 Good morning, everyone, and welcome to the 30th meeting of the Social Justice and Social Security Committee. Our first item of business today is a decision to take item 3 in private. Are we all agreed? Yes. Fantastic. We'll move on to item 2, National Care Service Scotland Bill. Our main item of business today is two panels of evidence on the National Care Service Scotland Bill. This is our second evidence session on the bill. I welcome to the meeting our first panel, Frank McKillop, Head of Policy and Research in Able Scotland, Rachel Cackett, Chief Executive Officer, Coalition of Care and Support Providers in Scotland, Beth Reid, Senior Policy Officer, Crisis, Chris Gerca, Community Leader, Director, Larch Highland and Andrew Ewing, Chief of Staff, Leonard Cheshire, who are joining us in the room today. Hello, everyone. Also, Sheena Arthur, Partnership Manager for Health and Social Care at Glasgow Council for the Voluntary Sector, who is joining us remotely. Hello. Just a few points to mention about the format of the meeting before we start. Sheena and members attending remotely, please wait until I or the member asking the questions say your name before speaking. Sheena, please allow our broadcasting colleagues just a few seconds to turn on your microphone before you start to speak. You can also indicate with an R in the dialogue box in blue jeans or simply with a show of your hand if you do wish to come in on a question. For all our witnesses, please don't feel that you have to answer every single question if you have nothing new to add to what's being said by others. That's fine, we do have a big panel this morning. We've got a lot to cover as well, so I would ask everyone to keep questions and answers and any follow-up questions tight, please. Colleys in the room should indicate to myself or the clerk if they wish to come in and ask a supplementary question. I would please ask all members to direct your questions to a specific member of the panel. Committee members online should use the chat box or WhatsApp. We're quite tight for time today but I'll try to give all members an opportunity for questioning. We will move straight to questions from members and I will bring in Paul MacLennan first. Thank you, convener, and good morning panel. Policy memorandum in the bill mentions about phasing of transfer functions from 25 to 26. We need to be based on delivery readiness assessments. Clear transparent local transition plans will be developed with partners so that everyone is affected as comfortable with what's happening where and when. I'm just going to ask the panel about how it is best to ensure that the process of reform doesn't destabilise your services and Andrea will probably come to herself first of all. I think that the key thing here is that because of the sequencing of the bill, because it's an enabling piece of legislation, I think that what that runs the risk of is the fact that the co-design process has to be from the get-go. We have to ensure that people with lived experience can feed in because of course the structures have to be right in order to facilitate co-design in itself. One of the key considerations that the Scottish Government needs to make is that it needs to build the systems in place, but it needs to build confidence that can allow providers, that can allow people who are supported in social care to have clarity about their entitlements and also about that there's not going to be any gaps in service provision. I think that one of the problems with the bill as it stands is that in terms of the broad principles, we need to better understand from the Government how those can actually be fulfilled by individuals. Individuals need to have clarity about how they can realise their rights, how they've got right to redress, that links in with the principles of the bill, but also with the charter, so all of these issues are intertwined and they're inextricably linked. I think that's the key thing. We need a bit more clarity from the Government. I think that we owe it to the people who are in receipt of care and support to provide them with confidence that the system is not going to let them down. As a sector, as a field, we are struggling with significant challenges here and now. The process of passing this bill cannot exacerbate those challenges and I think that that's a real concern at this stage. I'll probably come to you, Rachel, if that's okay. I'll be open up and see if anybody else wants to come in. Thank you and thanks for the opportunity to come and speak to you all today. CCPS is a member organisation of 91 exclusively third sector providers, some around this table today, and we work alongside around a quarter of a million people. Our members do, they employ around 40,000 staff, 5,000 volunteers work with them and they manage around one and a half billion income. Now I stop my answer to your question in that way because I think it's really important to understand the size of the third sector and the need for stability in that in order to get to the point of an NCS. And also on the co-design point that was just being raised there, the importance of the voice of our members in that co-design frontline focused process. Now we, our members are very interested in this bill inevitably and we met a number of them yesterday to talk about next steps in the legislation. And what I heard really clearly is that reform is needed. You're not going to hear from our providers the need to sort a system that is in many places broken and unfair. So we know that there is a huge amount of unmet need. We've still got competitive contracts that don't focus on outcomes for people and on relationship at the front line. There's a total lack of fair work where we are at the moment so if directed support is not yet implemented properly and we have a lack of parity for the third sector in the sense that sometimes social care exists to relieve the pressure of our acute sector which is important but not really the point of social care. So I would say in answer to your question that vision of where we go is really important. And as a membership organisation we took time when the bill was published to really try to articulate the vision of where we thought this bill should get us to. And I've shared with the committee our vision for reform. And we're now using that to overlay on the bill to work out is this bill the right reform to get us there? And if it's got holes or gaps at the moment, can it be amended to get us there? So I think vision is really important. We need to know what we're aiming at if we're asking people to go on a really radically different journey and we have to articulate that really clearly. We hope what we have done is a helpful contribution. We would like to see that vision far more at the front of the discussions on this piece of legislation which is a framework bill focused largely on structure. The other point that was raised was the current situation we're in. And it is dire. It is really very hard. Providers have their backs against walls financially at the moment. We have a recruitment and retention crisis within the sector. We cannot get enough staff to deliver. And that puts us all in a very difficult position whilst we're also trying to deal with this vision of a big structure or reform. The Order to General was on BBC Scotland this morning talking about the importance of reform if we're going to deal with where we're at and I think he's right. What we need to make sure is we've definitely got the right reform. And that's why we, like all of the committees in Parliament who are looking at this legislation, are taking our time through this stage 1 process to work with our members and partners to check can this bill get us to where we think social care should be, which is about enabling people to live the lives they want to lead. That should be what we're focused on. In order to do that, given the size of the third sector that I've set out, we do need to make sure we have a third sector to deliver on a national care service. And that does mean we need a twin track. And one of those is about making sure we have stability right now. CCPS has worked with our members and put out a winter manifesto called Urgent Action for Urgent Times, which is on our website. Again, in keeping with our model of change, we are trying to be as solutions focused here as we possibly can and to make sure that we're offering options to try and ensure that stability is there now to allow us to vision and make change into the future. Rachel, thanks for that. I'll probably open it up, but you mentioned the issue about contracts. I was going to ask a second part of the question. It was really said that the bill allows contracts to be reserved to volunteer in third sector organisations. I don't know what your views are on that, if you see disadvantages or advantages in that. I'm going to be open up and ask other groups to come in on the contact issue as well as the broader question that I asked. On the specific issue that you mentioned about contracts. I think there are two things in the legislation. One is its provisions around ethical commissioning and one is it's around its reserved contracts and the two things I think are interlinked. In terms of the ethical commissioning point, it's very thin at the moment and certainly if the bill continues, we would like to see that strengthened considerably because the whole ethical commissioning is something that should be at the heart of a radically reformed service. Competitive tendering is not a good way forward. That then obviously links into the provisions on reserved contracts. At the moment I think there are two issues for us in the provisions in the bill. One is do they go far enough? Are they just a rewriting of EU regulation into Scots law? Are they as radical as they could be? Certainly the idea of reserving contracts in certain circumstances could be a really positive way of thinking about how do we change the way in which we procure services right now. That's certainly one issue. The other is there's no commitment in the bill to ever use those provisions. We can put things into law, but that doesn't mean that they're actually going to make a change. I think that's the commitment that we really need to see if that is going to be the way, one of the ways to change how we procure social care in Scotland. We need a commitment that it will be used. Rachel, thank you. Frank, you can probably bring yourself in and mention about obviously reform. Doesn't de-stabilise your services, but also on the contract issue, if you can pick up on these as well. On the first point, there's no doubt that reform is required. That's why we've welcomed the introduction of the National Care Service Bill. I absolutely echo the points that Rachel and Andrew have made, especially with the crisis that's facing the social care sector at the moment. We need immediate action, as well as the broader, longer-term structural reforms. To be honest, there's perhaps some immediate-term structural reform that's required. I think that we're already seeing the challenges. If things worked as they are, we wouldn't be in this situation that we are with social care. That is, as far as we're concerned, sufficient evidence for the need for reform. Even in the immediate term, as we try to tackle the challenges that are facing the social care sector at the moment, we are seeing that frustration at times, that there's perhaps a reluctance to embrace some of the more innovative ideas, and the measures that might be taken to try to relieve some of the pressures that there are on the social care sector. I think that the most obvious one there, when we're thinking about fair work, we're thinking about terms and conditions and enhanced pay for front-line social care staff. We have to take that seriously. Obviously, there's been the cuts that have unfortunately been required to the health and social care budget in order to fund an NHS pay rise, but we don't see where the funding is for a social care pay rise in the current financial year. I think that it's those sort of challenges, and we prioritise what's important to us. Where is the prioritisation of the social care workforce? Because if we don't prioritise the social care workforce, then we are building up these problems for ourselves as a society, and indeed for the extra funding for an NHS pay rise, isn't much use if the NHS is on its knees because social care hasn't been built up to the capacity that's required. I think that's certainly a concern that we have. Of course, there's a need for the long-term reform. We need to have immediate reforms as well, perhaps outside of the legislation, just at a local level and across Scotland to ensure that we're doing more there. On the point about contracts, that's something that we welcome. It's a bigger philosophical and political discussion about the delivery of care and the models for delivery of care. The evidence is there. We saw the worst evidence during the Covid pandemic about the performances of the different sectors and the different methods of care delivery. Even keeping away from the horrific statistics that came through from that period, especially in care home settings, we know from the caring spectrum that the third sector achieves better grades in the private sector. We know that, especially for care at home services, they are more popular, they are more widely chosen by people to provide their care in their community. Around 46 per cent of the social care workforce for care at home services is in the voluntary sector with about 27 per cent each in the private and public sector. We know that the voluntary sector has a very strong record, particularly in delivering care to people in their own homes and in their communities. Something in the bill that recognises that is welcome, as Rachael said, that power has to be used. It is evidence-based policymaking. We know that people are choosing the third sector for their care. They are choosing the third sector because the caring spectrum tells us that a lot of those things are better than other sectors. I think that that evidence base and learning from what works and what people are already choosing needs to be a driving light for the development of the policy. I might just find one. Chris, pull it from yourself. The policy system works great across Scotland. The same question about the reform not destabilising your services and against the contact point. Are you conscious of the time, convener? Thank you, Paul. I just want to... This message has been made clear already, but the sector is not stable at the moment. We are about to embark upon change and reform, which is required. But only two years ago, I had a colleague who, a Ugandan lady came to the UK to train as a mental health nurse to work over here. She died, she left two children without a parent at the height of the Covid epidemic, and she was getting... It was called the living wage, but it's minimal. We've got tremendous pressures on the system with recruitment and retention. Management and leadership in the sector gets criticised, but we've not been given uplifts to allow us to maintain pay differentials with particularly frontline managers within the sector. We need to be very, very careful about how we go around the implementation of this bill. I think, to be frank with you, I know there's a debate about whether the co-design should have happened first, but my sense is, from a third sector perspective and experience in working in co-design and production with people who receive services, is that if you look at the outcomes within the bill, the very fine principles, I'm not too sure if you work through that, you'd end up coming to the conclusion that we possibly need a national care service to address those. We may very well need an improved capacity to draw the sector together, but I fear that we may be spending hundreds of millions of pounds on the creation of something that isn't actually delivering the outcomes and benefits to the end users, and surely that's what we're all about. In terms of the third sector involvement, I think, as Frank has said, the third sector delivers value, quality to end users. Once again, if the plan is to transfer services into the third sector and those services come with significant costs in Chupi, then you've got to consider is the sector funded enough, do we get full cost recovery in order to enable us to do that? In terms of small organisations as well, are we given the support to maintain our position within the ecology of third sector organisations? To my mind, the creation of the national care service is welcome, but it doesn't need to be this big bureaucratic behemoth that it might be. It doesn't need to be a precondition for delivering Ann's law fair work within the sector and all of the complaints service, all of the other laudable aims within the bill. I would urge caution because we can't take any more. The situation is very sick. In NHS Highland, I've got a situation where if you're a social care worker and you're starting pay, you're starting a band four, so you're starting to pay £4,000 more than we can offer, than we're funded for. It's a lead agency model, as you know it there. The same commissioner and provider is paying. It's sick and it needs to stop. It's a question of justice. I'm going to say where at the time. Unless anybody else wants to come in, I'm quite happy with the questions I've got. Okay, thanks, Paul. I'll bring it back in later. We'll move now to questions from deputy convener Emma Roddick to be followed by Pam Duncan-Glassy. Thank you very much, convener. Chris Larch has recommended that personal assistance be regulated. Would you be able to expand on why that's needed and what impact it could have? Yes, thank you. The notion for that came from a very practical experience of working with families who have, generally family members of children who have a learning disability, and they get to a stage in their life where they no longer feel comfortable in being an employer and attending to all the administration that's required with regard to an SDS-1 option. What I find with those people that do choopy into the third sector from that is that those colleagues really welcome the training opportunities which can be given and also the experience of employment within the third sector from a larger organisation. It seems to me that it's important that the national care service considers SDS and how we can support those people that rightly want to take SDS option 1 in order to be a good employer and offer fair work to their employees and offer the training that those employees require. I note that in the SDS survey this year that 45% of personal assistants said that they had to fund their own training. 