 Felly, ydych yn dda i gyd i'r 16 o ddweud y Fath, Ysgol y Cymru i ysgol yng Nghymru i 2023. Rwy'n ôl amddangos i gael ei ffordd i'u gwneud. Rwy'n gweithio i gyd i Gend Item 1, gan y cyd-igion yn cymaint. Felly, rydw i ddw i'r ddelyíais i gael gweithio eu mollegau 5 yn 6 o'i ei gynyfaniaethau. We move to agenda item 2 by the national care service, Scotland Bill stage 1 timetable. We have a evidence session by the minister for social care, mental wellbeing and sport on the timetable for stage 1 scrutiny of the national care service, Scotland bill. For this morning's session, I welcome to the meeting Mary Todd, Minister for Social Care, Mental Well-being and Sport from the Scottish Government, Donna Bell, director of social care and national care service development from the Scottish Government, and Anna Kinneyston, deputy director of the national care service of the Scottish Government. I invite the minister to make a brief opening statement. I thank you for inviting me to discuss the proposals for the NCS Bill stage 1 timetabling. I'd like to explain briefly why the Scottish Government has proposed to extend stage 1 to after the summer recess. The bill sets out the legal changes that the Scottish Government believer needed to strengthen and to integrate social care and social work. To make this happen, we are committed to the NCS and ensuring that Scottish ministers are accountable for delivering consistency and quality of care and support across Scotland that meets people's needs. We have heard repeatedly from people with direct experience of social care and community healthcare that the system needs to change to address standards and consistency across the country. However, it was very clear during the bill stage 1 process that, in order to deliver, we need to listen to the concerns of our key partners and stakeholders in part 1 of the bill. Those include but are not limited to local governments and the unions. However, we have far more consensus on parts 2 and 3 of the bill, which I am pleased to see because that covers the key legal changes to support Anne's law. To achieve the next stage of our listening process, we will continue to work in partnership with local government, the NHS and other key partners. We are further expanding our efforts with a series of engagements across the country this summer. If Parliament agrees to the extension of stage 1, we will use the additional time to reach consensus and compromise on the bill. We expect the details of that to be available by the end of the summer. I therefore cannot comment now on what consensus might look like or what impact that might have on the bill. Change of the scale is unique. The additional time before the stage 1 debate will allow both the Scottish Parliament and the Scottish Government a necessary time to consider all of the evidence to best inform the development of the bill. Of course, other NHS elements will need to be adjusted for any new timetable, such as providing the committee with a draft of the charter, which I now intend to do after summer. An extension provides an opportunity to have a more detailed and in-depth co-design process that better reflects the needs of people with lived experience. I will provide an update in writing to you before the start of summer recess on what detail we have at that point. In addition, I want to highlight that we are not waiting for a national care service to deliver positive change within the social care sector. As a Government, we will continue to drive forward improvements right across the social care sector, including improving terms and conditions for our valued workforce, making it an attractive profession and bringing even more talent into the sector. You mentioned further engagement that will be carried out over the summer. I wonder if you could be a bit more precise on that and give the committee an idea about the expected timeline for that engagement and who you would be looking to engage with and when you expect to have completed that part of the exercise. We would expect to be engaging with all our key partners. We already had a brief and formal discussion with some of our local authority partners and some of our unions, but we would expect to have more formal and more regular engagement with all of them over the course of the summer. We are also looking to set up regional opportunities for people who have an interest in the care service to gather together and to make sure that we capture the experience for the entirety of the country. Not simply, as you might imagine, being a Highland MSP, I'm keen to hear about the experience of social care in every part of the country, as well as from each of our individual valued stakeholders. I don't know if you want to say a little more, Anna Ardona, about what's planned over the course of the summer in terms of the regional engagement. Happy to very quick covers. We're doing nine co-design events that are targeted at people over the course of the summer. They'll start the second week of June and finish to accommodate the pressures of tourism probably in the middle of September, and we will use those to go out and have conversations around some of the co-design themes that we discussed with you in December and start to deepen the conversations around those pulling together a whole series of reports in September, so that everybody across Scotland can see the evidence that we've captured from people. As a follow-up to that, it sounds like you're almost separating that out from us at public consultation-type events and further discussions with COSLA and the trade unions. Are there other parties that you're considering consulting with or having further discussions with them, thinking here of social care providers? Yes, absolutely, and third sector. I have no doubt that we'll hear formally from groups that represent users of social care as well. We're keen to hear from anyone and everyone who wants to engage with us and feels that we need to understand their perspective, very keen to achieve consensus. I think that there's an awful lot that we agree on. In my few short weeks in this role, what I've found is that nearly everyone agrees that the way that we are delivering social care at the moment isn't really working for all the people who are trying to access it and it also doesn't deliver for all of the people who are working in social care. Those are the two key issues, the two key priorities that I have in terms of what I want to ensure that the national care service delivers. You said that you anticipate that you'll be publishing reports in September or autumn time. I'm assuming that some of those will be slightly later if some events have been in September. Although we would expect to capture their learning as we go as well, I'm happy to give you an update before the close of Parliament, so before summer recess and where we're at and what the plans are. Just to make sure that you are aware of the work that's going on and can plan your workload, I know that the committee has a great deal of legislation going through this. Of course, on my plate, in the suite of work that I'm doing, this is one of the most important things that I want to do. I think that it's one of the most important priorities for the Government and for the Parliament, but there's a whole lot of host of other work that it has to be balanced with, so we're keen to keep you informed so that you can balance your workload as well. I'm sure that reassurance will be welcomed by the committee as you say that we have work that we need to plan. I'm going to move on to Emma Harper, who's going to pick up on the theme of the nature of the planned work. Good morning to you minister and panel. Co-design and co-production are all often used interchangeably, but in this case co-design has been what we're pursuing. I know that, even just yesterday, I had a conversation with an elected member and they used co-production and co-design as if they were interchangeable. I'd be interested to hear about what the co-design process really is and how distinct it is from co-production just to help clarify that. I guess there are three clear phases to the national care service collaborative design understanding, so building that shared understanding of what the current challenges are, sense making, so what and how can we deliver improvement and then agreement do the proposed changes address the issues that are raised by people. Those are the three standard clear phases to what we're proposing with the national care service. In addition, once we've reached that consensus point, we understand how things work currently, we understand what needs to change and we have an agreed way forward on changing, then there will be the drafting of regulations, more operational detail on how we'll do things differently. That has to be within a legal framework, so that's a slightly tricky aspect of co-design, so things have to be developed within our legal competence. There's a review, so we come back to make sure