into account. We also ensured that local authorities disregard all veterans' income from more disabled pensions and the armed forces compensation scheme from financial assessments, and we worked with COSLA to ensure that people in the last six months of a terminal illness receive free social care at home. In my previous role as minister for social security, we ensured in this Parliament through legislation that those who are clinically diagnosed with a terminal illness are fast-tracked to ensure that they receive the maximum level of financial support that they are entitled to quickly and with dignity, regardless of any number that is put on their terminal diagnosis in terms of the expectation when they might die, to ensure that people receive what they are entitled to at the right time and as smoothly as possible. I believe that extending free personal care to all adults is an important further step in our work of reforming charging for social care, but further steps in reforming charging must be done on a sustainable basis. I recognise that this latest step does not go as far as the petitioner would like, because other social charges will remain for those who do not meet the criteria that I outlined earlier. Any future reform of the cost of social care and how it is paid for needs to be considered as part of our wider adult social care reform programme to ensure that our approach is sustainable now and into the future. Funding for £30 million for the extension of free personal care to those under 65 is part of our draft budget, which was published last month. I hope that we will have the support across the chamber for that budget in order to ensure that we have the resources to deliver this important improvement. With that, I will conclude, convener. If I may, I am obviously happy to deal with any questions that members might have. I welcome Mike Liddle, who is the policy manager of the adult social care policy, and David Fotheringham, who is the head of adult social care policy. You did make this point in your statement that your absolute expectation that the extension of free personal care to adults under age of 65 will be implemented by 1 April, and that the partners in delivering that confidence can be done? Yes, I am confirming that. We have worked extensively with COSLA and, in fact, only as recently as last night, I had the opportunity to discuss with Councillor Cary, who is the lead from COSLA on this and other matters in my portfolio, about the progress that is made and the readiness of local authorities to undertake this delivery. I am happy to say that we are on track. Do you accept the argument from the petitioners in pursuing the argument that there shouldn't be care charges at all, that there are human rights issues? It may not be simply about personal care, but the things that people need to support them in order for them to access work, to access college or whatever it might be, that charges often mean that they are not able to do those things. Do you understand the general argument around the petition that for somebody with a disability it may not be about personal care, it may be about provision of transport or whatever, and that does not come in with any remit of what you have suggested? I absolutely do understand that. I have had the benefit and the privilege of the two years that I was Social Security Minister of working extensively with individuals as we looked at that particular area of the portfolio to understand better from my point of view the situation and the difficulties that people face. I completely understand that. The point that I am making is that we have made step progress in terms of charging for adult social care, and I outlined that in my opening statement. However, we want to consider any further progress that might be made within the current work that is being led on the reform of adult social care. That is part of that. It is an important part of it, any further steps that we might make on charging, but it also extends into the second petition that we will be considering this morning about how we ensure that the correct facilities and support are available for everyone in our country to live as fulfilled and equal opportunity of life as they wish to. Would you accept, if you took it as we think that the Scottish Parliament has done, a human rights perspective, that it is at least an argument to be explored around the way in which social care is delivered around the human rights issue, that it is about levelling the playing field for people so that they can have access and the current charging policy is not compliant with human rights in that regard? So, in terms of legal advice as to whether what we currently do is compliant with human rights or not, and our requirement as a Parliament and as a Government to meet that requirement, the advice that we have is that what we are currently doing is compliant. That aside, and I think that the thrust of your question, is should we adopt a human rights approach to all of this work? I absolutely agree with that. It is an area to be explored, and the current reform work that we are undertaking on adult social care, which is people-led, very much adopting the kind of approach that we took and are currently taking in social security and establishing that area of work, led by those with lived experience in this area, is, starts from that premise, that this is where we want to be. We have made significant steps as a Parliament since the Parliament was first established, so not simply this Government, but throughout. We have made significant steps along that road, but there is more to do, but we need to be able to do it in a way that is sustainable, both financially and in other ways, so we need to take the time to undertake that work so that we properly understand everything that needs to be done to continue to improve and reform adult social care, including the question of charging. Good morning, cabinet secretary. Following on from the convener's initial question, you say that you are on track with regard to the implementation, but I am curious as to whether you anticipate any barriers to the implementation, and has everything been fully costied and budgeted for? We believe completely that it has been fully costied and budgeted for, and we have undertaken that work with COSLA, including looking at and including in that budgeted, a current draft budgeted amount that I set out, an estimate with COSLA on the implementation costs to local authorities of undertaking that additional work. Discussions have been undertaken with directors of social work, with directors of finance and with others to ensure that people understand everything that is to be done here, and that we hear anything that they think may stand in their way, and we work with them to try to remove any concerns or misunderstandings that might exist. On the basis of that significant shared work over a number of months, and where we are now, and as I said in my conversation as recently as yesterday evening, I remain confident that we are on track to deliver this from 1 April. I should also say my apologies, Ms MacDonald. Of course, in all of this, the work is around how you estimate costs, and the reality then is what the real costs may be, and they may differ from those estimates, so some of the work that we are undertaking with COSLA is around how we monitor the delivery and, included in the delivery, the cost of delivery in order to be sure that we can, year on year, adjust what needs to be done in order to make sure that this can be fully delivered to all those who wish it. Brian Whittle Thank you. Good morning, Cabinet Secretary. You have acknowledged that this extension does not go as far as a petitioner would like. I wonder if you would be good enough to explain the rationale behind that decision to do this on a consistent basis