25% of new personal assistants, only 25% of new personal assistants said that they'd received training in the last year. Only 40% feel that they've got any job security within the SDS-1 options. 11% are on zero-hours contracts and 12% don't have a contract. Obviously, there are grave concerns about social justice, about fair work within that sector. In no way should, am I suggesting, that the choice and control at the very heart of self-directed support should be challenged in any way. I think that there is a great opportunity here perhaps through personal assistants being added to the SDS-1 register and for some elements of support for SDS-1 employers to give a better experience to personal assistants. That's really helpful. I'm interested that you mentioned SSC. There has been some concern that having PA's register that way would push them towards a more clinical qualification and career trajectory. Do you share any of those concerns or is there anything that, conversely, you wouldn't want to see in regulation of PA's? It strikes me that the workforce is one. I don't know if it seems different, maybe from a different perspective, but at the front line, you've got people moving from personal assistant roles into the third sector, into the private sector, the independent sector, and they're moving around. It strikes me that it would be helpful for the sector if it was easy to transfer from role to role, if everyone in the sector worked to the same code of practice, if everyone had the same opportunities for training and qualifications, if personal assistants as well could... The SSC isn't supposed to be a stick to beat people with, it's not supposed to lead to a clinical and health-orientated culture within the workforce. I don't think it does. For me, it would be an opportunity to create parity and to create a more professional and flexible workforce. Thank you very much. My last question around this theme, coming from the Highlands, is there anything in particular that the national care service needs to consider when working with third sector providers in different geographical areas? It seems to most of my peers who work within the Highlands that rurality, the reality of living in the Highlands, and I'm sure other rural parts of Scotland as well, the borders, et cetera, is not understood often by people in the central belt, frankly, and I'm concerned that assumptions will be made the way in which services can be run and configured, the way in which co-design can happen, frankly, the funding required for operations in a very rural area with actually working within fragile communities as well can be the same. My fear is that some of this sense that the national care service, if the secondary legislation is wrong, becomes a top-down bureaucratic entity, then it's going to be, you know, we may end up with services which are delivered less well, are funded less well, and in the transformation as well from the local IJBs to the care boards as well, that local knowledge is lost. I feel secure at the moment that those who commission our services know very well the reality of life in the Highlands. In fact, due to the small scale of our communities, we support individuals. We can't lose that. We can't throw that baby out with a bath water, as it were. Convener, is it all right? Can I just press a little more on that issue? I completely appreciate everything you're saying there, Chris. Is there anything off the top of your head that you think needs to be included in the co-design process to account for that, that would make you feel more secure and reassured that you're going to be listened to? I think broadly, if the co-design process were to happen locally at grassroots, as it should, if there was funding for service use of representatives and simply expenses for travel and the resources to enable everybody to have equal access to the co-design process, it didn't just happen in urban centres. Inverness may seem far enough north for you, but what about the people of Wick and Thurso and the islands and all the rest of it? I think there needs to be consideration to it happening. Subsidiarity, the decisions happen at the lowest possible level within our communities that are closest to the end user. I'm afraid co-design and consultation is expensive if it's done well. It takes time, particularly we work with people with learning disabilities and autism. It takes a great deal of time and resources to do that well, unless it's going to be tokenistic in a tick box, which actually gets us nowhere. Thank you. I'll now take questions from Pam Duncan Glancy to be followed by Jeremy Balfour. Thank you, convener, and good morning to the panel. Thank you for the submissions you've given to the consultation in advance and also for answering the questions you have so far. I'm keen to understand a little bit about the experience of some of your members just now and the sorts of things that really need to be addressed today and what is the sort of thing that you could be looking to to the future in a bill like the national care service bill. Rachael, if you could maybe talk a bit about the experience of your members just now and what we would do today as opposed to longer term. Absolutely, and thanks for the question because I think it's such a pressing concern. I mentioned earlier that we've just recently published a piece called Urgent Action for Urgent Times, which I think sums up what we think is needed and we hope that is a very practical document. When I asked members in our regular member meeting on Monday what their most pressing concern was because we were meeting with Cabinet Secretary this week, yet again the answer is recruitment retention, recruitment retention, recruitment retention. Social care and support is about people and actually you need the people to have the relationship to be able to give the consistency that is required in that relationship at the front line and our members are really struggling and one of the key reasons that they're struggling is that the bill in the principles talks about being an exemplar of fair work and we think that's not strong enough because we don't actually know what being an exemplar is in terms of a principle but we have been talking about fair work and social care for some years and what is happening this year is rather than moving towards fair work we're moving ever further away so I've been in post at CCPS just four and a half months and I would say even in those four and a half months the tone of the debate around this within the sector has markedly changed and it's changed for a number of reasons one is that our public sector colleagues have been offered substantial pay awards and I do not begrudge them at all anyone working in health and social care should be paid appropriately that has not been met with the similar level of uplift for social care staff more than that were hardly mentioned in terms of those uplifts on top of that the real living wage announcement with an urgency to bring that in before May has also not yet translated into the pay packets of people who are working in social care so whilst a mid-year uplift was given to a minimum of £10.50 an hour that's now 40 pence short of the real living wage that's around £800 a year difference and previously there was a differential between the real living wage and the starting salary in social care to do that would be £11.55 we've heard nothing, not a squeak about how that will be delivered and what we're hearing of course is uplifts have been offered though not accepted so far but there is no more money that gives our providers a real problem because the money to pay for commission services comes through contracts which requires that money to be released at a central level we are hearing of providers who are doing everything they can to recognise the fact that their staff are not getting the real living wage let alone anything near the uplifts and those £4000 differentials are not uncommon in starting salaries between public and third sector providers some of them are having to eat into reserves to do that there are very difficult negotiations happening that's a very, very pressured space when actually the levers to pay that amount is not with our provider members it sits with government and with local government in terms of how to deliver on that there are some other practical situations so during Covid for example there were all sorts of immediate actions taken to recognise that providers had to focus on the front line we think some of those could happen again so suspension of tendering for example is a period of time over the winter we know our colleagues we talked about triple SC colleagues in the public sector have been offered triple SC fees being paid for some of our members' employees finding money for that triple SC fee is the straw that will break the camel's back we've not been offered the equity so I think fair work is absolutely at the heart of what the national care service should be it shouldn't matter who is providing a service equal pay for equal work it should be the tracks that properly recognise the needs of third sector providers are required but we could do some of that now and I appreciate the cost the cost of not doing it is profound and I think that is not said enough thank you for that do you think the issues almost might be self-evident do you think the issues with retention and recruitment are largely around things like paying conditions or other factors I think it's a huge part of what we're hearing there is a supply issue which we know about but the fact is when the real living wage was announced at 1090 many other employers, supermarkets for example immediately did the uplift we have to be aware that the people who work for our providers have to feed their families they have to pay their bills they have to do all of those things and the boards and chief execs of our organisations are doing everything they can to keep them but actually going down to the brass tacks of it right now when people are really struggling then actually pay is going to be right at the front of people's minds and that makes it hard to keep the good people that we have and we cannot lose that experience our other issue is the way in which some of those uplifts have been applied so it's not always known that the uplifts have only been applied to adult social care they've not been applied across the entire sector and they're only applied to the percentage of the workforce which means that within providers keeping that differential which one of my colleagues mentioned earlier is really hard that means what we're seeing as a knock on consequence is difficulty in keeping some of the more senior posts particularly if the differential in pay is minor because why would you want to take on all that additional responsibility but actually not be rewarded and appropriately rewarded for doing that so it's not just that we're seeing that we go up the chain within providers that we're not able to do that so one of our suggestions is that uplifts and we certainly hope there will be an uplift are actually on full contract value not on a percentage of contract on an average workforce which we think is not representative of the sector thank you very much for that can I ask Sheena the same question and how the situation is in Glasgow for your members thank you for the opportunity I would echo what has already been said we're seeing a sector in crisis and the value that the immediate action would be to value the workforce and including our volunteers we see a sector that is being through extremely challenging circumstances and continues to do so and for me as well as what's being said we have an issue around the wellbeing of the workforce we see higher absence rates recruitment and retention being an issue and the emotional strain on people we've got organisations wondering whether they can heat their service while trying not to destabilise the confidence and wellbeing of their people that they support and as has just been said organisations using their reserves to try and continue to keep their service going with the uncertainty of funding decisions that are coming maybe in a month's time it's really the question about not destabilising the sector we don't have a stable sector right now it's really critical that we do something now and the best thing we can do is that fair work that value in what people are doing and people are working too capacity to the top of their ability extremely challenging circumstances so that support for them is really critical and I have a real concern about the wellbeing of our workforce because people are really committed and as has been said excellent standard and a person centred approach is core within our sector but we've got people at all levels really juggling with the pressure with the demands Thank you for that Sheena and it's really echoed what some of what Rachel said and just paints a pretty grim picture actually of what's going on the other question I was going to ask if it's okay is to Frank and Andrew to ask about the experience of your members just now from a service user point of view as opposed to provider point of view can you say a bit about that and what their experience is and what we need to do today as opposed to the longer term I think that what we've got to remember with all that when we talk about a crisis of capacity and recruitment and retention pressures what we're talking about is individual people are not exercising or able to exercise their right to high quality social care and support so whenever we talk about these statistics it's not in the abstract it means there is a person in care and support that they need and we know as well that it's 2000 when the Scottish Government announced the policy intention to end institutional care for people with learning disabilities Lenox Castle was shut in 2002 but in 2018 the coming home report that was produced for the Scottish Government found there were over 700 people with learning disabilities and autism from Scotland who were still in some form of institutional care for 79 of those people they weren't even in Scotland so I think there are those sort of issues enables my own front door campaign earlier this year identified we think there could be over a thousand people with learning disabilities today who are in hospital or institutional settings who should be in their own community so I think we should never forget that impact the front page of the national care service bill talks about human rights and we absolutely applaud that but again it's easy to talk about human rights it's putting that into action it's what really matters as I said earlier if it's important to us, if it's a priority then we find a way to do it and I think that has to be the imperative that drives this you know that this isn't an abstract discussion about structures and systems and everything like that we have to remember that this is all for a purpose and the purpose is delivering and realising the human right that everyone in Scotland has to high quality social care and support in their own community do you think the bill needs to be strengthened in that sense? I think it's certainly the thing that's sort of strangely absent and it may be an oversight and I think it had been referenced earlier in the evidence there isn't a specific reference to self-directedness which we find a bit odd and again it's probably an oversight I think we do sometimes find a discussion that self-directedness and person-centred are interchanged as terms but they don't mean the same thing person-centred is still outlining a system where other people are designing it for that person so it's better that it's person-centred than supplier-centred or finance-centred of course that's preferable but it's not the same thing as self-directedness and I think if we're going to have a truly human rights driven and self-directed social care and support system in Scotland and self-directedness has to be at the heart of that the legislation is almost a decade old it's not a new concept in Scotland it's a concept that many countries around the world have applauded us for but the reality is it's not happening in practice enough and we need self-directedness to be right at the heart of a national care service and indeed for the delivery of care services today and that's for something that we really feel has to be there I think that as Chris had outlined the experience with PAs and certainly we recognise that to enable because everything that we're doing we're delivering two and a half million hours of social care and support for over a thousand people every year and that is all delivered through a PA, a personal assistant model but it is delivered with