that what we have co-designed aligns with what our aims and intentions were. Co-production can't happen in all the areas because it requires the collective decision making and those changes require Parliament to decide, so that's a slight tricky thing. Co-design is more like agreeing arrangements, co-production is that collective development of the idea. Co-production is about collective decision making and in this case we have to co-design because we're co-designing agreements which then come to Parliament for decisions, so there's a very technical difference in the world of co-production and co-design. When you made your opening statement, Minister, you talked about you're a Highlands MSP rural, I'm a South Scotland MSP rural, we know there's complexities around designing any changes that might be pretty impactful, so I'm glad to hear about the processes that will be taken, especially to look at services in Dumfries and Galloway. There's no council-run care homes, but there's a mix of private and council in the borders, for instance, so is that going to affect the work that's taken forward to look at each individual area will have specific needs? Absolutely. As you say, I'm a Highland MSP, I represent the northernmost constituency on the mainland of Scotland and I live in the rural west Highlands and if anybody in this Parliament knows that one size won't fit all, I know that one size won't fit all. I know how important it is for people to be able to remain in their own communities, that's a really strong priority for me. Even within Highlands things happen quite differently, care looks different on the rural west coast to the way care looks in Inverness and that needs to be dictated by geography, by the workforce that's available and the estate that is available. I think that what we're keen to try to reduce is that unnecessary variation. When we look around Scotland things are done very differently, 32 different local authority areas. The example of social work as a profession can often have very different contracts, very different pay and conditions, very different offers of continuing professional development and there isn't really a need for that variation, that really could be standardised nationally and supported nationally and in fact that would help us with some of the challenges that we have in local authority areas where there's a local authority area in Scotland where a starting social worker is paid £5,000 a year less than they would be in their neighbouring local authority and of course that local authority has real problems with recruitment and retention. So taking a more national approach and standardising what is required and expected from that profession and what rewards and values will be placed around that profession would be a very sensible way forward. So I suppose we're at and I guess it's really important that we understand, I mean we don't want everything dictated, I am never going to advocate for everything to be dictated from Edinburgh but I think that everybody could acknowledge that there are advantages to doing things nationally as well as times where you have to really have to make sure that the operational detail is down to local authorities. Okay just one final question in this wee section it's about the regional forums and that will help identify what differences that you're describing like differences in pay and I'm interested like as a former nurse educator looking at helping to support career pathways and career progression and a national standard approach would then give more weight to career pathways for social workers and carers as well. Is that what a like some the forum and the plans for regional approaches might help like determine that this is what what the aspect of the national part is is a standardised approach for education? So absolutely I think Donna will probably want to say a little bit more about this but we're very keen to hear from people who are employed in the care system at the moment what works for them and what doesn't work for them. Over the last few years the Scottish government has done a lot of work in terms of ensuring that everyone working in social care is in a regulated profession so everybody is registered with the triple sce and there are cpd requirements but we could do more to support individuals to fulfil their potential within their role and also to make clear what career paths that are available to progress on to other roles within the national care service and I think that's a really important aspect of it. I mean with the social work profession it is you know I've as someone who worked as a health professional in the NHS the level of variation across the country in terms of post-grad qualifications that are required to do different roles in the different types of training would definitely raise some concerns about governance and quality and standards as well as giving clarity to the people who are pursuing those professions you know they might well become qualified in a certain area in one local authority but those skills are not transferable to a different one they don't have the right qualifications to work in the next door like local authority and you know we need to maximise the opportunities for people we need to reward them for the extra efforts they're putting into post-grad qualifications and we need to make sure that things are clear in terms of governance and what standards we expect everybody to meet across the country and I think that's something we definitely can do nationally. We're keen to hear from people working in social care because we know that whilst there is an awful lot of political focus on paying conditions and quite rightly so that's a really high priority there is also concern about you know the differences in what's expected in terms of training and what minimum standards of training and what potential there is for people to do extra all over the country and it would be good to give some clarity around that. Thanks minister so obviously the work under the banner of the NCS will help us to develop a lot of this activity there's also work under way as part of the joint statement of intent with COSLA now so just picking up on the point that Ms Todd made about making sure we're focusing absolutely on the here and now so there is work under way on workforce planning on workforce development which includes learning and development, career pathways etc etc which is already starting to deliver so we have the national induction work that is already in place we have other continuous professional development work which is starting to deliver now as well and then a move towards the national induction framework so there is work under way right now to make sure that we are starting to deliver on both the training and development and the career pathways that are attached to that. I'm okay on this team thanks okay can I just ask before we move on to the next team so you've invited committee members to participate in the events that you're looking at organising do you see any or foresee any conflict of interest in the committee being participants within that given that we are then scrutinising this bill at stage one? I hadn't until you asked and I'm certainly willing to go away and reflect on that I mean I think it's really important that the committee and I think this is quite a different way of doing things and I want to be sure that the committee understands what is happening out in these events and understands the power that participants have to really shape a service that meets their needs. I'm happy to reflect on whether there are conflicts of interest and I'm happy to listen to the committee's thoughts on that if you've got concerns about that I mean I still would really think it would be valuable for you to come out and see what we're doing but we can reflect on whether you should be participants or observers I guess observing would take away any concern around conflict of interest but yeah I'm more than happy to consider that I mean I suppose you'll have formal roles to come back to us and say we think it should be done this way or we think you know we've got concerns about this area and so being an observer of those events rather than a participant would take any concern away but yeah we'll have a think. Okay thanks minister I'm going to move on to precision regarding Coslin and the unions and the other key stakeholders and I know that we've touched on this a little bit and I'll come to Tess Weipes first. Yes thank you so minister Cosler have said in their consultation submission we do not think that a centralised approach will deliver higher quality social care services indeed we know that there is a significant variation across NHS services which continue to face many of the same pressures as those experienced in social care so the question is do you disagree with Cosler and have you attempted to address their concerns regarding centralisation? So I guess this process of pausing and re-engaging is