with the approach for adults over the age of 65. I am sorry, Mr Whittle. You want me to explain why we want it to be the same for over and under 65. Quite simply, because if I can go back to the convener's perfectly helpful and correct starting question, our belief is that we should move progressively and increasingly towards an equality approach, because that sits absolutely rightly with a human rights-based approach. It seemed to us that it was the right thing to do if we were going to extend it to those under the age of 65 to go beyond a particular condition that individuals might be suffering from and extend it to all adults under the age of 65, who then meet the criteria in terms of free as opposed to charging. I wonder if you could respond to the petitioner's comment that I quote that this will leave most disabled people under 65 no better off, despite millions being given to local authorities for the implementation of the new system. Do you feel that that is consistent with the answer that you gave to my previous question? I need to start by saying that I do not agree with the petitioner's view on that matter. The fact is that what we will implement from 1 April with our colleagues in local government is that every adult, regardless of their income or assets, is eligible to receive the personal care that they require without charge. Many of those in receipt of social care already receive those services free, and we have provided the additional funding of £11 million that I touched on earlier to increase the charging thresholds and to support veterans, as I described. I do not accept the petitioner's premise. What I understand and accept is that there is an absolute need for us to consider whether we can go any further in this regard. As I have said, I think that the appropriate way for us to do that is in our current overall consideration of the reform of adult social care. I think that it is appropriate in the 20th year of this Parliament to stop and say, so what more do we need to do across adult social care, including charging, but there are other matters to be taken into account in that regard as well. Thank you for that very helpful, cabinet secretary. Given the petitioner's concern and what she does not agree with, which is fair, how will you monitor that to make sure that the concerns of the petitioner are not realised? As I said in response to Mr McDonald, we are developing with COSLA a series of monitoring tools that we will test run before 1 April to gather information and to check that we are gathering all the information that we will need from local authorities in terms of implementation. However, the reform will include impacts on individuals as well as key questions about the reality of the cost set against our current estimate or agreed estimate of the cost. In addition, all of that sits within that piece of work that I touched on earlier that is led by those with lived experience around the reform of adult social care. We have a leadership group of individuals from that area, stakeholders, a panel that is doing some of that work, many of whom I had the good fortune to meet and listen to in 2018. That will also provide us with feedback about any individuals or groups who appear to be being missed even with the extension that we can consider in that overall reform, including any further reforms on charging. I want to hone down a bit more on the monitoring process that is going on. In your letter on 20 November, you stated that the implementation advisory group had considered the effects of additional demand in assessing the likely budget required. You stated that the non-personal elements of care for adults under the age of 65 will be monitored. How will that be monitored and who will be monitoring that? The monitoring arrangements are shared arrangements between Scottish Government and local authorities. Local authorities are the primary provider of the data, if you like, as you would expect. Clearly, there are prominent and experienced stakeholder groups in that area of work, and our continued contact with them will feed information into that monitoring as well. We have developed, as I said earlier, a series of tools for monitoring across more than just cost. Again, jointly with COSLA, we will test run those tools before 1 April just to double-check that we are capturing all the data that we think is needed in order to effectively monitor all of that over the years and, should it be required, make any adjustments and changes to how we are implementing that as we go. However, the data that is gathered also feeds into the overall reform of adult social care that we are undertaking, because that will be important information to point us towards on the basis of evidence where there may be gaps or other areas that we need to take account of. I am interested in the system that you are going to be using with regard to the tools that you say that you are going to use for monitoring, because the petitioner shares the same concerns that I have about non-residential care services, whether they be something like a community alarm or other services, but they can range dramatically across local authorities. I have some figures that say that East Lothian Charges—I am just using these local authorities as examples, by the way—but East Lothian Charges is £4 a week for a community care alarm and Aberdeen Charges is £1.35 for a care alarm, so we are already seeing a disparity in these care services. I do not know if the tool that you are going to be using, whether it is software or whether it is some sort of monitoring digitally, but that is already showing that we are at a huge disparity across local authorities. Without sight of your figures, I am not going to disagree with the central thrust of what you are saying that there is a degree of disparity across local authorities. One of the areas that we have to temper in how we look at this work is the balance between wanting to have equity across our country in what people receive and how that is charged for and how they are dealt with with the fact that we have 32 local authorities, each of them in their own right democratically elected and accountable bodies to the population that they serve in their local authority area. That is, if you like, a tension between what the Scottish Government wants to do and what the local authorities perfectly correct position about their democratic mandate and accountability. That is a tension that I know that colleagues around this table are very familiar with and are 20 years old. That is why the joint work with COSLA is so important, in order to manage our way through some of that and to look at where we can increase the equity of provision on the basis of local authorities not only being willing to agree that, and there is no question that they are not willing but also feeling that they are being treated fairly in terms of the resource that they receive to do it. On the question of the monitoring and the tools, I am very happy to write further to the committee setting out what those are so that members are aware of it and see that level of detail and answer following that any further questions that members may have. Just lastly, cabinet secretary, on the balance of equity, what is your timescale with regard to this monitoring? I am probably asking this too soon, it is a bit futuristic, but we are on the cusp, if it has been rolled out, on 1 April. Regardless of politics or who has been democratically elected within local authorities, how will you ensure that there is an equity and a balance within that equity? What will happen if, for example, we are working with COSLA? What will happen if we see that one local authority is charging extraordinary amounts and another is charging what is considered fair amounts? What will happen? Will there be some sort of negotiation? Will there be