those individuals are employed by enable because we recognise that the challenge of self-directed support is that many people, as has been outlined there's difficulties and challenges essentially you've got to start running a small business which a lot of people don't like the idea of for obvious reasons, they don't want to have all the pressures and requirements of being an employer and everything that comes with that so we have built a model where enable as an organisation takes on essentially the functions of the employer we will support the individual with recruitment of their own team but ultimately they make the decision so we are doing all the stuff in the background for them but they make the decision about who they employ and then when that team is brought on board the individual is self-directing how their budget is spent and what they are doing to support them to live the life that they want to live so I think that there are those models that are out there that are already working and that's demonstrated we've got 88% of our care and spectra wellbeing grades are at 5 or 6 for very good or excellent so we know what works and I think that this has to be at the heart of it self-directing is absolutely critical when we talk about human rights and we need to make sure that the bill reflects that Thank you Sorry Pam, I was just going to ask if you could wrap up the question because all our members have a very specific amount of time this morning I don't have another question I was just hoping that Andrew might come in on the previous question just waiting for that, that was all Thanks very much There is a conversation about workforce I think that what is often the problem in the whole debate about the bill so far is that we have to remind ourselves that to deliver person-centred care we need a workforce that is sustainable, that is funded for the long term and of course the funding is critical to workforce planning I think that for any front-line worker to build a strong rapport with the people who they are supporting we need to understand that actually these relationships really matter and they affect the quality of care they are integral to it so actually all of these issues around funding for the long term I think to echo some of Frank's points as well, the whole debate so far about the national care service I think one of the things that it is lacking is we need to go back to the key point here, who is it for whose lives is it intended to improve I think it is also about ensuring that everybody has a stake in the co-design of the national care service I think one of the things that could be improved is enabling people with lived experience to shape for example the strategic plans of the care boards so at the very grassroots local level people need to have an input and they need to have clarity about how they can shape the national care service I think we need to focus less on structure and perhaps more on people Thank you Thank you very much Pam I'll move now to questions from Jeremy Balfour to be followed by Foisal Chowdry Thank you community, good morning panel I've got two questions on this area and it's really picking up a comment made by Chris that if it's going to be co-designed and properly it takes time and energy and input and I suppose I'm just wondering we've come out of the pandemic we're facing a very difficult time for many reasons at the moment do you think you have the energy and the time to engage constructively with that co-design or are you just running to stand still at the moment and this is going to be the straw that breaks the camera back Richard, I don't know if you want to come in first on that Thank you There is definitely an issue of bandwidth at the moment I mean we've set out some of the issues faced by providers to work with people who need care and support just now At the same time there is also a real understanding of the need to invest in reform so I know from our points of view that our members are doing everything they can to engage in this debate but it's tough at the moment because there are so many other pressures on our providers to keep the wheels going they need to keep the doors open over the winter and that's what they're doing and that has to be and should be their priority I think that the focus on co-design is a really positive one if it's genuinely what it's meant one of the things that I would say in the work that we're doing to look at the provisions of the bill and if the bill could be strengthened to get towards the vision for social care that we have is around issues of co-design and we think that the government could be way more radical in what's in the bill so the point around local care plans for example the way the bill is structured is a very traditional consultation approach where somebody writes something and then they throw it out and then a few people give comment we've done that before it's pretty much what it says in the Public Bodies Act I think if the focus is on co-design through the entire process that matters similarly co-design has to work right through the system so one of the big disappointments for us was that Derek Feeley's approach to the national governance of this is lost in the bill so we wanted to see a national care board good decisions are made by diversity of voice I remember once working with a very prominent lawyer in an old job looking at failures in the health service and one of the conclusions they made was if your board is diverse then naturally you'll make a good decision if it's not you'll get groupthink and actually the point of the national care board was a really important place for co-design because it's where you model as well what it is that you want to see through the entire system so the fact that it's lost in the bill is huge and certainly something that we would want to see put back in the time issue is definitely one that needs to be grappled with I would say that there are a lot of different areas linked to this bill which are requiring attention at the same time that is hard I was aware of the cabinet secretary talking about some issues of phasing at the weekend I'm keen to see what that looks like when the £70 million was taken out from the national care service for this year, there was a similar comment what we're not clear on is what does that look like and therefore how do we ensure that we're helping to support our providers to put what energy and space and bandwidth they have into the right things right now Bethan, I'm really under I just want to make a quick comment on this, we welcome very much the focus on lived experience we've been talking about involvement of service users, we need to think about those people who aren't able to access services and people who are sometimes labelled as complex who maybe require services from several different services, health and social care and homelessness and criminal justice and so on, often fall through the gaps cannot access those services are deemed too difficult and if their voices are not heard in this this will not work for them so, where to begin one of the things at the heart of all of this is to Rachael's point about the finances behind the system as it stands I think you're right to say that we are running to stand still I think actually alongside the bill there can be immediate action to take to bring about fair work and I think remuneration is obviously a part of that, differentials have been mentioned before, I think the key thing is for us, the Scottish Government in its own language has said about the need for us to rethink about as a society how we view social care and working in social care move away from the movement that we saw during the pandemic where sectors like retail and hospitality were impacted for example with lockdown restrictions and a great many people viewed social care as perhaps a changing career, perhaps a stop gap job if as a society we really value care in the words of Derek Feely we need to kind of change the paradigm of what social care is for and so some of the work around investment and to Rachael's point again what we cannot do and I think the financial memorandum of the bill is quite lacking in detail in this regard is we can't run the risk of investment being withdrawn from front-line delivery because there's a need for IT infrastructure for the systems that are required to be put in place and again the Scottish Government has said that this is going to be a landmark reform perhaps the most comprehensive public services reform in the history of this Parliament so we do need the financial wherewithal to ensure that this is meaningful and that has to start at the front-line and I think that needs to be at the heart of the bill Thank you, I'm conscious of times I'm going to ask you a question and I'm going to see if I can get a yes-no or don't-know answer from a panomist and that is around the charter the charter I don't think at the moment gives any new rights it clarifies the rights that people have but it doesn't have any legal status it's got no legal authority it can't be challenged by an individual or by an organisation my yes-no question or don't-know is do you think the charter should have a legal standing so that if it's appropriate to just a review can be taken place and maybe just go round Yeah, absolutely Yes I have no comment on that Yes, it needs teeth Yes, and I think some sort of commissioner or body like that that would have a responsibility to support with that Does she now have an answer? Yeah, absolutely Thank you I'll leave it at that one Fantastic, thank you Jeremy I'll move now to Faisal Chowdry who is joining us online to be followed Thank you very much Good morning panel I'll be very short I think I'll ask Rachel that question What kind of cost might be created for third sector organisations by the provision on monitoring and information sharing? I have a question I mean it largely depends I guess because so much of the bill is not clear So in terms of monitoring one of the things that I would say is the way in which contracts are designed needs to properly reflect the liabilities and responsibilities of providers beyond their front line work and if there are going to be additional requirements that has to be reflected in the ability of providers to employ the right people and to do the right work to report on potentially new provisions So in terms of information sharing one of my colleagues has spoken a bit about IT there's a lot in the bill which doesn't necessarily give those costs but we have to remember that if we're going to develop our IT infrastructure which we would certainly welcome and we at CCPS run a digital project with our providers to look at how to do that well we also have to be aware of the costs of things like reducing digital literacy and the on-going costs that providers will have in having new digital technology So I can't give you a figure partly because it's not altogether clear from the bill and the financial memorandum what that would look like we certainly commissioned Fraser of Allendo to do quite an extensive piece of work on the financial memorandum and they obviously came back with the report that has been widely circulated and I think one of the issues in the financial memorandum is well not only obviously is inflation now running at over 11% so some of the some of the assumptions that have been made in there aren't necessarily right but I guess it goes back to Andrew's point which is the financial memorandum is set up around the structure change within the legislation which is what a financial memorandum is meant to do of course it's meant to tell you what the bill will cost but actually what it doesn't necessarily do is take in all of the other costs including the cost of actually delivering care to pick up best point to people who were not even delivering care to at the moment so I think there's a lot in there that we need to think about in terms of the financial memorandum but I think your point about the costs for reporting and for developing our IT infrastructure have to be accounted for in the type of contracting that goes on to either individual providers or alliances providers perhaps in the future so that we can do as a sector everything that we would want to do in that as well Thank you very much I do have another question Thank you I'll move now to questions from Miles Briggs before we move on to our next theme Thank you convener, good morning to the panel thank you for joining us this morning I wanted to ask a couple of questions with regards to employment in terms of the bill as it stands of who the employer would actually be for many of your members which are maybe to start with you so my assumption for our members is that they will continue to employ the staff that they employ and that will depend on how services are commissioned and what they're funded to deliver I do think there are some other parts of the bill where we're perhaps less clear so obviously the paperwork accompanying the bill suggests a pretty whole scale transfer of social care and social work staff to the national care service and one of the questions that we've been really grappling with over the last few weeks is is the national care service a service delivery organisation or is it a commissioning organisation and I know some of the comment back is that whether or not those staff will transfer to the national care service is up for co-design and it seems a fundamental difference in the purpose of the national care service as an entity on whether it is intending to deliver services itself some of the other questions that we've been trying to work through and I haven't seen anything yet on this more publicly is the issue of 2P transfer which certainly one of our colleagues was mentioning so we've been trying to sort of work through you know if staff are not transferred but actually contracts go from current local authority provision to a third sector what are the implications and the cost implications for our members on that and how do you deal with all the usual things like pensions so we think in terms of almost working through the potential consequences of what the bill is suggesting on employment workforce and associated costs and responsibilities needs more work we would certainly wish to see that quite quickly because not only is it about cost but it's about the fundamental purpose of what the national care service is that was a comprehensive answer I don't know if anyone else wants to add to that if not just make a point it's not clear but I've got concerns really that if we remain the employer which we ought to but if then terms and conditions rates are somehow expected of us as a framework to work on which would be a good thing if that delivers a better experience for employees my concern is that we wouldn't be adequately funded for all of those elements because that often doesn't happen we don't have full cost recovery probably over the last five years plus haven't met all of our needs and also if there isn't in position upon us would that somehow militate against our model our way of doing things the beauty of the voluntary sector is that we've got different carasins different ethoses our charities have different aims different cultures and we need to be careful that the dead hand of bureaucracy somehow doesn't snuff out all of that difference to the end user whether it's Lash and Camp Hills particular model whether it's Enable or Lennard Cheshire or anyone else I do caution about the way in which that's implemented thank you for that I think it's a point all the committees have been hearing with regards to the national care service my follow-up question was with regards to progress parliament has made and I think collectively none of us are saying change doesn't have to happen but when you look at the last decade some of the reforms integration of health and social care Rachel and I both worked on health and care staffing bill self-directed support we've already touched upon carers breaks within the carers bill now that hasn't necessarily all been delivered but my question is could this undermine these policies as well as we move towards creating another basically organisation and all of that progress to see happen and not necessarily it has but it gets lost in translation I just wondered what your view was on on that so I think it's a risk and one of the risks that we talked about earlier was the fact that some of these things are not explicitly mentioned or translated into the bill particularly self-directed support which concerns us as well you'll see from our model of change that one of the things that we've put in there is that principle of subsidiarity individual and at the moment what we have is a bill which is inevitably causing a great deal of tension between national and local governments about control but actually I think it should be far more radical and that's what SDS is about because control and choice should sit with the person to manage their own life with support and I think it goes back to Chris's point so I think there is a risk I don't know if it's insurmountable that's the work that we're doing now like the committees to try and work through what could be improved but I think the fact that the bill in itself doesn't even really make clear what happens to IJBs we're all making some assumptions about what's going to happen but we are assuming that much of that will be repealed and that we're not going to end up with two different versions of how we manage health and social care integration it's also interesting that I think having also worked on the public bodies bill and acts extensively integrations hardly mentioned through this process so there's something about what is the it goes back to our vision