part of that process of addressing their concerns we hear loud and clear the concerns that they are raising and we are keen to work with them to see where we can achieve consensus and agreement. I mean I do understand the point about the national health service having variation although the national health service for many years has tried to tackle the question of unnecessary variation so there are some you know and I think I've said this already in this committee appearance with there are times when variation is necessary dictated either by geography or by state or what's available in local areas but there are times when variation is just down to historical practice and that variation can present a barrier to people trying to access care so one of the things that's you know one of the examples that's often cited to me is people younger people who have a social care package who want to move around the country and they you know they maybe they maybe live in Ellipoll where I live up in the northwest highlands and they want to go to university in Edinburgh and the systems are so completely different it is almost impossible you know they're almost limited to remaining in their own geography because the systems are so difficult to navigate now I think we can improve on that and it's not like that within the NHS you know that those there aren't those barriers to to I mean I you know I've said there are some barriers but but but it's not quite such an impossible task and it doesn't feel like for the user like you have to learn to navigate an entirely new system there's enough commonality between the way healthcare is delivered in each area for it to appear navigable and coherent to the people trying to access care so I think that I think that there are things we can improve on and I suppose at the heart of this is listening to the people who are accessing social care are very very very clear to us that things need to change that things need to improve and we hear them and I'm sure that Cosla hear them as well and we'll find a way to work together to make sure that those improvements happen. I'll come to Gillene Mackay. Thanks convener. I was looking to come in on the final theme if that's okay. That's all right. We can sit back to you please. Thank you minister for joining us today. Whilst accepting the need to undertake appropriate scrutiny and development of the proposed legislation does the minister accept that there is a severe and acute current crisis within the social care sector? I'm just referencing recently a case I was dealing with with Balmanno housecare home in Glasgow which cited food cost, utility cost and recruitment challenges as a reason for going into administration surely losing that capacity of 40 odd beds within Glasgow is not acceptable. What measures immediately is the minister looking at to improve resilience particularly when these assets are owned by social enterprises or charities which are focuses of community wealth building in local areas and actually aren't profit extracting models. How do we immediately take steps to retain that capability within the sector? You're absolutely right. We don't need to wait for a national care service to make some of the improvements and some of the improvements are needed urgently. I think so that in the medium to long term we have to consider the sustainability of our services. I'm in exactly the same position in the constituency that I serve. I've had three care homes close in the last couple of months. None of them are social enterprises, all private enterprises but a vast number of beds gone from quite a rural area so a huge impact on the availability for local people, a real impact on where they can be cared for at the end of their lives. When a care home closes in the West Highlands it means that you're likely to have to take a six hour round trip to visit your mum in the next nearest care home so really challenging situation and then challenges with the real challenge we're facing in the Highlands is with staff and labour shortages. I think that there is no doubt that our huge massive challenges facing social care at the moment. We need to support and nurture our service right now. We need to try to make some improvements. I think that's why I say that priority of improving the paying conditions for social care staff has to be a high priority for all of us and will probably involve us in making difficult decisions over the next few months in terms of how we achieve an improvement in that. Ethical commissioning and ethical procurement, that ability to have an impact to make sure that the money that we spend centrally to obtain care I think is the way to ensure that you continue to get that social benefit and to make sure that paying conditions is of a certain standard for everybody who is employed in social care and to make sure that you have that impact in local communities. As you say, and as you know, those third sector organisations are currently providing what we want to do is everyone in social care to be using that public money for public good. The minister makes an important point about pay in the sector being a bigger challenge. I visited the Prince and Princess of Wales's hospice in Glasgow a couple of weeks ago. They have a 16 bed facility of which a third can't be used because of staff shortages, particularly around specialist nursing. It seems to me perverse when we have delayed discharges in hospitals and people dying in rather unpleasant clinical conditions that they aren't able to be offered that appropriate setting because of staff concerns. I think that a lot of it is driven by that inadequate pay and retention within the sector. Does the minister accept that we really need to move beyond the £12 per hour by 2026 target in order to get the things moving in the sector, get that capacity retained? From a health economics perspective, it's a bit absurd to look at it simply in isolation when we see in the last decade over a billion pounds spent on delayed discharges in the acute hospitals. I think that we absolutely need to improve paying conditions and we need to do that urgently. It's a really high priority. I think that it's not the only challenge for the workforce. In my part of the country, Brexit has just devastated our rural communities. We have far fewer people coming to live in Scotland and in the rural highlands than we had before. I suppose that we have lost a tranche of that workforce. People have moved from social care into other roles as well as having life the country. We are short of labour right across the board and it's particularly difficult to attract people into social care. We're asking them to do a really tough job, so it needs to be competitive against jobs. It's a skilled job and we want them to deliver care with compassion, so it needs to be competitive against jobs in retail, jobs in hospitality, which is a big competitor up my way. It needs to be security and a chance of career development as well. We need to do more than just pay at the moment, but it is a really high priority and it's only going to deteriorate further if we don't stabilise the situation now. One of the big concerns that was raised particularly by stakeholders in trade unions and in COSLA was the balance of power between ministers and health and social care partnerships, which has traditionally been the leading body. Will the minister revise the initial proposals around centralisation of control of this and ensure that the role of health and social care partnerships or equivalent local municipal commissioning is preserved? I think that operational delivery will undoubtedly be local organisations to health and social care partnerships. Local care boards will be involved in designing and delivering local services, but even at the moment currently there's a perception from the general population and within politics that ministers have responsibility when they do not have direct responsibility for all sorts of things. I get asked questions in Parliament all the time, which is the responsibility of local health and social care partnerships. I think that there needs to be a clarity of who is responsible. I think that there's a general wish for ministers to be held responsible for the decisions in which case, if we're going to be held responsible, we need to have the powers to make differences. That's the challenge that we're in. Over the course of this summer, I am keen to hear from local government how they think that partnership should work. I have no interest in from Edinburgh designing operational detail and minuscule micromanaging of services in every local area, but there needs to be clear lines of governance. There needs to be, even just for national workforce planning, we need to have a better grasp. The central government needs to have a better grasp, a better understanding of what the workforce picture looks like nationally, and we don't have that because we don't have responsibility for it. I just wanted to ask, just in that