a sanction? What will happen? There won't be a sanction because that's not the best way to work in partnership with colleagues and local authorities. There will be continuous discussions with local authorities. We have a bit of an example about how we might manage that and reach a shared agreement when we look at school uniforms, for example, where local authorities have had different approaches in terms of the support that they would offer to eligible families for the purchase of school uniforms. We manage through discussion because, at the end of the day, more or less, everybody wants to do the right thing and we have to work out how, collectively, we can get closer to that right thing as possible, both in terms of managing some of those tensions that I touched on, but also in a way that is resource-sustainable. We will do that here. I think that we have benefited over years as a Parliament in terms of a good quality relationship with local authorities and with COSLA, not with standing political differences and disagreements from time to time on matters. You just keep doing that because that is the right way to reach conclusions and move it step by step forward. David Torrance A petitioner has previously raised concerns that some local authority representatives are poorly informed about the delivery of the extension. What is your response to that? Yes, I understand that. I believe that we have done a great deal of work with local authorities to ensure that they are very well informed about the extension and about what is required in the implementation, not just at the councillor level, but as important, if not arguably, in terms of implementation, more important at the level of their officials. I have had a number of conversations with Councillor Johnson. We sent a joint letter in July last year, setting out what was planned and what was required. We have also, as I touched on earlier, had discussions with the chief social work officer's group, chief finance officers, and we issued further guidance to local authorities on 21 December. We continue to meet with COSLA, and COSLA continues to monitor, through their network local authorities, preparedness and understanding. There is no question in my mind that if COSLA felt that there was any significant difficulty in that area, then they would be raising that with me and wanting me to do something further. I wonder whether I can come back to the issue about the role of the Scottish Government in monitoring. We are aware that the Scottish Government has a reserved power to intervene, which I think was given in 2002. It is not being used or exercised. There would be an evaluation of guidance from COSLA, and that has never, ever happened. If you look at the petitioner's evidence, they talk about variation in a single hour of home care being between £8.56 an hour, £23.70 an hour. They are very exercised by the issue of minimum income thresholds. COSLA recommends that the income support level is plus 16.5 per cent, but local authorities across Scotland set this at different amounts. For a single person under 60, it varies from £122 per week in East Ayrshire to £173 per week in North Lanarkshire, and both are less than the actual amount of income support that disabled people can get. Do you accept that there is a very substantial issue here, particularly for people under 65, in terms of their ability to sustain education and employment on because of the level of charging? One of the things that the petitioner goes back to is that the cost to all of us in folk not being able to achieve their potential, not being able to access education and work because they simply cannot afford the charging, and the variability across the country is so significant. I wonder if you see there being that this is a matter of urgency. The strongest thing that comes out of the petitioner is the urgency of this for many people. They are making decisions now, which are denying them opportunities in the future. As I said, I understand that. I also completely share the petitioner's view that, where people are denied the opportunity to pursue what the rest of us take for granted, whether that is employment, education or simply social engagement, that is, in very real terms, a cost that is counted in more than financial terms to society in Scotland as a whole. I absolutely agree with that. Yes, there is a reserve power. I do not believe that, other than in the most extreme circumstances, any Government should ever seek to use such a thing. I do not believe that that is the right way to make those approaches. The reserve power was not to come in and close down local authority. It was to say that we were going to evaluate the guidance, but the guidance was not effective. If the gap between the funding that I have described here and the inconsistency around what is defined as minimum income and what is caught or defined as income—there is an example of a young woman campaigner who told me—she made a film about this—that her student loan was counted as income. Those issues were massively impacting her ability to do what any other non-disabled young person would be able to do. Given the scale of those inconsistencies, that either the Scottish Government uses their power or we turn the issue on its head as a petitioner asks—we start from the premise that human rights is about the ability to get the support that allows you to function with a bit of support in the world—that would actually get a significant bog down in all of those different ways of dealing with things across the board. You took that view, would that be much more simple and straightforward? It is absolutely the simple and straightforward view, but at the end of the day you have to implement it and you have to be able to do it in a way that is sustainable. Those matters—the inconsistency in charging and the other issues that both the petitioner and herself have raised—constitute a significant part of the discussions that we have in the current work on the overall reform of adult social care and what we need to do next. We do that jointly in our discussion with COSLA to understand the rationale from different local authorities on how they approach that and what we need to do in order to reach improved equity of charging across the piece. You would be open to, in the discussions, looking at that approach, which is a human rights approach, to start from the basis that, no matter what the size of the cake, people have the right to access it in a fair way. With that point, I have been able to have the same economic and social opportunities as others. In terms of what we have done with under-65s, we have adopted that approach. Overall, that is my answer to Mr Whittle's question about why we extended the provision under-65s beyond a single condition in order to ensure a degree of equality of approach regardless of age. Taking that on to the next steps is, as I have said earlier, part of what we should do and what we are doing in the reform of adult social care. I have made it clear that my starting point is absolutely to consider that on the basis of a human rights perspective, but we need to be able to not simply have the warm words of a good policy but be able to implement it in a way that is sustainable. You recognise that, in terms of participation and frustration of the petitioner, when they did meet with the implementation group, they were only allowed to make a presentation and they were not engaged in developing the policy. You would look for something more than that in the future. The petitioner has one voice among many, and I would certainly be very happy that all those voices are heard. In terms of the group that they represent, they felt that they got a hearing, but that is not the same thing that has been engaged in in order to recognise it. Thank you very much for that, Jackie Baillie. I absolutely