 I welcome everyone to the 18th meeting of the Health, Social Care and Sport Committee in 2022. I've received no apologies for today's meeting. The first item on our agenda is to decide whether to take items 4 and 5 in private. Are members agreed? We're agreed, thank you. Our second item today is an evidence session with the Minister for Mental Well-being and Social Care. This follows a previous evidence session with stakeholders from the social care sector on 22 February this year. It focused on addressing the current challenges facing the social care sector, as highlighted by Audit Scotland's briefing on social care. I welcome to the committee Kevin Stewart, the Minister for Mental Well-being and Social Care. Good morning, minister. The minister is accompanied by his officials Gillian Barclay, deputy director for resilience and pressures unit and Donna Bell, director for social care and national care service development, both from the Scottish Government. Good morning to you as well. Minister, I believe that you have an open statement. I do, thank you, convener, and good morning to you and good morning to the committee. As you'll be aware, Audit Scotland recognised that our commitment to a national care service indicates our recognition of the significant challenge within social care in Scotland. Indeed, the findings of the report were largely in line with the independent review of adult social care led by Derek Feely, which is precisely why we are acting now to further increase investment in social care and deliver a national care service by the end of this Parliament. I am clear, though, convener, that we should not wait to establish the national care service in order to take action where it is needed. As such, the Scottish Government will increase public investment in social care by 25 per cent over this Parliament, so that by the end of the Parliament we will have budgeted over £800 million of increased annual support for social care compared to current spending. In the latest programme for government, we restarted our commitment to transformative social care reform, including developing options for the removal of non-residential charging for adult social care. In addition, I have committed to invest £50 million over the life of this Parliament to support the regulation and development of the social services workforce through the Scottish Social Services Council. For unpaid carers, the Scottish Government announced an additional £4 million to help organisations working with unpaid carers to put expanded services in place. Other more immediate action that I am happy to take questions on includes support for the workforce to address recruitment and retention issues and work under way to develop the healthcare framework for adults living in care homes in Scotland. For these interim steps, as well as the national care service establishment, we are committed to listening to the voices of lived experience. Conversations with those with lived experience are already informing our review of self-directed support. Keeping those with lived experience at the heart of our decision making will help us to shape a system that improves future services and makes things better for everyone. Thanks for that summary. It is pre-empting, I suppose, my first line of questioning on the pace of implementation of things that are going to address some of the difficulties that have been highlighted by our colleagues and stakeholders when we spoke to them. One of the things that I am interested in is that there is a work going on in the national care service. Obviously, we are not at the draft point of that bill yet and we appreciate that you will not be able to talk about that until it is published. There is the resourcing element of the formulation and the work that is going to be going on to respond to the consultation, to formulate the bill and then, of course, once it goes through Parliament, setting up the national care service. On the other hand, there are all the things that you have outlined in terms of the actions that you are taking now. I wonder whether you can tell me about the resourcing of both. I guess that people want to know that both are going to be fully resourced and that it is not going to be a case of resources being taken away from the things that you are saying that are targeting issues now into the development of the national care service. I wonder whether you can give me some thoughts on that. This is challenging. There is absolutely no doubt about it. There is a lot going on within the social care sector. I am very lucky in terms of the team that I have, headed up by Donna Bell, which Gillian Barkley is part of as well, in terms of what they are doing at present. They recognise, like I do, that we cannot wait for the national care service to make some of the change that is required. That means that we are having to do a lot of work, a lot of it at pace, to try and ensure that we are doing our level best for people in the here and now, as well as formulating what change is required for the future. For example, Gillian, on a day and daily basis, is looking at the pressures that are on social care right across the country. He is involved in the gold group that works fortnightly. He is involved with the Cabinet Secretary and I in our discussions with health and social care partnerships, NHS boards and local authorities in order that we improve the current situation. The committee will be well aware of the pressures that are out there at this moment in time. We are not trying to hide from the fact that there are pressures out there. What the Cabinet Secretary and I are doing and what the team are doing are trying to ensure that the best practice that is going on out there is exported across the country. We are giving help and advice where we can to health and social care partnerships, boards and local authorities in order to meet the challenge that there most definitely is. I have said previously in front of the committee that we are at a precarious time in the pandemic. Lots of folk think that the pandemic period is over, but there are still huge pressures in terms of the workforce. Still, folks off with Covid, listening and thank goodness for that, but there are other pressures that are on the go at this moment in time. We are doing our best to be helpful to alleviate some of those pressures so that we can get back to some kind of normality. A huge amount going on at this moment in time is that I am very lucky to have the team that I have in government. They are very, very active. It has to be said. We