statement what is the vision that we're looking to and therefore then does this bill help us get there and I think some of the principles that have been talked about they don't mention things like choice and control I know some of the DPOs are unhappy that it doesn't mention the right independent living for example if these are the things that really matter then we have to make sure they're reflected if this is going to be the legislation that gets us the reform that we want thank you thank you I think I would agree with that and I think the calls for a national care service have been building over a number of years and led to the Feely review and now the national care service bill I think it probably reflects a frustration that those policies were not being experienced in practice as I'd said there is a lot of international interest in some of the policies that Scotland has and Enable has been at various conferences around Europe where that's been discussed and people from other countries will say well that's amazing you've got self-directed support legislation and yes you have the legislation but and I think that perhaps we have that desire through this bill and perhaps it's fully optimistic on my part but I think part of the thinking behind this bill is that this is how we make all those things happen in reality and perhaps I don't think we want to get into finger pointing and I don't think that's healthy but as perhaps a feeling that the current structures haven't worked in delivering that and again as Rachel has alluded to I know there is lots of finger pointing in various directions as the funding coming to deliver it as the delivery being done by the front line there are those sort of questions and arguments that are always there in terms of the relationship between local government and national government but I think that it's recognised it's not been working for whatever reason so if we are going to have a structure a national care service structure there that has to be the final piece of the puzzle that has to be the solution to why these initial reforms haven't worked to date that has to be how we get to that place so I think it's really important that those elements like self-directed support baked into the bill absolutely clearly this is what's going to make this happen because if it doesn't you know we've just moved the deck chairs but haven't actually addressed the problem so I think it's absolutely critical that we make that at the heart of the bill thank you and just finally convener at local government committee on Tuesday asked the same question we've got the minister in after yourselves what would you say to him and I'll maybe start with Sheena I know you're online we've not brought you in thank you I think from the last question the bit for us and a lot of our conversations with our members and people that use services is that if we have people at the centre then we can make progress I would argue quicker and more effectively people who use services their families and their carers who are experts in this every day it's their daily life if we keep them at the centre of what we're doing and not you know change the language we use but use the same processes in the same system that we know has a lot to improve on you know I think there's a risk we change the language we can actually change the behaviours in the practice and as we've heard we have a lot of great legislation in place in Scotland but it doesn't translate for everyone to have a great experience and I think that's the bit but we really need to have people who live this daily leading, supporting not being consulted or in a side what other people are suggesting but really leading and that we ask people who maybe are used to being in the decision making spaces to to step back a bit and enable people to really direct what they need and what they want because they have experience of it every day that we can really listen and learn from so that would be my plea to really enact all the great vision and desire to make things better but not to try and do it by using the same processes the same structures and the same power relationships that we currently have and that we can support each other with that Does anyone else have any other points? I think with regard to the minister let's slow things down to enable consultation on this so there's true co-design and we've got to grasp the hot potato of funding you know no nation in the UK seems to be willing to do that because it's eye-wateringly expensive potentially need not be but we need to commit money to the sector to enable a fair work to be delivered the report came out in 2019 and also proper funding so that end users have better experiences I've got somebody who she wants to live alone but is repeatedly told there's no money to enable you, a young lady in your late 20s to live alone that's wrong, that's unjust a young guy who in my previous job sits the stairs outside of his window because his package was reduced that they're the realities you know, as an employer I'm having to give bridging loans to enable people to get by in life other organisations have charitable funds etc you know that they're the three bits of action we need now thank you my lady I'll now move on to a supplementary question from James Dorran who's joining us online thank you convener it was just to take to go back to what Rachel and Frank were talking about Frank kind of answered my question were they were talking about the co-design the problems that they had they wanted co-design but Frank then went on to talk about some of the issues that had happened self-directed support etc and this clearly is a way to try and ensure that all these things that should have been happened in the past and didn't happen very often across the country because of local authorities as opposed to national government this might be a way to make sure that there is that sort of equality of commitment across the country and except the financial situation differs in different parts of the country but maybe this is a way that we will be able to resolve that issue as well to say Rachel particularly not agree that we saw with the Social Security Act that the co-production co-design after the framework bill was introduced could be a way forward that Mr Feeley certainly seemed to think so why is it that you don't think so Okay so I'd start by perhaps not challenging slightly the interpretation of what I've said but I'll come to that I think the Social Security Bill is a very helpful model in some areas where we are looking at that as well in terms of some of the changes that we might want to see if the bill continues when we get to stage 2 because I think it's really important to do that thinking early so Frank was talking about commissioners for example and that's been a really interesting part of the Social Security legislation though perhaps requiring additional resource than it has which doesn't appear in this bill despite the Social Security legislation being promoted as an important model I think there's also a fundamental policy difference between Social Security and Social Care and Social Care is an on-going one-to-one relationship with people to live their life sometimes for the entirety of their life and it is a very different place we can't necessarily pick up a policy idea that's worked in one place and translate it and the co-design piece I think is really really important and we are totally supportive if we are clear what we mean by a co-design approach one of the things I would say is I think some of the difficulty that this bill is finding itself in as it goes through Parliament at this point in time is that the right co-design approach that is being promoted wasn't necessarily applied to the bill ironically so we have a bill that sets out a structure to some extent it's not entirely clear to us exactly how that will work and I've already said the co-design and co-production part that Derek Feely suggested and the national board is missing and that's a huge omission so one of the difficulties that we've got is almost like a timing issue and we are where we are this is the bill that we have and this is what we will work with and continue to be productive with as long as we feel it can get us the bill itself sets a tone which is about let's sort out the national structures first our point is in our model subsidiarity to the individual is where we would begin and it's far more radical than whether local government or national government have the power and control the power and control of self-directed support was meant to be the radical place in which control was held by people who required care and support and actually one of the things that we're thinking through at this point in time is does the principle of the bill and does the structure that's being set up enable what could be and Frank's point about being in Europe and talking about this could be an absolute exemplar of how social care is provided in a way that gives dignity choice and control the difficulty is because inevitably you only legislate for certain things because we're starting with the legislation you can't legislate for everything nor should you but we've started with the legislation so that does mean it's the process we've got and we're working with that but some of those big unanswered questions don't give us the colour on the legislation to be sure that those specific provisions are the right ones to deliver the vision so that's what we're trying to do now and we're really open to working on that to finding a way at this point in time though I would say it's there are a lot of questions unanswered that make it hard to necessarily know that each provision is exactly the right one to put choice, control and dignity to the people who are needing to be within our social care system Thank you very much for that and I'm not for a second suggesting that you didn't support the principle of national care service but surely what you're asking for you've got the opportunity to excel that I mean I don't think that the Government are looking for a constructive method of national care service what they're looking for is like what happens in the national health service if you get ministers that are responsible being held responsible for something then they've got to have a general overlook of what's happening in a service which doesn't happen just now because of the break up between national and local governments so surely it's for you and the other organisations to point out that the ministers coming to us when you leave some of the questions that you're asking us I'll then be taking on your role in asking him but surely you can see that there is an opportunity here for you to get the kind of care service that you want that will give a sort of a parity of esteem right across the country So to come back on that I guess I come back to my point that we are still doing our work just like the committees are to see if it could come what we want You'll have seen from our response to stage 1 to the Health, Social Care and Sport Committee that we do have serious concerns and I'll come to the accountability point because I think it's a really important one We know that the minister has very explicitly said that the consultation has he has heard very loud and clear that a majority of people who were spoken to are looking for national government accountability for social care fine, okay, so that's fine but the bill then lets those accountabilities out in very specific ways so the core accountability of ministers which is contained really in two provisions at the very start of the bill once you've gone through the principles are quite broad and they don't necessarily give a clear and transparent enough sense of accountability of ministers it's to promote a national care service which will improve the health of people or the wellbeing of people and actually I would suggest that if ministers are going to hold accountability for something with the risks of social care with the profound consequences of people being able to be full participants in their community, those accountabilities should probably be a lot clearer than they are and indeed in how ministers choose to apply the principles then basically they are choosing themselves whether they think they've applied them appropriately one of the things that we're looking at is we've spoken about commissioners but there is very little in the legislation about how ministers will then go to Parliament for example to report on what the success criteria for this national care service are and those are not yet set and please do not misinterpret me I'm not asking for the equivalent of the heat targets for the NHS in social care but there needs to be some way of saying is this successfully helping people to live the lives they want to lead in giving people choice control and dignity none of that is in the bill so if it's a political decision where that accountability sits it is not a decision for providers it is a political decision but if it is going to be held centrally we need to be clear how is this being held what that accountability is for how it will be reported on and how it in and of itself will solve the sorts of problems we've been talking about this morning how will that solve the implementation gap for self-directed support and I know I've had one provider talk to me self-directed support had done everything we'd hoped for would we be here and I think it's a reasonable question so if this is about changing accountability how will this make that better and I am really open as CCPS is really open to that being the case but the bill itself in being so much of a framework bill doesn't yet we think do enough so the question for us is could it and that's where we would get into that stage 2 discussion okay, thank you very much for that thank you we'll now move on to our next theme although there has been quite a bit of crossover so I believe there's only one member looking to come in here fabulous we will move on to theme 3 which is homelessness and I will first bring in my deputy convener, Emma Roddick thank you convener Beth, you've been quite quiet this morning so far so I'd like to pick up on what the crisis has already said obviously around not including homelessness in the functions that can be transferred to the national care service what in your opinion is the impact of that so I think we need to really think about the relationship between homelessness and social care so 8 per cent of the population have experienced homelessness at some point some of those people will only have needs for new accommodation but over half of people now have support needs and they come to present as homelessness the majority of those are mental health needs independent living skills physical and learning disabilities some medical needs most of those will sit within the remit of the national care service so that's really important to note we often talk about people with complex needs it's not a great term but often the needs that they have will sit within the centre of that triangle of homelessness of health and of social care support and we know that good housing underpins social care we saw that in the pandemic and social care supports good housing outcomes and vice versa a lack of support from social care can really exacerbate the risk of homelessness the policy memorandum says that homelessness really is a housing function that seems to be the reasoning for leaving homelessness out of the national care service that kind of goes against the grain of homelessness policy over the last few years where we've been talking about no wrong door approaches we've been talking particularly around homelessness prevention about the importance of shared public responsibility for preventing homelessness and we've talked a lot about the pressures and the difficulties in accessing social care services today but actually we have been making progress of linking up homelessness and social care support through the pandemic and through the rapid rehousing transition plans over the last few years so we're a bit concerned about the kind of quite simplistic analysis that homelessness should sit with housing functions what we need to do is we need to put the experience of service users right at the centre of all of this and what they need and what they want they tell us is a seamless service where they approach a service and they get what they need we need to make sure that these changes don't create more barriers they don't create more complexity we really need to make sure they don't create more stigma you go to the national care service unless you're homeless when you go to the local authority I think it's really worth noticing that we are separating for the first time social care and homelessness from being within one public body with local accountability to being homelessness in one public body with local accountability and social care in a different public body with a different kind of accountability and we need to make sure that those links remain so strategic planning across the board is absolutely essential to get this right it has to be the experience of the end user that is there at the centre and if we don't get the function behind that strategic planning the shared objectives the interagency budgeting right then that is a real risk it's concerning that there isn't more detail about that in the policy memorandum it's not touched on in the bill at all there is some policy that's already out there so housing to 2040 has touched on some of this so if we can bring some of that in the work around shared accountability frameworks and shared objectives that would be really value but I think we need to go a bit beyond that but we