have no doubt about the cabinet secretary's intentions, but he will forgive me if I am slightly frustrated, as indeed the petitioners are. There was guidance issued in 2002—that was not evaluated. I think that it was at least nine years ago that COSLA and the Scottish Government set up yet another working group, again to look at consistency of charging. I am not sure that it ever produced any guidance. If it did, that guidance has certainly not made a difference. I am wondering—I hear what you say about your current work on the reform of adult social care. That is very welcome, but when will it be concluded, and will it make any difference given the history, both in 2002 and nine years ago, under the current Government? I have to start by saying that I was not the cabinet secretary in 2002 or nine years ago, so I can only speak for my own personal commitment to that. The work that is under way in the overall reform of adult social care has a number of important strands in it. That is an important strand, and that is around the whole question of consistency. We will conclude elements of that work as we get towards the summer of this year. We have to determine, along with those who are—one of the important elements of how we are undertaking the current review is that those voices of lived experience and a version of the approach that we took in terms of social security. Part of what we are asking those individuals and stakeholder groups to tell us and COSLA is what are your priority areas that you want us to fix first. I think that it would be a reasonable expectation that consistency of charging will feature in those priority areas. As that work proceeds, my conversations with COSLA proceed in parallel, because I am not in the business of—and I do not have the time, frankly—to wait for the work to conclude, and then we have the discussions with COSLA, and then we do. There is no reason why it cannot run in parallel. It runs in parallel and, looking at some of the approaches that were taken, for example, on school uniforms, is a good indicator for me about the way in which we can work together and try to reach a degree of equity and try to see whether or not, in the course of this year, we can produce a better resolution to the question than we currently have. At this point, that is as much as it is fair for me to say, because it is a joint discussion between me as a representative of the Scottish Government and COSLA representing local authorities. We can expect, in the summer of this year, some change to happen. Again, I do not doubt what you are saying is your intention, but history tells us that, no matter the partnership, the discussion, things do not change on the ground. The reason that I am so exercised by this is that if you take people in my constituency in Western Bartonshire where charges have trebled, because the local authority has limited resources, people are taking themselves out of their own care packages because they cannot afford to contribute to them. We have very real unmet need because of the inconsistencies in care charging, not something that the cabinet secretary wants to see. If the conversations, the dialogue and the discussion get us to the same place that we are today, what will you do then? I am not going to be curtailed by the summer. There will be guidance and there will be change. I could easily say that that is the case, but I do not think that that is the right thing to do. I am only going to put dates on things that I am confident that I will meet. Ms Bailey would expect that of me. However, I am more than willing to say that, by the summer of this year, I will be in a position to make sure that this committee and others in the Parliament are updated on how well we are making progress in this area. There are a number of difficult issues around the whole question of resourcing, charging and equity, some of which you have touched on. One of the other big areas is where we have high-cost packages and some of the impact on individuals on how local authorities seek to manage that high cost. Some of our key third sector providers have strong views on that and very important propositions about how it might be handled that equally need to be listened to. Those two areas of work have been the subject of discussion with COSLA since this summer, and we will continue to do that to see if we can reach an improvement with them—not necessarily as far as to commit to an absolute resolution—but an improvement on the current situation going forward. That work is under way at the same time as we are looking more widely at some of the other areas in adult social care. Convenor, if I might ask one more question just to shift this over slightly. My interest is ever in numbers. I wonder whether you could provide, perhaps not now but to the committee, the budget for free personal care for over 65s and the number of people that that covers, and your estimates for the budget for those who will now receive free personal care that are under 65s and the numbers. The reason that I am asking for that is that the contention by the petitioner is that those under 65s receive less free personal care than those that are older, and therefore for the younger co-hort, the under 65s, that is not as much benefit as we imagine it would be because they receive other kinds of care support that would not be covered by this. That would help us to understand the impact of the policy. I am very happy to undertake that we will provide you with those figures. Are they correct in their assumptions? They based on raw data from the Scottish Government, I think, that is no longer published, but that was their analysis at the time. Is that correct in terms of their analysis of the situation? I think that the Scottish Government does not always agree with the analysis that Scotland against the Care Tax produced. We sometimes see things differently, but we are happy to provide you with information based on what we regard as reliable sources. These are from you. Obviously, data can be analysed in different ways. Different assumptions can be made. I think that we can only undertake for our analysts who are very skilled in this. Scotland against the Care Tax is also very skilled, I am sure, but we will obviously commit to providing it with our own modelling and assumptions, which will make clear. I think that that bit is partly the critical bit. There are numbers, and then there are assumptions and modelling, and we will provide you with what we have used. It should say in terms of this petition, when the argument was made, there was a big, huge, massive sum, and if it could not be done because it was unsustainable, it would not be pressed. The big, huge, massive sum, people could not explain how they would have got to that figure. I think that, reasonably, the petitioners expect a bit of rigour around the figures. I wonder if you would be interested in looking at that. It is a cost-benefit analysis of people being able to get to work to study, not to have to withdraw themselves from care packages and so on. There is a benefit to that, which could be set aside against the cost of any estimated care packages, but I think that the committee will be very interested in those figures. I want to go back to my own clarification. It has been mentioned several times around the inconsistency and charging of approaches across local authorities, and in the Community Care and Health Scotland Act 2002, the Scottish Government did have the power to regulate the practice of care charging. I totally understand the position that there is tension between a Scottish Government policy and a freedom to implement from local authorities. For that reason, I have not exercised that power to date, preventing the support of a self-regulation by COSLA. There was a commitment to hold that power until the implementation of