will continue to work at pace not only on the formulation of the national care service but in terms of the reinvigoration as we recover from the pandemic. You mentioned listening to the voices of lived experience. I know that initially you were talking about that in terms of the formulation of the national care service, but you also said that you listened to the voices of lived experience right now. What are those voices telling you about what needs to be done right now? Let's take for example a call that I had yesterday with disabled people's organisations, folks from the independent living movement and folks with lived experience of disability. Although a lot of the conversation yesterday was about national care service and how we move forward, it has to be said that folk talk about the hearing now, because that is relevant to them. A large part of yesterday's discussion was not about national care service per se, but a lot of folk were discussing the difficulties that they currently have in certain parts of Scotland accessing self-directed support. The committee knows that there is a bit of a postcode lottery at this moment, where in some parts of Scotland the options available to people are restricted, which does not really conform to the act itself or the spirit of the act. We are at this moment reviewing the guidance of self-directed support to make it easier and more understandable for people to access what is their right. That is just one example from yesterday, which was not a focus on national care service but a focus on the hearing now. We are currently reviewing that guidance in order to improve the law for people. I was going to ask you about self-directed support, because that is something that goes obviously out in your constituency and you speak to people who have care or are coming in or have care needs. That is one of the things that I mentioned just before I allowed Callan walking to come in. I just wanted to mention something that was mentioned to me around self-directed support by one of my constituents when I was doing a bit of a street surgery. She made a really good point and she said that self-directed support is for me because I am the one who has mobility issues. I am a mum and I am a wife and I have a family around me but that support seems to be only targeted at me and it is like my meal will get made and you cannot do anything else for anyone else. If I were able, I would be doing this stuff as well. Is that something that you are hearing as well, almost that whole family approach? That seems to me a bit of dignity in there as well. You hear a lot of different stories, convener, about where it works and where it does not for an individual or their families. I think that some of the flexibilities that were in play during the pandemic, we have to look at to see if they should be embedded as we move forward. I have heard stories of transformational change for individuals and families with self-directed support. At the same time, there are other cases where maybe that support has not gone far enough in meeting the needs of the person who requires the support. One of the great things about this job for me is the ability to talk, unfortunately not very often yet, face-to-face but online with people around what works and what does not. It is quite amazing when you hear where SDS has made a real difference in the law, not just for the individual who is being supported but also for the family as a whole. Those kind of stories are the ones that we should be aspiring to as we move forward, instead of the situation that we have at the moment, which is still a bit of a postcode lottery to say the least in terms of the delivery of support and services for some. Thank you for that introduction. I am keen to push the minister on timetabling and dates, and I suppose that it is twofold. First, I would like to hear a clear commitment with some dates or some idea of when things will progress in terms of the overall change in national care service in that bill. Secondly, in terms of the implementation, I was listening this morning to the evidence that we took in September. People were saying that we need some actions now, which you have talked about. It is great that you have allocated funding, and it was good to hear that your department is indeed very busy, which is excellent. However, again, it would be important for people to have some kind of actions and some time frame about when those actions may take place. What actual concrete things are you working on for people to see a difference in the next year of my parliamentary term? Thank you, convener. As the committee well knows, I want to commit myself or promise anything unless I know that it can be delivered. Timelines are kind of difficult because we do not know what coronavirus is going to do next. I think that trying to second guess all of this is not an easy thing to do. However, as always, I am more than happy to continue to brief the committee on where we are at in all aspects of our work streams as we move forward. On the timeline for the bill, we have said that we would introduce the bill by the end of this parliamentary year, so that is June, and we are on track to do that. However, again, I emphasise the fact that it is not all about the bill or the formation of national care service, because we know that we have a lot of work to do in terms of ensuring that we get back to some kind of normality, the remobilisation of social care. The committee will be well aware of the actions that we have already taken, for example, on pay and introducing that minimum £10.50 an hour rate. At this moment in time, we are in discussions with COSLA around about conditions. I hope that the newly elected members in our local authorities and whoever the new COSLA spokesperson is will continue to engage with us on that. I would put on record, convener, that Stuart Curry, who was the previous spokesperson who stood down at the election, was extremely co-operative. I think that we are in a good place with our local authority partners, because we both want to achieve the same thing. However, we also have to recognise in that front that we are dealing at this moment. That is one of the big difficulties for me and for those folks in local authorities, with 1,200 employers. However, we will continue to try and make gains in that regard. As I mentioned in my opening speech, one of the other things that I would like to see—I know that COSLA shares that ambition, but we have to work our way through that—is the demise of eligibility criteria for non-residential