point, if I may. You make an important point with detail. If the devil is always in the detail, people can often read into things that might be difficult for them in terms of saying that ministerial control could mean loss of complete managerial authority ability to design local services. It might well just be simply setting national standards, et cetera, but all that could be developed on the face of the bill, and that was one of the big concerns that came out in the previous evidence sessions that we have held around the skeleton bill, framework bill, and the lack of detail within the face of the bill itself. Minister, except that was a deficiency and part of this pause could offer an opportunity to really get into the detail of how this balance will work, such as the structures and lines of authority between health and social care partnerships, can ministers, Parliament, indeed, in ratifying the charter for the national care service? I think that officials may want to say a little bit more about this, but, undoubtedly, people were very keen for us to put a little bit more meat on the bones. We have committed to co-design, so we are keen for the people who are accessing services and the people who are working on services to be part of that putting the meat on the bones. That is why we weren't for a framework bill in the first place. I think that this pause does offer us an opportunity to put a little bit more meat on the bones and for people to understand better what the ambition is and what the detail around that ambition is going to be and how it is going to look. I think that it is such a different way of doing things that it has been a little bit hard for everybody. I mean, I will admit that it has been a little bit hard for me to get my head around it again in this new portfolio. I think that this pause does offer an opportunity to give a bit more detail, a bit more clarity and a bit more understanding. To be very clear, I mean, for me, one of the things I am very clear about is that the national care service has to deliver the ambition, and we have to be able to articulate that well to the country. There are many times when I think, well, you know, the national care service would enable us to do that. A national care service is the answer to the problem that you are raising, but the understanding is not out there amongst our citizenship and our partners, and I need to do a better job of articulating that case and explaining that the national care service is the answer to many of the concerns that are raised and articulated around social care. I would hope that this few months would give us that opportunity to be clearer about what the benefits are that it brings. Is there anything that you want to add on that? Just to pick up on some of the issues around engaging with COSLA or the unions, I know that, when we took evidence of the Scottish partnership for palliative care, they said that the national care service is a real opportunity to be part of improving people's experiences of living with serious illness and of dying and bereavement, and Age Scotland said that the Scottish Government has made it very clear that there is a commitment to involving people with lived experience. I am interested in engaging with the unions. For instance, I read a statement from Unison that talks about the bill will keep profiteering at the heart of care, and I know that there are issues raised or concerns about employment and pensions. In contrast with Alliance Scotland's partnership for palliative care and Age Scotland, who welcomed the bill, there are concerns from others that feel that they need to maybe have a voice as well. Is that something that you would be able to speak to today? I am certainly more than happy, so I have had brief discussions at the parliamentary event that happened a couple of weeks ago with some representatives from Unison, but I am keen to hear from them and other unions who operate and represent staff working in the sector to hear what their concerns are and to understand each other's perspectives on what advantages or disadvantages a national care service and the approach that we are proposing could bring. I think that, from the point of view of pensions and things, most of the concern appears to be around the possibility of people who are employed by local authorities transferring their employment to the national care service. I would not expect that there is no plan for that to happen wholesale or automatically or anything like that. Those would be individual decisions for the local care boards to make if they felt that employment needed to transfer, and then there would be a process of ensuring that paying conditions transferred over. I suppose that the landscape is complex, so I think that the biggest employers in social care in Scotland by quite a long chalk are private companies, private care. Then we have local authorities, direct employees, and third sector, the smallest in the order. Less than 20 per cent of the staff are unionised, and that is largely local authority employees who are unionised. In general, there is a concern that this is a disempowered workforce that does not have a clear voice in negotiations about pay and conditions. There is definitely an agreement across the board—I was even across the board politically—that their pay and conditions need to be better. I think that there is a real opportunity for all of us to work together, including the unions, to try to improve that situation. On the ideology of who should be allowed to be contracted to deliver care, I do not have really strong feelings about that. What I want is for that contract to absolutely deliver a high quality and a high standard of care to the individual who is receiving it. I know that there are private businesses who are delivering excellent quality care out there. I want to make sure that everyone who is delivering social care in contract with public money is a high standard and that their staff have reasonable paying conditions. That is part of the advantage of a national care service, which is built on standardisation of the contract, procurement and ethical commissioning. There is an opportunity to build into those contracts constraints around how businesses operate to ensure that they operate to a financial standard and with financial ethics that we would want to be put in public money into. Prior to the pause, would you agree that key stakeholders such as COSLA were against the current form of the NCS? Many key stakeholders express concerns. I think that you missed my opening statement. I did not minister. You know that I said that there was a great deal of consensus over part 2 and part 3 of the bill. The debate is largely on part 1 of the bill, and that is where we need to achieve consensus over the next few months. Do you agree that there were key stakeholders such as COSLA who were against the current form of the NCS? They certainly raised concerns. This is how we develop legislation in this country. If it were not for a change of leadership, we might well be pressing ahead with the current form. Would you give us for assurance that if key stakeholders like COSLA are against the proposals that are developed, you would not press ahead? My aim over the next few months is to achieve consensus. I think that there will need to be compromise on both sides about what we come up with, but I am not going to proceed without close partners being in alignment with me. We are not a Government in any area of developing our legislation. We do not impose our own view on the Government, on the country. We work with the country to develop legislation that aligns with the problem that we are trying to solve, and we proceed that way. We generally build things quite carefully. Even if there had not been a change in the Government, there would have been a pause. There were so many concerns raised during stage 1 evidence-taking. There were a couple of committees in the Parliament who had concerns, so it is not just COSLA who had concerns. There were a couple of committees in the Parliament who had concerns about it, and I think that any Government would have to reflect and take on board those concerns and find a way forward that is in agreement with the Parliament. Otherwise, we are never going to get it through Parliament, are we? COSLA did make a positive statement in the official report that I have in front of me. It says, while recognising a national care service in some form could provide national leadership on several matters such as workforce planning, training, terms and conditions, national standards, ethical procurement, registration, inspection and improvement, but COSLA did have concerns. It asked for the bill to be amended. That means that you will need to work with COSLA and the representatives, which is what you have already indicated. I just wanted to clarify that. Absolutely. Routinely, in this country, what we do is that all legislations we put forward a proposal, we consult on a general