the guidance from COSLA could be evaluated. It is my understanding that that evaluation has never taken place. I wonder whether there are many plans to evaluate that and whether that would be helpful at all. I have to confess, Mr Whittle, that I have no reason to disagree with you that the evaluation did not take place. I am very happy to discuss with the officials the value of evaluating that now, given the other work that we are undertaking, and to come back to you on that. I am just in conclusion that you mentioned your people-led policy group. I wondered if you could clarify who is in the leadership group and what kind of lived experience people have, and to what extent would the experience of those reflected in the work of the petition, which is a very broad coalition of people behind it, be engaged in that and how you see them being engaged in terms of the sense from the petitioners that they had a hearing, but were not particularly engaged in the past? I wonder how you would address that. The people-led policy work is hosted and led by inclusion on our behalf, so we have commissioned inclusion as the organisation to undertake that work on our behalf. In terms of those who are involved in the leadership group, I do not know if we have a list here, but I will advise you to provide that information. All the information that I have committed to providing the additional information, we will make sure that you have it by next week. That will include exactly who is on the leadership panel and the way in which that people-led policy work is progressing. That is a very helpful route for me. I just wanted to put this on record on behalf of the petitioner. Despite what Brian Whittle was talking about, the original guidance from COSLA being just advisory, the petitioner is very sceptical that COSLA will ever succeed in standardising the care charges. You have mentioned COSLA a lot, and you will work with COSLA. The petitioner is basically concluding, which Johann Lamont said is that care should be made on a human rights issue at the end of the day, because he believes that there is no possibility that we will ever get to this position of standardising care charges. I just wanted to leave you with that point because it is important that we do communicate what the petitioner is stating here. I think that that is very clearly communicated. In terms of then, thank you very much for responding to our questions and the way you have them. We look forward to receiving the information that you have committed to. In terms of action, I think that probably the most important thing would be to get a response from the petitioner to what we have heard today and, indeed, from others who may want to respond to what we have heard. We can reflect on those further submissions and see what we may wish to do, subsequent to that. Obviously, once we have more information from the Cabinet Secretary, that would be useful. Is there anything else that we should be thinking to do? I think that the petitioner's response is probably the most important thing. In that case, I think that we are concluding a consideration of that petition. I thank the Cabinet Secretary for that, and I will suspend briefly in order to have a change over of officials. If we can call a meeting back to order. We now move to the second petition for consideration, which is petition 1545 on residential care provision for the severely learning disabled. The petition has also been under consideration for a number of years. It was lodged by Anne Maxwell on behalf of the Muir Maxwell Trust in December 2014 and was first considered by the session 4 committee in March 2015. At our meeting on 25 October 2018, we noted that the petitioner's anger and disappointment was a lack of progress in the action that she is calling for in the petition. Of particular concern to the petitioner is the data visibility of learning disabled children and young people across Scotland, together with a lack of suitably high-quality and appropriately resourced residential care homes. We agreed to take evidence from the Cabinet Secretary to respond to the petitioner's concerns. For this session, the Cabinet Secretary is accompanied by Gillian Barclay, strategic lead for dementia learning disabilities in autism, and Pauli MacDonald, policy officer, autism and learning disabilities. Cabinet Secretary, can I invite you to provide a brief opening statement after which we will move to questions? Again, my thanks to you for the opportunity to speak to you briefly on this important matter of residential care for severely learning disabled people. Firstly, I want to record my respect and appreciation of the Maxwell family for all the significant work of the Muir Maxwell Trust in providing practical support to families raising children with epilepsy, and for helping wider understanding and awareness of that condition. It is significantly important work and valued, I know, by everyone who benefits from it. Commedia has been a policy priority since the 1980s, consistent across different Governments or different political parties that all adults with learning disabilities, including those with complex needs, should experience meaningful and fulfilled lives. That includes where individuals live, as well as the services that they receive. The closure of large-scale hospitals is, I believe, widely acknowledged as a major step forward for the human rights of people with learning disabilities. I am sure that no one here wants to return to large-scale residential institutions. Although we have come a very long way since that time, I acknowledge that it has not always been a smooth road. However, Scottish learning disabilities policy, from the early days of same-as-you and keys to life, has been developed on a human rights basis and informed by listening to the views of people with learning disabilities and their families. During that time, we have not heard a persistent call for more residential care establishments, indeed quite the opposite. Finding appropriate and sustainable community placements for people with the most complex needs has, nonetheless, proved difficult. It is true that the sector has some good examples of very good practice where people with complex needs are well supported and live full and active lives in their communities. When things have not gone so well, though, we find examples of individuals who have undergone multiple placement breakdowns, hospital admissions and difficult experiences and who have not received the right support at the right time in order to meet their desired outcomes. However, we know that people with profound learning disabilities and the most complex health needs can be well supported with personalised care packages in their homes and with their own tenancy agreements. In my view, that makes for better provision. The provision is available across the country. All adults with severe or profound learning disabilities are entitled to that support. They do not have to live with their family unless they and their family wish this. I want to touch briefly on the recently published report by Dr Ann MacDonald, which the Government commissioned, which looked in some depth at the reasons why young people with learning disabilities end up being placed in care homes or hospital facilities far from their families and their home communities. She found that the factors influencing why young people end up in that position are multifaceted and complex. As a consequence, solutions for the situation and the group of young people need more than individualised service changes but must instead be seen within the context of a more transformational systems change. We agree with her conclusions and are working with our integration authorities to take forward the recommendations in the report on how we can ensure that that happens. Support to people with learning