need to join up these policy agendas and if we can take the learning from things like housing to 2040 into this that will help thank you very much and you actually answered my next question thank you I believe we now have a question from Fautil Twiggy who is joining us online thank you convener given that homeless is not included in the functions that can be transferred to the national care service is it at risk of falling through the cracks on strategic planning we have to get that right the homelessness prevention recommendations that are expected to come to Parliament this year have a strong focus on strategic planning and the recommendations that they made in those proposals that was around health and social care partnerships so we need to look at what that would look like under national care service plans including what that would look like with the national health service as well as the national care service if we don't get that planning right I think there is definitely a risk that things would fall through the gaps thank you thank you very much we will move to our last set of questions then I believe from Jeremy Balfour I suppose I just want to go back a wee bit to what again Chris and others have been talking about how this co-design actually works in practice and what your expectation for is it is it a consultation document that you all respond to Scottish Government go away and do whatever they want or do you see it as a much more interactive way of doing it and how would that actually work in practice and I maybe start with you Chris because obviously you come from not the central belt so even for you in regard to geographical area how would it work or how could you envision it working where it really is input it's tested, it comes back, it's tested and have you a timescale on how long that would actually take in practice to get to where we're ready to when the Government's ready to bring forward regulations my thoughts are that as I said before Jeremy I think the co-design process really ultra started from the top to look at the objectives and the principles within the bill and then put that to users and actually those whose needs aren't currently met carers and everyone else and allow them to map out and work with those ideas, I mean that seems to me the sensible place and the authentic place co-design process with regard to the process itself I think it would have to happen within local communities, it would have to happen with over a dispersed area or there would need to be a very clear and well resourced process that could be picked up by providers different community bodies different authorities and that process would need to be well resourced so there need to be accessible materials there would need to be consideration to the time restraints that people might have particularly for their unpaid carers to access that because then would need to be given to the costs associated with that as well and certainly in terms of Highland there's a particular sensitivity that all areas of Highland don't have an equal say and aren't always listened to and the only way really to address that would be to ensure that there are proper resources and adequate resources to enable the consultation process to reach all areas and Berth can I in another remark previously you said often people who are homelessness aren't even picked up in regard to this how would you envision that happening and can it happen in terms of consultation and how we engage with those who don't often get the opportunity to engage in that process I think the first thing that I would say is that there's a long history of doing consultation sector and engagement things like the prevention commission that informs the homelessness prevention review group the deal for change group as well so there is a lot out there and we do know a lot about what people want you know crisis did some consultation earlier this year where people were saying we want a multi-agency approach we want to see its services to be joined up from the beginning we don't want to have to talk to lots and lots of people about the same issue over and again to get the help that we need and what we've already done out there there's also a lot of expertise in doing this and there are organisations who have that expertise we need to get to the people who find it very difficult to engage with services or find services very inaccessible and that is challenging but there are people out there with expertise so we need to draw on that I mean just finally, Frank I don't know obviously your members how would you see it working they're engaging rather than just being a couple of hours when they walk away how do you make it more fluid yes and again we have been involved in a few of the Scottish Government events that have been looking at design and ideas for national care service at the various points a number of our members have been engaging with that and I think the thing that strikes me at those events always is a great deal of sympathy for the Scottish Government teams that are running them because if we're trying to corral literally hundreds if not thousands of views from different people across Scotland and some will have very different experiences and very different thoughts about how they would like to see those systems designed so it's certainly something that we are trying to do is to try and deepen that engagement because I think it is there is always the risk that that sort of format can be quite unwieldy that it is, you know, we don't want it ever to be a tick box exercise but there's always that risk with the civil servants who are undertaking that because how do you possibly come with a you know, I think it's probably difficult to get a collective view from the six witnesses in this session so I think to have a nationwide consultation process and co-design process to come to an agreed end point is very difficult so I think it's something that we always do with our members is to try and perhaps bring one of the officials in separately for a smaller group discussion and I think what's really important in that co-design is to have an evidence base to learn from what's actually working because I think the risk perhaps is that we have lots of new ideas without the capacity to implement brand new ideas and test brand new ideas and see what would work so I think alongside co-design we do have to have that learning from evidence of what's already in the sector and what's already successful in the sector and the experiences that people are having the good experiences that people are having of social care in reality and get beyond just a collection of views and opinions to a collection of evidence from what already works Thank you very much Jeremy well that brings us to the end of this session and I would just like to say thanks very much to all the witnesses for joining us this morning especially at such an early time we really appreciate you feeding into this so I will briefly suspend the meeting to allow the witnesses to change over thank you and now welcome to the meeting of our second panel we have Kevin Stewart, Minister for Mental Wellbeing and Social Care Ian Turner, Deputy Director Adult Social Care Workforce and Fair Work and Anna Kinaston, Deputy Director of National Care Service Programme, Design, Engagement and Legislation so I will invite the minister to make an opening statement Thank you very much and good morning to you and to the committee and thank you for having me along today to give evidence to your committee it's fair to say that the National Care Service is one of the most ambitious reforms of public services it will end the postcode lottery of care provisions across 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 so I will set out a framework for the changes we want to make and allow scope for further decisions to be made this flexibility allows 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 a significant incremental change over the last 20 years but 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 will receive social care, social work and occupational health support in Scotland demand is forecast to grow and the NCS must be developed to take account of our future needs we'll 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 centre of social care that means that the national care service will be delivered in a way that respects, protects and fulfills the human rights of people 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 that 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 the 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 enhance paying 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 at its very heart 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 and at its very heart will be human rights thank you very much minister I will start with a question of my own before I move on to questions from other members overall I think it was 2 per cent of respondents who responded to the consultation on the national care service agreed that Scottish ministers should be accountable for the delivery of social care through a national care service so I'm just wondering can the minister advise what would be the benefits of having that accountability at a ministerial level well I think and taking up this post after being asked by the First Minister to take on this role and to begin what I always do which is listening to the voices of lived experience what featured very highly from people much higher than I expected was the accountability issue people feel that when they have a difficulty that often accountability is not there so I'll give you an example many times myself, my officials have heard people telling us their stories where things have not gone right for them and they have gone to the health and social care partnership and been told that's not our responsibility that's the king's responsibility or that's the NHS's responsibility and that's not acceptable and what people can understand including members in this place at points is the fact that I have in the Scottish Government has no accountability in any of this we set policy direction but we are not responsible for delivering the services but many of the folk around this table many of the folk in Parliament write to me on a regular basis asking me to resolve problems that they are encountering with folks in their own constituencies people believe that there should be ministerial accountability they believe that the accountability at local level must be more robust because I think for all of us who regularly deal with casework there is absolutely nothing more frustrating than somebody coming to you with a problem sometimes a very easy thing to resolve which hasn't been dealt with so it's a bit of a surprise for me about how high up the agenda accountability was for people but it is very high indeed up their agenda thank you minister two questions from deputy convener Emma Roddick to be followed by questions from Paul MacLennan thank you convener and good morning minister I know that you focused a bit in health committee on the order that this process has been done in with this being an enabling piece of legislation with the detail developed through a process of co-design and subject to sign off from the Parliament through secondary legislation does bringing forward enabling legislation in this way and then co-designing the systems provide more opportunity for organisations and people with lived experience to feed in convener I think this follows on almost perfectly from your question because feedback from stakeholders has made a number of things clear as said they want ministers to be accountable for the delivery of social care and they want the voices of lived experience to be central to the shaping of the national care service so having a framework bill allows us to achieve these things the bill sets out the framework for the changes that we want to make and the principles that will be absolutely central to the national care service it allows Parliament an important opportunity to scrutinise and influence that framework and you know that's immensely important given the scale of all of this and it also gives us the ability to gradually build what is required with consultation and listening to people to come up with the right secondary legislation to be accountable and flexible as we move forward and all the way through this process we have to ensure that in terms of co-design and in terms of building the service that we have people at the very heart I've spoken already this morning about the incremental change that there has been over the past two decades or so but one of the things that is very definitely the case is that in doing that with the best of intentions there are still implementation gaps so we have made moves but we still have gaps in services and what we need to do is to plug those gaps sometimes some folk out there would argue that some of those gaps are not gaps but gaping chasms but we must ensure that we plug those gaps and the best way of doing that is listening to people all the way through this journey in order that we get this absolutely right and the alternative to that would presumably be bringing detail forward and then asking people to respond to it would that allow the same consultation and the same co-design to happen I think so because we've done it that way for so many other things before and the Government has been quite clear that we will ensure that those that currently require care and support carers, the workforce needs to be at the heart of the shaping of this new service and I think that those voices have lived experience you know if you talk to many folks they have gone through lots and lots of other processes in the past which has not worked for them and we need to make sure that we get it right this time this is the greatest opportunity in terms of listening of consultation and of co-design and you know if nothing else one of my big ambitions here is to remove as many of those implementation gaps as we possibly can in order for us to do so I think that this is the right way Thank you and just a final question around this theme I think in this committee we've always been very aware that we do ask people to come and give very personal testimonies and that can be quite difficult to do and to believe that it's going to be difficult in change would there have been any danger in doing the co-design first of then not having that parliamentary approval and things not actually ending up the way that those who fed in expected it to Well again I think if you were to talk to some of the voices of lived experience people from the social covenants steering group others that we have talked with and listened to since we began this you know they would argue that the framework is the right way to go because if we started the co-design process without the framework they could put in all of that effort and then find all of that wasted and I think again if you talk to some of the very active people in social care if you talk to disabled people's organisations for example you know they have been involved in things previously thinking that that was going to lead to change and it hasn't done so so the framework has to be there in order that we can do the next part of the work in terms of the co-design and you know others have argued you could have done it the other way around I don't think that that would have worked but even if we'd done it the other way around I don't think that any of the folk that lived experience would have necessarily had the confidence and participated to the degree that we want to without that framework Thank you Thank you very much We'll move now to questions from Paul MacLennan to be followed by Foisal Chowdry who's joined us online Thank you, good morning minister Witnesses have told us that urgent reforms can and don't need to wait for the national care service to be established to what extent is established key conditioning to improving social care and just an expansion on that as well we asked the witnesses on the last session basically asking around about how can Scottish Government ensure that the process of creating the national care service doesn't destabilise existing services at this time of transition Commander, I thank Mr MacLennan for the question and I think it's a very important one particularly given what we have gone through over the past two years with the pandemic but also what we're going through now with the cost of living crisis and the on-going war in Ukraine and for many things we don't have to wait for the national care service and the Government are working with others at this moment to make improvements so let me give you examples there are a lot of things that we can do in the here and now to improve and we are taking action to do so we've committed to increasing spend on social care during this Parliament 25 per cent by the end of the parliamentary term and that helps lay the groundwork for national care service in April as you know we set the minimum early rate for providing direct adult social care to £10.50 an hour the second pay rise that there was in a year the Government has also transferred £200 million to local government to support investment in social care including to deliver that uplift and we are also working with COSLA at this moment to progress fair work in the sector the fair work and social care group has developed a set of recommendations for minimum standards for terms and conditions reflecting those fair work principles and that will look at things like improving the rates of maternity and paternity pay and sick pay and of course we are doing a lot with partners to try and assist in recruitment and retention so there are a lot of things