idea for a bill, then we put forward a bill and consult on the actual detail of the bill, we take evidence and we amend and that legislation evolves as it passes through Parliament. Parliament has its role in scrutinising and amending legislation. I guess one of the fundamental differences with this legislation is the process of co-design and the process of working with people who access care and who work in care to ensure that they are absolutely integral to the development of the legislation. That is possibly slightly different to the way that we have developed other pieces of legislation. We just need people to be empowered into understanding that they will be part of the co-design process, because the bill is a framework bill that we build on. Is that really what we are asking people to believe and trust that they will be part of the co-design? Absolutely. Thank you. We are going to move on to the next theme that the committee wished to explore, and that is local and national responsibility and accountability, and I am going to pass to Stephanie Callaghan. Thank you very much, convener. Minister, you have already offered clarity and quite a number of the points that I was going to raise with you there. Certainly, during the stage 1 scrutiny process, the Scottish Government confirmed its intention that the integration joint boards will be replaced by new local care boards. Is that still the intention? Replacement? I suppose that I can follow on from that as well. What reassurance can you give local government stakeholders that care boards will be suitably aligned with local governments? That is still the intention. Again, I will be keen to hear. We have not yet decided the composition of care boards. I would expect to hear from stakeholders who they think need to be represented on them. I would absolutely expect local government to have a say. There is a question, and that is something that has come up very early. Again, in my time in this ministerial role, there is a question over whether there needs to be geographical representation of even more local areas. If I give the example of Highlands, that question over whether care looks different in the rural west highlands to Inverness, which is in a city with an all-sing-and-all-dancing hospital on the doorstep compared to the rural west coast. I hear that about Glasgow. Glasgow is an enormous local authority area, enormous NHS area, and there are very distinct communities as you go from one side of the city to the other with very distinct needs. Do we somehow need to capture that in the local delivery in order to ensure that it delivers for the people? We are open to discussing those things as it evolves. All those stakeholders who have an interest will have a say in how that is designed. Are you expecting care boards to be quite standard, the representation on them, or are you expecting variation in them? Are you not quite sure about that yet? How does that fit in with eliminating variation across local authority areas? That is exactly it. There is attention. We need to have a clarity on who is responsible. There needs to be clear lines of governance, but we need to capture that local delivery as well as provide that accountability. We will engage in those conversations over the course of the next few months. In fact, probably beyond—I do not think that it is a little later—that we will be making decisions exactly on the composition of care boards. You can see some of the challenge, but I think that it is one that we are up for. We need to have that conversation about how it is best going to work and how best we can reflect those different needs in different communities, but we need to achieve a certain standard of care and a clarity of governance arrangements. Those are the things that we are keen to do. I am wondering about methodology. Is it the Scottish approach to service design that you are looking at using? I can see you nodding away there. Are the public sector and other stakeholders there in a good place to coalesce around that just now? As the minister said, it is a different approach. At this scale, it is obviously a much wider cohort of people that need to get around the table and to understand the process. We have some really good learning, both on the promise and from Social Security Scotland, so bringing that knowledge to the table in advance and doing the work that we are doing gives us a really good sense of both the capacity, the wish and the will to engage on this basis. I am going to move to Tess White. In relation to the financial memorandum, I am trying to find a way for that. Once the minister is particularly around the point of choopy transfer of local government employees, that was a major point of concern. Is that still something that is planned or will that be removed from the revised legislation? That was a clear sticking point. We still need to have the power. There still needs to be the possibility of people moving, but it is certainly not the wholesale aim to transfer people from local authority employment into national care service employment. If that does happen, there will be choopy arrangements in place. We are also very mindful of the concerns that have been raised about pensions and pension rights transfer, and we are certainly keen to look at that more closely to give some reassurance that people will not lose out by changing their employer. Just on the point that you mentioned earlier about resilience, see care home closures happen from time to time, and it can be a loss of significant capacity within an area. It might not be that the local authority has the ability to intervene there, but we do know, for example, in the railways where our franchise fails, there is an operator of last resort that comes in and takes over the asset so that it is protected. Could there be a similar model developed within the national care service where a care home that goes into administration could be purchased by the Government in order to protect the asset? That is in the bill. Yes, so I will grab my bill out. We have a section in that covers operator of last resort so that that is an option in the future. Thank you. Minister, you spoke of being a highland and rural MSP earlier, but the national care service has been described quite a lot as being centralising and negatively affecting rural and island communities disproportionately. A quote from Nick Morris of the NHS Chairs Group said, the logical conclusion that is suggested by the NCS proposal at the moment is that island communities would have less control of the NHS elements of care because it would all go to a care board. Do you agree with Mr Morris' interpretation and do you feel that that is where the NCS was? I think that islands have particular challenges in terms of delivering social care. Particularly in the western isles, there is an ageing demographic and a lack of young people to work in the national care service, which provides a particularly challenging set of circumstances for our island communities. I am absolutely clear that one size does not fit all. We cannot have exactly the same system working entirely all over Scotland because it is not possible, but there are not enough people in some areas to work in the way that it is possible for care to be delivered in urban areas. We need to make sure that there are no unintended consequences that make things tougher for our island areas. I know that some of our island local authorities had real concerns when we introduced self-directed support, but we are keen to work with them to ensure that we get the balance right between the empowerment of the individual access and care and their wishes to have their needs and their choices respected, but also the possibilities of their being perhaps a more limited range of options in rural and island communities. On local care boards, when would you be able to give us more details on how they will be drawn up, for example, who would sit on them? Where would you say where that is on the timetable? The current timetable as set out requires us to get stage one at least approval of the bill, so we know where the principle of the bill has been approved and then we can start negotiating in detail, but over the course of the summer and the nine events, we will be out speaking to people in the workforce about what they think local care boards look like and what community means to them, which will start to add to the evidence base to allow those decisions. I think that the regulations are currently planned for 2025 bringing forward the details of regulations, but that is obviously subject to the bill timetable. At the moment, the idea of a local care board is one that is a concept and you are going to firm that out once you go and have further discussions in those nine events. It is more than a concept, it is a proposed delivery model and what we need to do is understand the governance. We need to go and put in place and understand what people want to see is those governance. We