disabilities needs to be framed in the broader context of equality and social justice and not solely within the narrower focus of service design and delivery, important though that is. Services or models of care should not be the sole focus. It is about everyone with a learning disability having access to the support that they need and that, crucially, they are involved in the decisions about all of those. I am committed to ensuring that we implement the recommendations of Dr MacDonald's report and our current work that we touched on in the earlier petition on the reform of adult social care, working with those directly engaged in that and with that personal experience, and with families. I am certain that that will help us to achieve that. Thank you very much. Can I start by asking how you respond to the petitioner's concerns and disappointment that, in the four years since her petition was lodged, nothing constructive and supportive has resulted? I do not agree with that. I do not believe that that is an entirely fair characterisation of where we are. I would certainly share what I am sure is some of the petitioner's frustration that we have not seen enough done, but I do not accept that nothing has been done. There are some examples of very good practice where people with complex needs are well supported and live full and active lives in their communities. Beeswing in Dumfries and Galloway, Teviot Court in Midlothian, Murray Council, New Homes and others. I acknowledge that there are examples where that has not worked and we need to do more working with our integration authorities to implement the recommendations of Dr MacDonald's report. Are you aware that one of the reasons that we sought an invitation for yourself to come along was that the response from the Scottish Government was not to respond to the questions that the petitioner was raising and was suggesting that research was being done, which was not round the issues that she was identifying around the needs of people who were in the category of somebody with complex needs? Or do you simply think that that is a policy difference, that you simply do not believe that there is a need for long-term care for people with complex needs that should always be supporting the community rather than those kinds of units? Part of what I have to do is listen to a range of organisations, including, of course, the petitioner, but also organisations such as Enable, which I would quote from them, that it is vital that we resist any temptation to revert to building more multi-bed residential units. There are different approaches that can be taken in terms of the accommodation and the support packages and how that is configured. I have given some examples of that. I have had discussions with Kevin Stewart, as you know the Minister for Housing, on some of the approaches that we might take in terms of the Government's commitment on social housing build and the work with some RSLs. There is some coverage of that too in our disability delivery plan, but what I do not agree with and would share Enable's view is that we do not want a return to multi-bedded residential units. I suspect that that is not what the petitioner wants either, but there will be a false characterisation to present that. Those are the only two choices, but there is something about particular needs that are not being addressed. Part of it is the argument that those people are not even visible in terms of the data, which is a lot of what the conversation with the Scottish Government has been with. I will bring in Angus MacDonald at this point. You mentioned in your opening remarks that you are committed to ensuring access to the support that learning disabled children need. What assurances can you give the petitioner that the issues raised in her petition will be and are being given due consideration by the Scottish Government to deliver support for vulnerable and severely learning disabled children, young adults and their families? A significant part of my answer to that is contained in the work that we commissioned from Dr MacDonald and in the recommendations of her report and our acceptance of those recommendations and the work that we now need to do in conjunction with the integration authorities to ensure that we can deliver on those recommendations. Brian Whittle Thank you, convener. The convener mentioned identifying the databases for the young group here and for this group of people. Understanding what support is required to be delivered by the Scottish Government would be required to understand what databases and identify the databases for the group. I wonder how you would respond to the petitioner's comment that the Scottish Government has, and I quote, repeatedly deflected the matter to the learning disability's observatory in an attempt to convince her, the petitioner, that its research is relevant to the issues raised. The learning disability's observatory was set up to provide a high standard of research analysis on data that is routinely collected about people with learning disabilities. Of course, that does not necessarily mean that that is all that we need to do. I am happy particularly on the basis of Dr MacDonald's report to look further at how we might improve both data collection but also data analysis and how that informs the work that we need to undertake to improve the situation. Brian Whittle I think that following on from that, if there is a apparent absence of clear databases, I wonder if you have an estimate of how many children and young people require long-term residential care provision, and again, how would you respond to the petitioner's assertation that the group of young people are actually invisible? My understanding is that, if we based it on research findings, approximately 1,000, there are just over 5,000 children, 21,000 adults in Scotland with learning disabilities. Approximately 1,000 children and 4,000 adults from that group have severe learning disabilities and a similar number with profound learning disabilities. Now, those are numbers of people who require significant additional levels of support. Some of that may be particular to their residential needs, their accommodation needs for others. It will be a combination of that and other areas of support. I wonder if the cabinet secretary is aware that the observatory in responding to the petition said that we are not aware of any existing data sets in Scotland that include a marker for profound learning disabilities? The observatory figures that the cabinet secretary has just quoted were an estimate. The petitioner is right. We do not know what the level of need is for profound learning disability. While most people here would be very much in support of the thrust of policy around community support, inclusion and the interlong-stay care hospitals and all the rest of it, we do not even know. We do not know when the point of the petition makes that there is no visibility for the particular needs of those who are profoundly under disabilities. Do you think that there should be research in that regard? Would you be able to make a commitment to carry that forward? Yes, I would. Thank you for that. In Scotland, the petitioner states that there are no long-term residential care facilities, but she also makes the point that, although there is not enough in England, there are some good-quality residential care homes. She states a number of them, for example, the David Lewis Centre and Cheshire Home from Home, Lincolnshire, St Elizabeth's Hertfordshire, and she goes on. There is a different position in the rest of England in terms of residential care. Why is it that they are looking at it from a different point of view to us? Clearly, I cannot answer for the approach that England takes. The petitioner is asking that she does not understand why we do not have the long-term residential