going on I agree with those folks who say that we cannot afford to wait for national care service to make movement in some of these areas and we won't and we will continue as we move forward to make the right investments to build our social care system here in Scotland and to ensure that we do our level best for the social care profession Just on the second point I suppose minister really just was talking about I suppose process transition to the national care service what can we do to try and assist organisations going through the process as we move towards the national care service Well as we move forward with incremental change we have to continue to listen to organisations now I'm very pleased that you've had this morning already a number of organisations here today that you can hear firsthand some of the things that they want to see and their voices are required in terms of that co-design too I've talked about the expertise of those with lived experience but there's also the expertise of those folks who work in the front line of the third sector of many many groups including those disabled persons organisations that I mentioned earlier too and that is what we pledge to do we pledge to listen as we go along now let's be honest co-design will have to be done within parameters but people understand that and people also understand that certain things are maybe not achievable but I have got faith and people to bring their views to the table and help us to make the right decisions as we move forward I just want to expand a little bit on that because this was Kenny moving on to my next question but you've really focused quite rightly on lived experience ensuring that people with lived experience are part of that co-design I don't know if you can say a wee bit more about that because I think that's the incredibly important part and we just expand a little bit on that because I think that's really important but we want as many folks as possible to get involved in lived experience experts panels we want other stakeholders to get involved in the stakeholder groups we're at some of the early stages of this convener but just last week for example I attended an event which was looking at the charter of rights and responsibilities and how we established that I think that was extremely positive meeting and I'm not saying that there weren't negativities there because there always are but if we go forward in the spirit that that meeting was held where there was a level of trust around what we were doing and people felt that they could contribute then we're going to be doing very very well and that is what I want to see across the board so just on that for my own point of view that would be very useful if we kept aware of the lived experience panels as a developer because I think that's an incredibly important part we can easily do that convener and keep committee and parliament up to date about how we're getting on with all of these at the moment in terms of the lived experience expert panel there have been 400 registrations I want that to be much higher and we will do all that we can to boost that and of course there is also the stakeholder register that I've already mentioned too but I want as many people as possible to play a role in helping us with us and beyond that beyond the lived experience panels beyond the stakeholder groups I will continue to do what I have always done and that is to go out and about and to listen because that is the essential element in all of this and sometimes you'll go out and thought will come up with a simple solution for something which has never happened or happens in one place and not another and what we need to do and again this is in the here and now is to make sure that we're exporting the best practice that exists right across the country and we're quite a small country but sometimes we have not done that particularly well and NCS gives us that opportunity to do better in that too but that doesn't mean to say that we shouldn't be doing that in the here and now okay, so thank you thank you very much Paul now we move to questions from Foisal Toudry to be followed by Jeremy Balfour thank you convener good morning minister this committee has heard and I'm sure many individual MSPs have heard that there are pressing issues facing care right now that cannot wait for the national care service is all reform of the sector on hold while this bill is being considered I think convener I've made it quite clear that for many of these issues we can't wait for national care service and that's why the Government at this moment in time has invested in the sector two pay rises in a year and as I highlighted earlier we recognise that there is much that we could and should be doing now and we are joint work with COSLA in terms of advancing that fair work agenda that is happening that is on-going now and we recognise the pressures that are out there at this moment and that's why we've invested money to combat what we will face over the course of this winter so some folk have accused us of our concentration of efforts being on the national care service and you know this is the third committee I've been at in a fortnight and it may seem that way to folk from outside but you know myself as a secretary Hamza Yousaf in a day and daily basis are dealing with the here and now you heard earlier on from Rachael Cackett Rachael will tell you that she's been involved in a number of meetings over the past couple of weeks with folks from right across the sector to make sure that we are advancing in terms of trying to reduce delayed discharges and of course making sure that we are in the best possible stead as we move into winter and that is going to be a tough winter for social care for the national health service but we must do all that we can to make as many mitigations as we possibly can in order that we get as best we can over that period in time Thank you Thank you, moved to Jeremy Balfour to be followed by Pam Duncan-Glancy Good morning minister and good morning to your team nice to see you again We don't often get consensus amongst a panelist but I did ask one question both last week and this week in regard to the charter and the legal status of that charter and at the moment it has no legal status and in your answer to a previous question you said accountability is really important and that is minister and it's got a government you can be held accountable would it not give a greater weight to that if the charter had legal status and what's the thinking of not giving it legal status at this time I thank Mr Balfour for his question the purpose of the charter is to ensure that everyone knows their rights and understands their rights and responsibilities and what to expect from the future national care service and also the charter will provide the information on the process available for upholding those rights and the forthcoming Scottish human rights bill will underpin statutes human rights in Scotland and we're working across Government to ensure that co-design work taking place now will reflect the contents of that future bill the intention is to include information on the NCS complaints and redress system which will provide the necessary recourse if the rights in the charter are breached and that will provide a clear pathway to empower people to claim their care specific rights through raising awareness of those rights and how to bring a complaint should those rights not be met but just to appreciate a wee bit my minister if they were legally enshrined they would then be released the opportunity if someone felt there'd been a major breach of those to take to diso-review against those my understanding is without that legal basis that is not there for an individual to do but there are other ways that folk can get redress Mr Balfour and again I would point out that in terms of that complaints and redress system which are really important for people we need to ensure that we listen to people on that front too and we will listen to folk during the course of the co-design work in order that we get that right again in some regards some aspects of complaints and redress system work well according to people others do not and what we need to do is to look from the bottom up how we need to make the change in order that people actually feel that they are being listened to that their complaints are dealt with appropriately and there is the right redress there so again I would say to Mr Balfour to the committee in this work that we are doing we will listen to what folk have to say and we will listen to them about the pitfalls and where it has gone wrong for them in the past and build a system that is right and works for all The other question is on this particular area I think particularly last week but to some extent this week there was a view that we have come through the pandemic there is a lot going on and the opportunity of a breath for people to actually engage in this particularly maybe those with lived experience is going to be difficult have you given any thought I think everyone recognises the short term and long term performance required but in regard to the long term to give a bit of breathing space to allow people to get through the next year a couple of years without having to engage in that consultation because we simply don't have the energy or the time to do that so you end up actually missing people not because we don't want to but simply because of what has happened in the last number of years We are going to make it as easy as possible for folk to engage and we will continue to listen again around about the barriers that may exist for engagement but I cannot stress this enough for many individuals who have lived experience for many organisations particularly some of the disabled people's organisations they want this change yesterday basically that is the fact and I think Covid shone a light on some of the areas where we do not do well for people and they want to see change now for many activists who have lived experience they have been seeking change for sometimes 20, 30, 40 years and I better not name any individuals because I might get into trouble for being ages but a lot of folk have been at this a long time and have put a lot of work, a lot of graft into trying to get the change that they think is necessary these folks really want this done now they don't want any more delay they want movement now as I say there are things that we are doing in the here and now to improve things but they want to see that change and I have to say we are not seeing many folk going away from engagement and that engagement does not have to be in terms of the lived experience experts panel either my officials myself have gone out and engaged with people right across the country and we will continue to do that as we move forward too and we will take the snippets and the suggestions as well as you know looking to the suggestions the comments from the lived experience panels the stakeholder groups etc thank you I'll come back in a moment on co-design but I'll leave it there at the moment thank you thank you and good morning to the minister and your officials thank you for answering the questions so far I'm pleased to hear that you've referred to the fact that we can't wait to do some of this now and I'm not surprised at all to hear that disabled people and their organisations are doing change as soon as possible this goes I remember being involved in asking this Government to address social care 15 years ago so to say it's been incremental change is probably an understatement there are a number of problems right now so disabled people are having to choose between they're getting so few hours of care and support they're choosing between whether to go shopping with those hours, to pay their bills with those hours like with someone with them to help them go and pay their bills I should be clear that is the reality that disabled people are facing right now carers who are working in the sector are living on poverty pay the minister has mentioned there have been two pay increases that has not been enough people are leaving the sector to go and work in supermarkets because the pay there is better and that is leaving people without care and support they need so which parts of the problems I've just outlined is the minister going to address now rather than wait to the national care services to develop as I said earlier I have the responsibility at this moment and some will probably think why would the Government want a kindability for some of these delivery aspects I have to say that I get very frustrated and I think members get very frustrated when they write to me and I say this is a matter for the local authority for the health and social care partnership so we do need that change and I think there are a number of things where I think we need to make major change in terms of delivery and that's why the national high quality standards that will be in place are so important but I kind of put those quality standards in place now because I don't have the power to do so but the bill and what we're doing will give us that opportunity like you Ms Duncan-Glancy I get these kinds of stories on a fairly regular basis it is annoying and frustrating for me but even more annoying and frustrating for those folks that have to make those choices and we have to move away from some of the things which we do now which actually are not beneficial to anyone we must move to much more preventative care and we must ensure that that's person-centred recognising the needs of people and we talk about person-centred care a lot now but that does not happen in certain places and you have the situation as you're well aware of postcode lotrace where in some parts of the country some people are very well served but in others they are not and we can't have that either and NCS gives us the opportunity to rid ourselves of those postcode lotrace in terms of paying conditions because this is important and it's not just paying conditions it's also career pathways that are lacking which means that it is often difficult to particularly entice young people into the care profession we've got to change that opportunities there and of course what NCS gives us is the opportunity for national sexual bargaining and the fact that that hasn't existed means that we have that low pay situation that has existed for a long time I would say to the committee that in terms of pay adult social care pay we're paying more here than any other part of the UK at this moment and we will continue to look at all of this as we move forward because fair work has to be at the heart of this too this is about changing services for people but also it is about recognising a workforce and valuing a workforce that often feel at the moment that they haven't been valued and I'll say one final thing because I've talked about that move away from crisis to prevention in terms of care which is extremely important crisis actually costs the public purse a huge amount of money but there's also that human cost of not getting it right for folk and I think making that shift with those high quality standards can make a real difference in terms of savings to the public purse stop some of the things that have happened to folks which shouldn't have and those savings we then can put in to the system to continue that work I think finally I've said finally twice a bigger pardon convener I hate when folk do that myself so the other aspect here for me is also about freedom and autonomy for staff because where front line staff have freedom and autonomy now we're seeing much better service delivery and the prime example of that is my own home city in Aberdeen and I'm sorry for boring some of the folk that were at the committee on Tuesday but Granite the Granite care consortium their care at home staff have the ability to step up and step down care obviously in consultation with the person or in their families and as you can imagine there'd be more stepping up than stepping down but giving them that ability means that folk are not reaching those crisis points and beyond that that obviously is an impact in stopping folk requiring additional services or maybe even being hospitalised I thank the minister for that answer and the problems that have been outlined around postcode lotteries and the need for a real personal approach to what people can expect are not new and I share the characterisation of those concerns I don't however share the characterisation of government saying that they don't have any accountability or responsibility for this I don't think it is the case that people who receive services for social care and people who work in social care can or should be expected to have to go to multiple doors and multiple agencies to get answers on this I'm afraid I do actually think that the buck does stop with the minister and so I hope that in the here and now there will be a mechanism for people to be to hold the system to account but also in the future the other point I want to make on that and then I'll get to a question on it as well is I'm pleased that the sectoral bargaining was raised but there's nothing in the bill about that whatsoever and that is giving serious concerns to trade unions or sector organisations to various people across the sector so it would be good to hear if there will be a commitment to collective bargaining on the bill going forward I thank Ms Duncan Glancy again and in terms of the accountability aspect I'm no Scottish ministers are not accountable for service delivery a lot of folk out there think we are but we are not accountable for service The Scottish ministers are accountable for what you direct local government to do and the money that you put into