need to make sure that there are clear lines of accountability and we need to understand really what local means to people. I think that that is being covered by a number of people today in terms of the differences between local and localities, so we will be underneath local authorities and how we can better represent the needs of people across Scotland's communities. Thank you. I am going to move to Evelyn Tweet on questions on the financial memorandum. Thank you, convener. Good morning, minister. Good morning, panel. Minister, can you outline for the committee what the Government's present thinking is on the financial memorandum? Can you give us an update on present work? The finance committee has written asking for an updated memorandum and I will be responding to them very soon. What I am mindful of—usually, you would update the financial memorandum after stage 1 or before stage 2. I am mindful that I do not want to have to give multiple updates of the financial memorandum between now and the usual time that you would get an update on the financial memorandum. If there is going to be a period of pause and engagement and possibly some further change to the way that the bill is, it makes sense for the updated financial memorandum to wait until those changes are woven in before we update it. Obviously, the committee had outlined various concerns. Will your response deal with those concerns? Will you be able to offer reassurance? We will certainly try to. As I said, one of the reasons for pausing and re-engaging is that, as well as all our stakeholders, Parliament itself had some concerns that it expressed. I need to be able to better articulate the advantages of the national care service, put more meat on the bones on how it is going to work and what it is going to cost in order to reassure stakeholders and to work together with stakeholders, but also to reassure Parliament. I am keen that we provide sufficient reassurance that we can make progress. You feel that, after you do the engagement activities over the summer, you will have more meat on the bones, as it were, and will you be able to offer those reassurances? Absolutely. I hope that I will be able to give more reassurance and more clarity on what we think the cost will be. Two questions, if I may. We have just talked about the financial and public administration committee, and you have said that we are going to wait until they have asked you if you can come back to them by 12 May. I understand why you will not be able to do that, but harmonising terms and conditions, and you have talked about the difference in social workers from one region to another, has had huge cost implications. I have just looked at the service design, Scottish Approach to Service Design, and it says on page 10 that it is very important to be able to define what good looks like. Will you be including the cost of harmonising terms and conditions in your consideration at this stage of the Bill? Obviously, ministers have talked to the Finance and Public Administration Committee in-depth about this. The Bill does not require us to harmonise terms and conditions, but it does, however, to have many fair work principles. The financial memorandum needs to be limited to the cost and set-up or incurred as a result of the enactment of the legislation. I suppose that there is a point there that the bill has to be represented in the financial memorandum and the financial costs. The harmonisation costs are not as a result of the legislation, so we would not be putting them in. Just to follow-up question before I go on to question 2. Do you accept, Ms Bell, that that could go into billions? I think that the cost thing of that is under way at the moment and I think that Ms Todd has already referenced the commitment to consideration of fair work, pay terms and conditions, so that is a matter for the budget rather than for this financial memorandum. I do not know yet. My second question, if I may convene it. In October, Michelle Thompson said that the financial memorandum for this bill did not represent any value for money at all to the taxpayer. Kenny Gibson also said that it is like trying to crack a nut with a sledgehammer. Have you taken on board the concerns of your colleagues with regard to the revised financial memorandum? What are you, as the new minister, going to do differently? Yes, we have taken on board the concerns of Parliament and what we are doing differently is engaging, again, with stakeholders to see where we can achieve consensus, to see where we can put a little bit more detail into what the way forward is expected to be and to provide reassurance to colleagues within Parliament and stakeholders and partners outside of Parliament, so that everybody is clear on what is going to happen over the next few years as we develop and bring into being a national care service. I am keen that we clearly articulate what the advantages might be. In all of the concerns that have been raised, some of the advantages have been lost. I recognise that it is my job to make sure that I clearly articulate those advantages to both Parliamentarians and the wider citizenship. We are going to move on to the impact of the delay in current services. Carol Malkin has some questions on that. Thank you. Good morning. I am really keen to have quite a robust discussion around this section. I think that there is no doubt that what came out from the discussions is that the national care service proposals did not address what needed to be sorted now and that there are a lot of things that we could do to help with social care, which is an absolute crisis, as we have heard. I was very heartened to hear the minister's contribution around the professionalism of the workforce and the way in which we make sure that that workforce has good training, but there is absolutely no doubt when you talk to the trade unions that we need to look at pay terms and conditions across the board. They are very keen to look at sectorial collective bargaining, so I would be really interested to know from the minister and the officials. Do you have a plan to look at that, and will you commit to that for this workforce? Absolutely. I am keen to work with the unions. I am committed to improving pay and condition. Fundamentally, that is one of the advantages of having a bit more time to understand each other's perspectives. In my early discussions with Unison, one of the things that became clear that was that when we in Government are talking about sectorial bargaining, we are talking about something different from what the unions are talking about in terms of sectorial bargaining. Unions, when they talk about sectorial bargaining, are talking about bargaining for all local authority employees together, whereas when Government was talking about it, we were talking about bargaining for all social care employees together. There is a fundamental difference. As I outlined earlier, the vast majority of people who work in social care are employed by private enterprises, not by local government. It is clear, almost immediately, that we need to spend a bit more time understanding each other's perspectives. I am pretty confident that our aims align, though I want people who are working in social care to have better pay and conditions. I want them to be empowered, and I want their voice to be listened to. I am pretty certain that the unions want that as well. I think that we will find ways to ally together on many issues. We will absolutely… I think that both sides want what is best for the workforce, so we will work together on the areas in which we do not agree. I am confident that we will find a way forward. I am genuinely… I do accept that that is what you want to do. I suppose that the problem for me is that, often in the Parliament, we do lots of talking, but we need the action, so I am really clear for a timetable when we might be able to move towards better pay terms and conditions for staff. There is a budget cycle that will be involved in that. There are negotiations and discussions going on within Government about budget at the moment. Last year was a very difficult, really challenging financial year for the Scottish Government in that the budget was set and fixed very early on in the year. The total cost of living crisis and the energy costs and the labour increase in people's wages and all the inflation just meant that very quickly within months of that budget being set, it was worth significantly less than it was at the time it was set. It was hugely impactful in terms of tough decisions in having to work so hard to rebalance that budget in the year. We are quicker on the negotiations this year. Those financial headwinds are not blowing right at the moment and we are working really hard across Government to see if we can make those changes as soon as possible. Does the minister accept that we need to be brave in terms of some of the stuff that my colleague Paul Swinney mentioned, in terms of the economics of health and social