care facilities in Scotland, so, naturally, the petitioner would look elsewhere to find other examples of that provision. If there had been any work done to suggest that that type of provision, that service, has a benefit, why would that be offered in the rest of the UK when it is not in Scotland? I am just trying to get an answer on the bar for the petitioner, if you do not mind. I do understand what you are asking me. I think that there may be a false distinction being made here about what is residential care and what is not residential care. The convener, quite rightly, made it clear that the petitioner is not looking for a return to the situation that we had in the 1980s. None of us are. However, some of the examples that I gave in relation to Midlothian housing, for example, and others, would constitute a form of residential care in individual homes. I believe that I need to understand better from the petitioner, and I have not had the benefit of meeting with her yet, exactly what it is that she is looking to see that is not the examples that I am pointing to, but equally is not that return to the 1980s. What exactly is it so that we can have that better conversation? That is important to inform the work that we then do to implement the recommendations from Dr McDonald's report. I intend to do that. That is an extremely generous offer. If the convener took it to the petitioner, we can ask that question. It would be very helpful to distinguish the complex needs and services that she is talking about. I wonder whether the cabinet secretary is aware that one of the arguments that the petitioner makes is that, because people—and it is a blessing—are able to live longer and quite often into quite old age and are still supported by their families, but because there is not an appropriate residential support, they remain within their own homes with care packages under pressure, and what is happening is that we do not know the scale of the problem. She describes them as being invisible. If we do not know what the pressure is on the carers and the community around them, is it the case that, under the guise of a policy that we all support, we are missing a group of people who should not be—we are not going to do what we did in the past—we have a policy approach that is failing. In fact, the petitioner talks about failing a group and the essential that we meet the real needs of this voiceless group and their families. I think that your offer to meet would be, I am sure, welcomed, but I wonder if you would recognise that that is what is at the heart of this petition, is that we are not identifying this particular group, how do we do that and how do we then shape policy around their needs as well? I am grateful to you for that question and for encompassing it in that way. Broadly speaking, I would agree that I am very conscious that we are working now to try and provide the right support in the right setting for a group of people who, in the past, would not be living as long as they now are. That is very welcome that they are, but that places significant additional strain on their families. I absolutely know about the significant worry and concern that families have about what will happen to their son or daughter or whoever, perhaps when their parents are no longer here. I understand that. I would not characterise it as a policy failure, but what we are seeing is an inadequacy in the full extent of that policy and all those that it should encompass. I would want to stick with the core principles of the policy, but do more work now, as the petitioner argues for and as you have highlighted, to ensure that we know the numbers of people that we are talking about here. I want to understand from the petitioner what they have in mind when they talk about residential care and how that might differ from what I have in mind when I talk about some of the good examples that I touched on earlier. That feed into some of the issues that we touched on in the previous petition, in terms of overall cost and charging and how some of that is managed. I have raised with me their issues and their concerns about high-cost packages not being fully met. We are giving some consideration as a Government into how we can assist in that way in order to ensure that local authorities are to a degree relieved of that additional burden so that they can have less of a difficult choice in terms of some of their resourcing about whether we fund a number of high-cost packages and therefore not others or what might we do. There are some complex areas to work through here, but there are some clear basics that we can do more on, a lot of which comes from Dr McDonald's report and some of which I have touched on so far. I should probably declare an interest as the chair of the cross-party group on learning disability, and we very much welcomed Dr McDonald's report. I also welcomed the cabinet secretary's what I thought was a clear commitment to collecting data, because we count what matters to us. I have been working with a number of families for more than three years now, and they are exactly as you described, those families where there are people with profound and complex learning disabilities and their local authority is unable, not unwilling, but unable to deal with some of the large-scale packages that are very labour intensive by local authority. I was going to ask whether the Scottish Government would co-ordinate some of that effort across local authority boundaries to bring a lot of the people who are cared for away from whom—actually cared for in institutions down in England and elsewhere—back to whom, but back to a collaborative approach that would provide some of this very small-scale residential-supported, very labour-intensive accommodation much more locally. Given that you have partially answered that, based on your discussions with Enable in Censcot, I wonder whether you could unpack a bit more of that, and when we would expect to see something, because, as I say, I have had families waiting three or four years now. No, I completely understand that. I understand the degree of frustration and the impatience to see the significant improvements that people want to see. As Ms Bailey and others will know, I am a pretty impatient person myself. We began discussions through COSLA in the summer on propositions about how we can look at the high-cost packages, which are high-cost over a number of years, and how, with local authorities and overall funding approaches, we can find a way through that. We have not yet reached a conclusion. We are doing some more thinking based on some of the responses that they gave us, as are they. We are due to come back and continue those discussions. I would not want to imply that we have not had anything since the summer, but I will keep going to refine that through to see if we can find a way that we can afford, and is therefore sustainable, but that meets those needs by providing the assistance that local authorities need. We will keep going in that direction. I am quite keen that we reach—that forms a significant strand in the reform of adult social care that I touched on earlier. I am keen that we get very close, if not to a resolution on that element in the summer by the summer, because it will need to be something that I feed into, budget negotiations for future years. We are working on that, and part of that then does encompass our response to those elements of Dr MacDonald's recommendations about—I cannot recall her exact phrase, but I think that it is inappropriate out-of-area placements, I think, is the phrase that she uses. She has helped to produce some analysis of those out-of-area placements and what she means by that. Some of the out-of-area placements are out-of-area in Scotland, as well as south of the border. The work is under way to see what might we do here in a