local government and the work that you have in social care I don't think it's fair to characterise it that you don't have any responsibility or the minister doesn't have any responsibility I don't have any responsibility for service delivery we have responsibility for policy direction you're right in terms of resourcing but one of the things which we have not done is direct local government health and social care partnerships we have removed ring ffencing from the local government landscape to a huge degree which local government is asked for there are things which I know are my responsibilities but I am not accountable for service delivery and that is something that the public out there find it quite hard to believe we are not and that's one of the reasons for this change ensuring that we are that ministers have that accountability and that we get that accountability right at a local level because people don't feel that that is necessarily right at this moment either and your other point about sexual bargaining sexual bargaining is extremely important it doesn't necessarily need to be in the bill itself however we are working closely with stakeholders and with unions around how we move all of this in the future and I want to push the boundaries in all of this we in this Parliament don't have powers over employment but we must ensure that we get this right bargaining is one of the key elements of gating this right and again we need to engage and listen to colleagues on the front line with trade unions and I hope local government will come to the table I'm sure the third sector will we need to get this right for folk I've always talked about care as a profession if you go back long before I got this job I talked about the care profession that many folk don't see it that way for the simple reason that it has traditionally been an area of work with low pay and often very poor conditions and we have to change that we have to build that workforce and we have to build that workforce for the future and what I want to see is that profession becoming attractive to young people and if it doesn't become attractive to young people then it's not sustainable as we go forward so we must get all of these elements absolutely right I appreciate that minister I have one final question and you won't need to come back to me if I ask it now I'm pleased to hear that sectoral bargaining is on the agenda and I would press the minister to give an absolute commitment because I know that there are a number of people seriously concerned about fair work actually going backwards as a result of this process rather than forward so a firm commitment on that would be really helpful I'm also keen to know one person's view of a framework and flexible bill can be another person's view that there is no detail and people can't have any confidence in what it's going to deliver so one of the areas I'm interested in is around human rights and there are two specific rights in the bill neither of them are about article 19 of the UNCRPD and I've heard what the minister said about the human rights bill coming forward but we cannot have a situation in Scotland where we have one overarching human rights bill that governs everything and all the services we have to also look at how we implement that through different parts of government including the national care service so will the minister commit to putting independent living on the face of the bill and how does the minister imagine human rights to be delivered for the people who use the service and the people who work in it going forward a number of complex things there first of all let me say we are fully committed to fair work I have a very strong desire to make sure that we get all of this right I probably should declare an interest I've got two nieces who work in social care one of whom is on maternity leave at this moment and I'm not going to go into the detail but very nearly did not get maternity pay and in the 21st century that's unacceptable so you know I want to make sure that we get it right for the workforce that in the main is majority women and you know some of these things in terms of maternity pay we need to move now with the co-operation of COSLA and others but for the other paying conditions aspects NCS gives a huge opportunity in terms of your question around about human rights and how we handle this in terms of the inter-government working if you like making sure that legislation connects you know we are constantly talking across government about how we get these things right in terms of ensuring that we get at right for people that the human rights is at the very heart of all of this we need to continue to listen to folks themselves around about where they think that their rights and their needs are not being made and again the co-design process gives us that ability in order to make sure that all we are doing covers as many bases if not all bases that we can to do our level best for folks human rights is extremely important in all of this is said at the heart of what we are doing here and you know again we need to continue to listen to folks around about what we need to do in that front I've missed something I've got a feeling I've missed something I think the bit about independent living on the bill and actually Dr Jim Elder Woodward has prepared a paper to be aware because he's a good promoter of this work and in that I think he actually sets out various different ways and means that the bill could make clear what human rights of the people who will use the service will be would the minister be prepared to look at the structure that Dr Woodward has outlined and embedding that into the framework on the bill and including independent living on it? As always convener maybe get a sound a little bit flippant and maybe Dr Jim Elder Woodward will have a pop at me later I've got no option whatsoever but to listen to Jim and whatever Jim puts forward you know I will always look at and will always consider Dr Elder Woodward serves on the social covenant steering group because the committee may or may not be aware he has been a very strong voice for disabled people's rights for a very very long time and you know I give the commitment to Ms Duncan Glancy that you know whatever Jim puts forward we will look at and consider I don't think I have an option Thank you Thank you very much Thank you Some of us have been explored but I just want to cover two areas that were brought up in today's evidence If the bill is passed by Parliament and you render the co-design around the regulations and guidance that would then come out of that have you within your own mind a timescale for that period of consultation drawing up the regulations bringing them forward have you in your mind a timeline for that or when these regulations would then come back to Parliament for them to be scrutinised convener I think it would be a bit daft of me to commit to timelines at this moment on any of these aspects for the simple reason you know I've highlighted that we want to have the voices of lived experience and stakeholders at the very heart of all of this and obviously co-design work can go on forever but at the same time you've got to give people the ability to feel that the time that they're taking is right and also it would be wrong of me to give any indication around about timelines in terms of secondary legislation because that's a matter for Parliament rather than for me but what I would say to the committee is that I want to give folks the ultimate opportunity including Parliament the ultimate opportunity to scrutinise what we're doing in order to get that secondary legislation right and I know that you know sometimes parliamentary processes themselves you know can be onerous but it's not up to me to decide those timelines if you want technical aspects of the process I'm happy for Ms Kynaston to come in but I think it would be daft of me to commit to timelines many of which I would have no say over anyway well the timeline is your decision because it's when Scottish Government labour regulations in Parliament the timescale then starts so to the extent you know it's not for this committee to scrutinise anything until you're brought forward so you are the ultimate person that starts you may not decide how long it takes but you start the starting gun if I can put it that way or that and I just wondered if that had been anything you considered I suppose the other issue around this is ultimately the final decision of the regulations that Parliament would scrutinise will be yours so co-design to make us so far but ultimately the decision of what is decided by Parliament is yours and I also just wonder using so much regulations one of the frustrations for MSPs of whichever party is that we can't amend regulations you either have to say yes to them all or no to them all and I wonder as well as engaging with stakeholders and how much engagement do you see happening with members of the Scottish Parliament around these regulations so will they come to committee as drafts before you leave them or will they simply come as that is it convener again I'm not going to commit either way to drafts or no at this moment but what I will say as always I want to be as co-operative and collaborative in all of this work as I possibly can be not only with the voices of lived experience not only with the stakeholders not only with local government not only with the third sector but also with Parliament the framework bill is similar to the framework bill that was used to create the national health service this is a big piece of work as I said probably the biggest reform I want there to be co-operation and collaboration right across the board and I know that there are going to be areas where we're going to agree and I know that there are going to be areas where we're going to disagree sometimes to a great degree but I as always will have my door open and will do whatever is required to get that ultimate amount of co-operation and you know for a number of you who have worked with me previously you'll know that that's the case absolutely I would absolutely confirm that I think there's no doubt that certainly around my planning bill there was a very good relationship between yourself and those of us that were interested in it my final question you'd be glad to hear minister for tonight today is around the IJB boards and obviously again there's nothing within the primary legislation we have at the moment how do they fit into this will they need to be formed or which area do they fit in around that so we have said that we will form local care boards and again you know this is a matter for the co-design process you know people have been trying to get me to say who should be on care boards for example and there's some very obvious folk that should be but this is a matter really for the co-design process what I will say and that is the one thing that I am very adamant about is that the voices of lived experience should be on care boards and should have voting rights which in many places they have not had before and obviously there are people who are likely or will definitely be there but elected members from local authorities trade unions employees and you know the list goes on but it's not for me to dictate who should be on those care boards that has to be part of the co-design process as well thank you in terms of co-operation I think Mr Balfour gives a very good example in terms of the work that he did and I did with others including some past members on the planning bill around about changing places toilets that has changed the dynamic not only in terms of planning and building standards terms but also in how we continue to enhance and improve that that kind of work is Parliament at its best and I hope that we can achieve exactly the same thing with all our most aspects of the SNCS bill thank you absolutely minister all of us around the table want to achieve that I'll now bring a question from Paul MacLennan it's really just about the human rights issue last week we heard about some people's rights that were removed during the Covid pandemic I'm just wondering how you think the bill will prevent that happening again I think it was about probably the end of care homes issues that was brought up in that context so we're absolutely committed to using the learning from the pandemic so that people are supported to see and spend time with the folks who are important to them I know that Mr MacLennan has had a lot of dealings with members of the care home relatives group as have I over the peace some of the stories that we've all heard are very harrowing indeed and that's why ANS law is included in the bill itself to support the rights of people living in adult care homes to remain connected to the outbreak situations and over the peace we have done a lot of work and the committee will know that I've already changed regulations around about this talking to the care inspectorate yesterday and I speak to them every month or so there have been no complaints since their last report around about folks not being able to see relatives and long may that continue and that shows that that change of regulation has helped dramatically but you know this is one of the areas which we need to get right in terms of that primary legislation and it will give ministers the right to issue visiting directions to care home providers to comply with the directions that have been given I'm quite sure that this is one of the areas of the bill that the public at large will have a great interest in particularly some of the folks all of the folks from the care home relatives group that I know that Mr McLean and others have been engaging with as have I I was going to move on to the next team of that because I think that's the next question and it's really just talking about because obviously we're talking about the context just now about care users, carers and the workforce but it's really just talking about the broader societal impact that this bill will have in terms of that so I don't know if you want to expand on that because I think that's not something that's kind of going on it's almost wrapped around about the bill huge impact I think in terms of the way people think around about care and I think we have the ability as I said in earlier answers to create a profession where we can attract people I probably at that point should expand in terms of the career progression aspect because sometimes we don't make it easy for people to change to swap to be flexible in their careers so sometimes it's not so easy to move from care to social work or to the health service and I think especially talking to young folk who are working in care at this moment that's a frustration for them and getting that right building those opportunities attracting younger folk to the care profession could have a real change in thinking and culture around about care so I think that's one impact beyond that the other great opportunity here and we are very much trying to change the way of thinking a lot of people out there feel that they are seen as a burden because they require care we shouldn't be seeing that and the investment that we are making in care is for the greater good of our society as a whole so to give you the example in terms of language I myself don't like the term respite very much and that's why we are talking about short term breaks and one of the reasons why that right to short term breaks is very much part of this bill so I think we've got a lot of changes that can take place with this and that is always the case and discussions around about big pieces of work like that often get folks thinking a lot differently Thanks, minister I've got questions on the next team but I don't know if you want to bring another people in and I'll come back enough I will do, thank you Paul I'll now move to questions from Miles Briggs to be followed by Foisal Charger I wanted to ask a couple of specific questions and it relates back to some questions we've already heard so I wondered specifically if you want to listen to folks where their rights and needs are not being met why the right to independent living isn't on the face of the bill and given the concerns and issues about self-directed support across Scotland the policy we all agree with why that's not really front and centre of making sure we get that working properly so self-directed support a big bugbear for me I have to say and probably a bugbear for many of the folk around the table today because again that was a piece of legislation which had cross-party support all done for the best of intentions all in primary legislation and you know unfortunately folk out there have not with a spirit of the legislation but have tried to find flaws loopholes in the legislation to deny people their rights in terms of self-directed support and again we see a postcode lottery across the country in terms of folk's ability to access self-directed support that's not good enough and you know I've had folk working over a fairly lengthy period now in terms of changing the guidance which I think we publish in the next couple of weeks new guidance in self-directed support and that will be helpful in some regards and teasing out some of the difficulties that are out there but it won't do it all and you know this is one of the reasons why I think that a lot of what we're doing in terms of secondary legislation is important because it means that we can be flexible and adaptable if we have not got it quite right in terms of the legislation itself whereby in order to change a piece of primary legislation often there's not the legislative vehicle to do it and often that takes a very long time so flexibility and adaptability is the key thing there