care and how we break that cycle in terms of the huge overspend and delayed discharge and that the way to resolve that is to make those kind of decisions? Absolutely. The focus on delayed discharges is slightly unhelpful. When I think about social care, I think about the entirety of the picture and much of it, much the same as in healthcare and you will agree with this very much. We need to get involved in the prevention. We need to be thinking about spending the money upstream. We need to be going back to the Christie principles and thinking about not just the back door of the hospital when people have reached a crisis and have been admitted to the hospital and then we are unable to move them out of the hospital. We need to think about all the things that help people to live healthy independent lives at home with support in their own community before they ever reach a crisis and have to go into the hospital. I am sure that we can do better at that. I am absolutely certain. That sounds really good. I do not know whether the minister would commit to coming back in quite a short time frame to lay out some of our suggestions for that. I think that I am going to be back and forth a lot to this committee. You are going to see plenty of me over the next week while. I know that that is an interest of yours. I am keen to find political allies to make those brave changes and investments. I do not see social care as a drain. I see it as an investment in our society. I feel like I have a vested interest, particularly if I go back to being a Highlander. I want to grow old in my own community. I think that it is brutal when people have to be uprooted from their communities and go elsewhere for care at the end of their lives. I am keen for this system to work well and to deliver for its citizens, of which I am one. I have one very short last question on something that you mentioned earlier about private profit and care. I hope that the minister would understand that social care is not about private profit and that we need to work really hard at making sure that that should move from the system. I am more than happy to work on the detail of that. I think that the idea of if we go to the NHS, GPs are private contractors and run profit making businesses within the NHS, but they do so in a way that upholds the standards and ethos of the national health service and they deliver a high-quality service to our patients. Most people do not realise that GPs are private businesses, so private business can work really well in healthcare. I am sure that private businesses can work really well in social care. We need the contract to be absolutely focused on the areas that are important to us, which would be the quality standards, the governance, the fair work, ethos and there may well be room for building in something about ethical investments and financial regulations so that they are not using public money to play the stock market. There are plenty of bits of the bill that I think around this table we could agree on, such as Ann's law and other pieces of legislation. How do we make progress towards some of those? Obviously, we want to have national standards. Some areas have further to go than others to potentially meet those national standards that we might bring in, so what work can be done before the legislation comes in, especially over the summer to have those conversations with local authorities or with care homes to ensure that we are meeting the standards that we want to see in the legislation before the legislation is in place? You are absolutely right to raise the issue of Ann's law, which is an area where everybody is passionately behind that, and we want it to be a reality as soon as we possibly can. Those are the tensions that we are balancing. We know that we need to pause and reflect before moving forward, but that cannot be an infinite period of time because there is urgency around issues such as Ann's law making progress. Over the course of the next few months, we need to reflect on the scope of the bill, we need to reflect on how it is phased. I need to think about what I can do that does not require the primary legislation. How can I tackle some of the more immediate pressures in social care that do not need primary legislation to fix them? When we introduced the primary legislation, we all know that it is not like a magic wand that does not change things overnight. You have to phase the implementation of that primary legislation. What needs to be the highest priority? What do we need to do first? What can we do a little longer? How do we achieve that nationally? Do we need to pilot certain aspects of it locally before making the step to national delivery? I would hope to have a bit more clarity on all of that and a bit more, as I said, consensus around what it is that we are expecting to do, how far we are expecting to go and how fast we are expecting to go over the next few months. That is great. I recently hosted a meeting of the cross-party group on carers, particularly around young carers and how they interact with the process and what they want to see from the national care service. Are there plans over the summer to take evidence, particularly from young carers? I think that that is an ideal point where they may not be in school, in university and in other things, where some of those pressures and pressures that they face are multifaceted, but that would seem like an ideal time to take some of that evidence and hear those voices. I wonder if the minister could commit to doing some of that work over the summer. Absolutely. I am always keen to hear the perspective of young carers. You are absolutely right. Unpaid carers are a voice that we absolutely need to be at the core of this development. Time and time again, that voice of lived experience helps us. It is so key to the way that we develop policy in Scotland. It helps us to get the policy right in the first place and then they hold us our feet to the fire in terms of delivery because they are still involved and I just think that it is a really good way of doing things. It is better to get it right first time. We have a couple of brief supplementaries following up on a couple of points earlier on that you raised. I am going to come to Stephanie Callaghan, who has a question on self-directed support. Thank you very much, convener, for allowing me back in. The minister had mentioned self-directed support and many of the witnesses spoke about it being an excellent initiative in piece of legislation. It is kind of along the same lines and the same connect ethos behind it as the national care service. It is all about people having agency, having control and putting what matters to them at the centre. Is there a focus on building and replicating the successes because it has been worked incredibly well in some places and not so well in other places where it has not been properly embedded? Is there some work around that? I think that Donna might want to come in on this. It was her baby. So there is a huge amount of work underway at the moment. There was new guidance published a few months ago and we have been working with colleagues and the team that have been working with partners around the self-directed support improvement programme. Exactly as you say, making sure that the legislation, and I think that Derek Feeley described that as world-leading legislation, making sure that that is embedded, enacted and delivered across the country. So there has been quite a lot of activity on this so far, but we would expect quite a lot more in the coming months. I think that it is really important to just to note the enthusiasm, again, both from people who use support and services, but also from professionals who really see the benefits of putting forward a really coherent approach to self-directed support too. Minister, you recognise that many people want clarity and you are working towards consensus, which is commendable. The design principles that you have for Scottish Government following and your following do say it's important to know what good looks like, but you wouldn't buy a car or a house if you didn't know what it looks like. So too many stakeholders are nervous regarding the use of secondary legislation in the bill and the Scottish Board, as councils said, and I quote, we have a concern over the sweeping powers proposed by the draft primary legislation without a clear expression of what is actually being proposed and the further ability to make further radical changes, but as yet unspecified change to the health and social care system through secondary legislation. So I accept that you're going to have, I think it's 15 consultations over the summer period through to mid-September, but what are you actually going to do differently to put some flesh on the bones to use your words, thank you? So I think we will update during the process, during the progress of those events, so after each event we'll certainly update on what we think we've learned and I