way that is financially sustainable that works with our local authorities and our integration authorities in order to shift that along significantly. The petitioner highlights the work that groups such as Quarier Scotland are doing in providing excellent care for those who have much less provenably learning disabled and do not have the adequate medical support for the group that we are currently discussing. I wonder if the minister is aware that there is that gap between that provision and the provision that will be required for those with much more substantial requirements. As I said, the petitioner wanted to highlight the fact that there are groups that are doing excellent work in the community such as Quarier Scotland, but they are not working with the groups that we are discussing today. Just to recognise that there is that gap between what they are providing and the provision that we are discussing today. Yes, I think that that is fair. There are other stakeholder organisations in Scotland who have a significant understanding and degree of expertise in that area. They are primarily, as well as others, who have raised with me the points that I was discussing a minute ago with Ms Bailey about the extent and the complexity of the need and therefore what needs to be done to meet that need. There is an under-provision in practical terms for those with the most complex learning disabilities and needs. I would not necessarily say that that means that that is because there is an under-understanding of what is needed, but it touches on what we are discussing and what we need to do on the basis of that understanding to improve how well we meet those needs. We often hear a lot of the issues lie around the transition from children's services into adult services. What consideration are you and the Scottish Government giving in your deliberations in delivering that policy to that particular issue? That is a common area of concern across a whole range of levels of learning disability and needs. I am very familiar with the work that I did previously on the disability delivery plan. There are elements of the disability delivery plan that sits with other portfolios that look to address those transition gaps in areas of education and in employment and other areas of support. Similarly, at this more complex end, that needs to be part of the consideration that we give now to how we implement those recommendations and what more we need to do. I want to highlight something that the petitioner said in conclusion, because it is reflected in the conversation about the danger of seeing that there is a choice between what we do now and what we did in the 1980s. She says that many parents believe that they can cope or are wrongly stigmatised for putting their children into what may be perceived as others as institutions that learn disability children can involve greatly and their needs are different as they get older. She believes that community care is not the answer for this group. Scotland needs long-term residential care options for this vulnerable group, and the Scottish Government should provide the funding in which to make this a reality. It is suggesting that, because we do not have this facility, there is inadequate support—a couple of hours in the morning, a couple of hours in the evening for people and therefore the burden on new families. Do you recognise that, in pursuing the policy that we all support, there is a danger of implying that those who believe that there is still a need for residential care feel stigmatised in asking for help for their young people? I recognise that that may well be the case, but I think that I need to go back to my point that I need to understand better what the petitioner means when she talks about residential care and whether that is what we are trying to do with some of the examples that I highlighted earlier, or whether there is more that needs to be done as a consequence. I accept that, perhaps in a parallel with presumption favour of inclusion in mainstream schooling that we have ended up losing some of the specialist support that parents would say in presumption of mainstreaming does not mean that they should not still have that very highly specialist provision for some. In fact, they should not feel that somehow they are letting down their young person by asking for that support, that there may be a parallel here that we are closing down what people understand as the need for their own young person because of an adherence to a policy that somehow creates the impression that there should never be that kind of supported accommodation. The people who are being left in the community with a bit of support from carers because of a very narrow interpretation of a policy, which I believe is not narrow at all, should be a wide spectrum of support. I do not believe that everyone in this group is being left in the community with inadequate support. I think that some of the examples that I have touched on and some of the other key stakeholder organisations would argue very strongly against a generalisation of that sort. I am not suggesting that you are making it convener, but I think that it is important for the record to say that. What I do accept is that there is undoubtedly more that we need to do and we need to test out whether the policy that we all broadly agree is the correct policy has, in either its sweep or in its implementation, unintentionally created a gap in provision and support that we now need to address. That is very helpful. I thank you again for responding to our questions. I think that, particularly being responsive to the issues around the petitioner herself has identified, I wonder if that is something that perhaps we can ensure that the Cabinet Secretary has information in terms of pursuing protocol of an invitation and so on. However, in terms of our work, the suggestion is what we should be doing with this. Rachael Hamilton It is fascinating that the possible unintended consequences with the lack of markers on the data set may identify a hidden group of people with profound disabilities. Therefore, I think that it is in my mind until the Cabinet Secretary has met the petitioner and understood the petitioner's absolute aims within that petition and that those markers are created. I do not think that we can formulate or take this as far forward as we want in the pace that we would like to do. I think that, in my view, we have made more progress in the past hour than the petitioner has made in quite some time because there has been a conversation, whether deliberately or otherwise, and I would not say deliberately because that would be most unfair, but it has simply missed the point and that has been the frustration of the petition. I think that we would want to hear from the petitioner the response to what has been heard and, of course, other people with an interest in this area, whether it is the cross-party group or organisations that support individuals may have a view on what is, in some ways, about individual needs, but it is also about the way in which policy is being implemented and how you ensure that you have the right information. Therefore, I would hope that we could also invite the petitioner to respond and I would hope that others with an interest may want to respond too and that we can get further update at a later stage in terms of how it has been progressed by the Cabinet Secretary and the Scottish Government. That would be acceptable. In that case, I again thank the Cabinet Secretary very much for your attendance. I think that that has been extremely productive and is perhaps an interesting lesson about the benefits of direct conversations, sometimes in correspondence, which some of the substantial points have been missed. Thank you very much for your attendance today and I thank everyone else. I will close the meeting.