I'm not ruling out at all putting independent living in the face of the bill however what I want to do is to listen to the likes of the Jim Elder words of this world and others around about what is required here and what do we actually need to achieve out of all of this and is that best done in primary legislation or is that best done in secondary legislation where there's more flexibility and adaptability but you, Ms Duncan Glancy can be assured that we will look at what we get from folks like Jim and a lot of others and we will listen and we will consider and move accordingly for those of us who want to make sure self-directed support is not lost in translation in the bill part of that is Can I expand on that and I'm sorry where self-directed support works well it can be absolutely a life changer for people for their families, for their carers and there are some immense stories about where self-directed support has made real differences to folks' lives and there are parts of the country where flexibility has been brought in to play because people have been listened to and doing something a little bit differently for someone which will make a huge odds to them is the right thing to do but in other parts of the country there is a closing down in terms of options that are available we have a situation where there are different payments and I spent the summer going around the country asking about SDS and various other things and there are stark differences and we have to end that postcode lottery and I am pretty much in favour of ensuring that we give folk as much independence and autonomy here as we possibly can I wanted to look at and we have heard in the first panel with regard to the diverse fabric of the social care centre different models, interconnectivity between the NHS, councils housing associations employability services etc but I wanted to focus on homelessness because that is not going to be necessarily transferred and that is not within the bill but on the direct impact that that will have on the homelessness sector and other bits of legislation which is coming forward on that so can I just ask what is going to be put in place to ensure effective joint working between homelessness services and the potential national care service so can we Mr Briggs and others around the table know the role that I had previously and the changes that we made of homelessness legislation, regulation and changes in terms of culture and I certainly want to ensure that all of that hard work that has been done continues to bear fruit and that means that there has to be an interconnection of services without doubt I recognise how valuable the interfaces between housing and homelessness services with the national care service will be and again we are working closely with stakeholders through the development of national care service to make sure that all of those links are in place we have already held our first round table meeting on homelessness prevention strategy group which I used to chair myself and will continue to engage regularly and meaningfully with the sector I have met people myself and you would expect that to be the case and again we with all services no matter what is in or out of national care service we have to make sure that those linkages are there and that there will be difficulties in terms of transition phases or anything like that that we have seen before what I would say to the committee is in terms of my work with colleagues across Government we are very very clear that we have to get all of those linkages absolutely right and that is why there is a lot of work going on in the background and again somebody argued that maybe that is a diverting resource to deal with NCS rather than the here and now but a huge amount of that work that is going on in the background is work that we need to do anyway in order to improve linkages to stop difficult transitions so I would say to the committee I am very well aware where there could be blips and we are doing everything possible to make sure that those connections are there OK, thank you for that and I think for the committees who are all looking at this there is real concern out there from different sectors about what that will look like what detail they haven't been part of so as this progresses through Parliament I think it's critical that we start to get answers on that as well I think people are always wary of change sometimes we tend to look at the possible negatives the challenges rather than looking at the opportunities and I think there are a huge amount of opportunities here I'm very happy to continue to engage and to listen with the housing and homelessness sector and other sectors as well I want them to be involved in the co-design so that we get this absolutely right homelessness services may not be in NCS but very much we need those voices in order to get those connections right I agree on that point and just finally convener Is your next question around homelessness? No, it was going on to the thick one OK, we've moved on to theme 9 so we've moved a bit far ahead as long as you're still on theme No, that's OK for homelessness Thank you OK, we'll move on to questions from Foisel Trowdry to be followed by Paul McLean Thank you Thank you very much convener I think my question was on third sector how will the third sector be integrated into the long-term delivery of the national care service I know that the minister has given a lot of examples but I'm not clear how that will be integrated into the long-term delivery of the national care service The third sector is a valued part of social care here in Scotland and it will continue to be as we move forward The third sector at this moment are delivering quality social care across Scotland sometimes very specialised social care as well Third sector organisations are absolutely vital in terms of providing advocacy for people and a huge range of other services So I have no doubt that the third sector itself will continue to be a major player in delivery of social care in Scotland in those specialist services as well and we expect with the national care service that there will be a mixture of providers and that is the way it should be What I would say is that in terms of the current scenario that the third sector organisations face in terms of procurement and tendering that does not work well for many organisations at this moment Again you have heard from people this morning and before you have probably heard that in some areas it is much easier to tendering situations that exist and we have the ability with ethical procurement to iron out some of the difficulties that have arisen over the past two, three decades in order to get that right and again that will give much greater clarity to third sector organisations and many would say that they have at the moment Thank you I move now to Paul MacLennan I will ask the first question and the minister touched on the second question that I was going to ask about procurement so thanks for that one small question was about representation on care boards for the third sector I wonder what your views were on that because I said that I really don't want to be drawn and giving my views only about who should be around the table however I think that in terms of the discussion in the co-design phase I think that many will say and advocate that the third sector should be there but it's a matter for the co-design Thanks That's me Thank you very much Thank you We did hear concerns from crisis earlier on and in their written submissions around homelessness not being one of the functions of the NCS Does the minister believe that the public sector prevention duties and other joint working will ensure that adequate consideration is given to preventing and supporting those who are experiencing homelessness? Yes In short we are bringing forward those new GPs to prevent homelessness including the new GPs on public bodies to ask and to act to prevent homelessness that has to be embedded in NCS and we need to ensure that there are much earlier interventions than there often are at this moment we need to ensure that there is case co-ordination in order to get it right for folks and we need to do this across services not just national care service but across services as a whole and I'm sure that Ms Roddick and the committee are aware that the new GPs will be guided by that shared principles shared principles of public responsibility to prevent homelessness this is some of the work that has happened over the past number of years which I was involved in previously just because I've changed jobs doesn't mean to say that I don't have a deep interest in ensuring that we get this right the lessons that we have learned from the homelessness and rough sleeping action group and the lived experience panels that we put in place around about our work too it gives us as a Government it gives Ms Robison the right information in terms of to ensure that this work leads to real change across the board That's really reassuring and speaking of early intervention are there discussions going at this early stage around the NCS in particular and how it's going to react to and be compatible with the prevention duties? We will look at all of this as we move forward I've had a fair amount of discussion with Ms Robison officials are working together in all aspects of this emphasis on homelessness prevention here but also we have to look at where there is already that intersection between care and housing so if you look at housing first for example which I'm very proud the way that we've moved forward in Scotland I don't have the most up-to-date figures so excuse me if I get this slightly wrong but figures from a while back showed that tenancy retention rates for folks in housing first was 90 per cent most folk never thought that that would be achievable why has that happened? it's not just the housing aspect it's ensuring that care services match addiction services match in order to prevent homelessness and to make sure that we're doing our level best for people there has to be that continued co-operation across the piece to ensure that we're doing the right thing by the person thank you my final question today is around what we heard from the last panel Larch Highland told us that there were concerns that rural voices wouldn't be heard unless the co-design was taking place in those communities and was funded enough to provide things like travel expenses for voices from those communities to be able to feed in is this something the minister is happy to look into or perhaps already is? this is an all Scotland programme and we have to get it right for everyone whether they live in a city like this one or an island or rural areas and in all of that we also have to draw the distinction between those folks who live in very remote rural areas I want everybody involved in this and we will do what we can to ensure that we get as many voices as possible and I should say to the committee in terms of my travels and I'm really pleased that we can get out and about a bit more now I recently visited Shetland and it may well be in terms of looking at aspects of the care boards for example or delivery that we may have to adapt for island communities or some of the more remote communities and we're open to that and we need those voices to say that that may not be quite good enough for us here because we'll do all we can to attract those voices and I have to say that if we move away from geographical communities we also have to ensure that we hear the voices of other communities including minority communities that often are much more difficult to come to the table and again in recent weeks thankful to Meacop here in Edinburgh who gave me the opportunity to talk to Chinese and South Asian carers and their loved ones and folks from the Gypsy Traveller community too so we're doing our best in terms of trying to get all of the voices that we can fantastic thank you and I must apologise minister so we do have one final theme left which is carers and I just have questions from one member, Miles Briggs, thank you thank you convener, most important last I think is probably what I would say because for unpaid carers I think we need to see how this bill is also going to deliver for them now looking at the carers Scotland Act 2016 another Abaddonian, Nanette Milne who I know the minister knows well brought forward amendments to put in place breaks for carers I think that was really important at the time it hasn't been delivered and that's partly due to the fact that support plans are not being delivered are not being commissioned statistics show around £20,000 of an estimated sorry, £20,000 of an estimated £339,000 unpaid carers are only able to access these so I just wondered how the potential bill is going to make sure that's turned around and that people who are unpaid carers actually get these breaks so as far as I'm concerned improved carers support is one of the core objectives of the national care service and I have to say that I was at carers parliament last week and heard stories which are galling to say the least the government has put substantial resource into carers support and over the last period recognising what folks have gone through with Covid we put additional monies in to allow for more short-term breaks but if you talk to carers parliament and you'll hear it in your constituencies as well that money often does not get to the people that it should and we have to do much better in that regard and that is why we have in this bill enshrined that right to short-term breaks and obviously we have got work to do in that as well and again we need to listen but it is absolutely essential that we get this element of it absolutely right I think it was a man from Shetland again and I'll name him because I think I've seen his name in the paper so hopefully when I get into trouble a guy called Jim Guy from Shetland who was saying he has asked Shetland Health and Social Care partnership and others where money for carers support is going there and says he is unable to get that information folk shouldn't have a difficulty in getting that information around where money is going and again there were discussions at the carers Parliament by some around whether Government should ring fence elements of carers support it's not popular with local government as we all know it's often not popular with some of you folks around the table but you know I think there's a level of frustration out there amongst many carers that they are not getting the deal that they should be and that will enhance those rights Thank you for that and I think that as the bill progresses it's something that I want to try to make sure any amendments can actually deliver just finally, convener the minister started this session and the cabinet secretary said when he launched the bill that we're going to end and that's something that we all want to see but I just wondered given this framework bill has been designed around the NHS we have a postcode lottery within our NHS but ministers are responsible for policy direction and responsible for delivery as well why will this be different because I worry as an Edinburgh MSP who has some of the worst delayed discharge in the country some of the highest homelessness in the country that necessarily isn't going to change with this bill so I just wondered what learning the minister thinks ministers who have been responsible for the NHS for 16 years are bringing to this bill I think that the key element of all of this is getting the national high quality standards right to end those postcode lauries and if you look at it from the other side of my portfolio in terms of mental wellbeing I'm doing similar in terms of introduction of standards for various treatments so we now have a new CAMHS standard specification so that you may change right across Scotland in terms of the way services are delivered improving those services because you've heard me say before CAMHS and Grampian because of the way that they change delivery much more community focus have gone through the pandemic period in fairly good shape still delivering for people much lower waiting times reaching the targets in the main we need those same standards everywhere so that's what we have done in CAMHS we're about to do the same in terms of psychological therapies we're going to do that across the board so those quality standards specifications are important in terms of ending those postcode lauries beyond that though what we also need to do and I think because all of this is going to be at the forefront of our mind is to also change some of the cultures that have built up in certain places which actually impede good service delivery good care and support delivery for folk and again I come back to my point around about not just the high quality standards but also making sure that good practice is exported across the board because it often is not and the flexibility that will be in the system will still lead to different ways of working and we should learn from those different ways of working and make sure that those best ways become the norm thank you very much I'd like to thank you minister and thank you to all the witnesses who joined us this morning it's been a very helpful session so that concludes our public business for today next week we will be taking evidence from voice ability on their progress to date in providing independent advocacy under the social security Scotland act 2018 we will also consider an instrument relating to the Scottish child payment regulations we will now move into private can members who are joining us remotely please use the microsoft teams link in their calendars to join the meeting and I close this meeting