guess co-design, there is a process of agreeing what everybody has learned. So we absolutely will be putting some detail on to that as we go. I understand the concern about the lack of scrutiny of secondary powers. I'm very mindful that the process that is laid out is a minimum standard. I'm comfortable with making sure that we engage on the secondary powers as well and that there is a process of assuring that everybody understands what's required. I get your analogy with buying a car, but it's not quite the same. We're building the car, we're designing the car and building it. We're not going out to showroom and buying one, that's kind of the point. So there has to be a process of checking in with stakeholders at regular points throughout that process to make sure that everybody is comfortable with the direction of travel. I think that we've demonstrated with this pause that we are willing to do that. We are keen to do that, in fact, because we want it to work. We see this change as absolutely vital for Scotland and we want it to work. The only way that we're going to manage to deliver it is by working closely with all those stakeholders and partners and delivering it together. Thank you very much. I thank the minister and the panel members for their contributions today. We're going to briefly suspend to allow officials to change over. We now move on to another evidence session with the Minister for Social Care, Mental Wellbeing and Sport, and this time on the powers of attorney bill, legislative consent memorandum. I welcome back to the committee. Mary Todd, Minister for Social Care, Mental Wellbeing and Sport from the Scottish Government, Douglas Kerr, lawyer from the Scottish Government legal department, Peter Quigley, adults with incapacity team leader, mental health law and incapacity unit from the Scottish Government and Sarah Siddique, policy manager from mental health law and incapacity unit from the Scottish Government. The purpose of the powers of attorney bill is to enable modernisation of the process for making and registering a lasting power of attorney made under the Mental Capacity Act 2005. The DPLR committee considered the legislative consent memorandum relating to the bill at its meeting on 18 April and raised no issues. I invite the minister to make a brief opening statement. Good morning and thank you for inviting me to speak about the powers of attorney bill and the associated legislative consent memorandum. Powers of attorney are incredibly powerful and useful appointments. They allow people to retain control over aspects of their lives in circumstances where they might not otherwise be able to make decisions or take actions. They ensure that people have the opportunity to make provision for a future where they may no longer have the mental capacity to understand what is happening to them and therefore to make decisions about the things that they care about. The powers of attorney bill is intended to modernise the process for making and registering English and Welsh lasting powers of attorney. The bill also adds chartered legal executives to the list of individuals who can certify a copy of a power of attorney. It is a private members bill that was introduced by Stephen Metcalf MP in the House of Commons on 15 June 2022. The bill passed the committee stage in the House of Commons on 1 March 23 with broad party support. It has now completed its passage through the House of Commons and is awaiting a second reading in the House of Lords. Clause 1 introduces the schedule containing various provisions that will allow for a simpler process for making and registering a lasting power of attorney. That will increase access by allowing lasting powers of attorney to be made and registered electronically in England and Wales. Most of the provisions of the schedule only extend to England and Wales, but one provision of the schedule extends to Scotland and requires the consent of the Scottish Parliament. That is paragraph 8, which concerns proving the content and registration of an electronically registered lasting power of attorney throughout the United Kingdom. Clause 2 amends section 3 of the powers attorney act 1971 to enable chartered legal executives to certify a copy of a power of attorney. That extends throughout the United Kingdom. That provision also requires the consent of the Scottish Parliament. That provision will increase the channels through which consumers can certify a copy of power of attorney and promote consumer choice. That is why we are asking Parliament to provide its consent to those amendments to Scottish law. It is right that we support a bill that increases the accessibility of powers of attorney. We know from the work that Scottish mental health law review has undertaken that using powers of attorney can encourage people to think through how they might want their health, welfare and financial affairs to be managed in future. That means that adults who use powers of attorney are better placed to be involved as involved as possible in decisions about their lives, even if their circumstances change. I am pleased to recommend supporting the bill because it aligns with key Scottish Government priorities of increasing accessibility of powers of attorney and ensuring that the most vulnerable in society are protected. With the prevalence of dementia increasing and our population aging, power of attorney documents will become ever more important in ensuring that people can continue to live the lives that they want to. That is why I have recommended that Parliament consent to the relevant provisions of the bill. Does anyone have any questions? No. I just ask a small question of the minister, and it may well be that she might want to write back to the committee on this issue if she is not able to address it directly today. Ahead of the session, the committee received submissions from the Law Society Scotland, the faculty of advocates in the office of the public guardian Scotland. The Law Society raised one issue relating to the recognition of Scottish powers of attorney in England and Wales, which is causing practical difficulties and is the source of frequent complaints, which the Law Society advises that the committee of the UK bill will not resolve. Are there any plans for the Scottish Government to look at that issue? What would that timescale be? The legislation currently allows for the recognition of Scottish powers of attorney in England and Wales. Schedule 3, paragraph 13 of the Mental Capacity Act 2005 states that if the correct process is being followed for the power of attorney to be created in Scotland, it would be legally recognised in England and Wales without the need for further action from either the Court of Protection or the Office of the Public Guardian for England and Wales. Given that there is already legislation in place that provides recognition of Scottish powers of attorney in England and Wales, I am not persuaded that further legislation is the answer, but this is about ensuring that institutions and organisations have awareness and are educated on the legal status of Scottish power of attorney. I liken it to the debate about accepting Scottish 10-pound notes in England, so they are legal tender, but people are not aware—they look unfamiliar—and people are not aware of them. I guess that that is the point. It is not the law that we need to change. It is the understanding of what the Scottish powers of attorney are and that they look just a little bit different. That is the piece that we would be keen to commit to. It is working with third-party organisations raising awareness and publicity about the validity of the Scottish powers of attorney in England and Wales, rather than changing the law because the law already allows for recognition of them. I thank the minister for her answer. As no other members of the committee have questions, I thank the witnesses for their attendance today. The committee will move on to agenda item 4. We will allow the panel to leave. Our fourth item today is consideration of a negative instrument, National Health Service Optical Charges and Payments Scotland amendment regulations 2023. The purpose of the instrument is to increase NHS optical voucher values by 4.5 per cent from the first of June 2023, and the instrument amends the National Health Service Optical Charges and Payments Scotland regulations 1998. That will ensure that the values of NHS optical vouchers issued in Scotland continue to match those issued elsewhere in the UK. The Delegated Powers and Law Reform Committee considered the instrument at its meeting on 2 May 2023 and made no recommendations in relation to the instrument. No motion to annul has been received in relation to this instrument. Do members have any comments? I propose that the committee does not make any recommendations in relation to this negative instrument. Does any member disagree with that? Thank you very much. That concludes the public part of our meeting today. Thank you very much.