services. As we have those discussions, negotiations and, hopefully, may progress, we will keep the committee informed of all of that. At the heart of all that change, of course, people are getting it right for people, not just for the workforce but for those folks who are being supported and receiving care. We would like to move on and talk about the biggest issue that we hear about in the social care workforce. Questions led by David Torrance and David Torrance. Minister, what evaluation has the Scottish Government made of the impact of current commission arrangements on social care workforce and how could they be addressed? The commissioning aspect is one that is vast in its differences. Let's put it that way. I think that that would be fair to say. In terms of current commissioning, in different parts of the country, as Mr Torrance is well aware, not only as an MSP but as a former local authority member, it can be vastly different. What we need to do as we move forward is to make change there. I have put great stock on ethical commissioning as we move forward. I think that that is extremely important. We have tried to provide some comfort to local authorities around changing their commissioning now. Hopefully, we can make more progress on that front. Let's look at what the independent review of adult social care said about current commissioning arrangements. What we are trying to achieve is to begin to look at their recommendations and implement some of those already. I talked about trying to give comfort at this moment. On 6 December last year, the Government issued a Scottish procurement policy note that was co-designed with key stakeholders to advise public bodies involved in the commissioning and procurement of social care services of the action that they can take in the here and now to improve commissioning practice. The Government is clear that by taking action now to embed ethical commissioning and procurement principles, we can help public bodies and providers to fully engage in the new and changing responsibilities that will happen with a national care service. That note includes advice on how to use resources well, to seek to extend or modify contract terms to support transition arrangements and asks that where a new procurement is required for community health and social care services that efforts are taken to embed the ethical commissioning and procurement principles that we all want as we move forward. You mentioned earlier that there are nearly 1,200 employers that must be difficult to control, but Audit Scotland highlighted that 20 per cent of workers are not on permanent contracts, 11 per cent are on zero-hour contracts and 13 per cent work more than 50 hours a week. What is the minister's view on establishing national minimum standards of pay and conditions for all social care workers, regardless of what sector they work in? That is one of the key principles of the national care service to raise those standards and to look at national pay bargaining as we move forward. I am a great believer in fair work. The Government is committed to fair work principles that will be embedded in the national care service. One of the reasons why so many of the employers in delivering social care at the moment have difficulties in recruitment and retention is because they are not providing their workers with that fair work. I am quite sure that many of you will have seen a situation in which, at this moment in time, there is a lot of movement in the social care workforce. In a lot of cases, and who can blame them, there are folks who want permanency in terms of a contract, who want higher pay and who want better conditions. At this moment, those good employers out there and there are good employers out there without doubt are gaining the benefits from the pay and conditions that they offer. Some of the employers who are not living up to the principles of fair work are losing employees. A lot of that is at the moment fishing from the same pool, which is a difficult situation that may resolve attention in one area but causes one in another. That is a scenario that I hope that we can iron out as we move forward with fair work, with national pay bargaining. The other thing for me as we move forward in terms of attracting particularly young people to social care and to social work is that we have got to show young folk how they can progress in their careers within social care and social work. That is not so easy at this moment in time, but we have had discussions with the likes of NHS Education Scotland, the Open University and others to look to see how better we can provide training qualifications in education to make those progressions easier. We know that, during the course of their careers, some folk will want to flip jobs. It may well be that folks may want to go from social care to the health service or to social work or vice versa. Sometimes that is not so easy at this moment, and we need to make that easier. In order to grow this workforce for the future, we have to make it much more attractive, particularly for young people. That career progression and those career pathways are immensely important as we move forward. Minister, Audit Scotland highlighted the 5.1 per cent vacancy rate in the sector. How difficult has Brexit and UK immigration policy made it for employers to recoup staff in the studio? It has made matters for many very difficult. Some of you around the chamber have heard me say before that, in conversation with one employer in one of their facilities, they lost 40 per cent of their workforce after Brexit, where folks chose to return home because of what happened and the feeling of the hostile environment. That has a real impact on service delivery. Some folk have said that we overeg the pudding when it comes to talking about Brexit, but that is a prime example of the real impact that Brexit had on service delivery. I am not saying that every service lost 40 per cent of their staff. There are tales from right across Scotland where folk have talked about the real impact of people returning to their home countries because they did not feel welcome in the UK anymore. I know that we have done our level best to try and reassure folk that they are welcome here in Scotland, but we lost a lot of people, a lot of people, good people who were delivering for our most vulnerable. A couple of things I have to ask you, minister, and thank you very much for coming along. Nice to meet your team face-to-face at last. You spoke about discussions with COSLA, so I was wondering that when you are doing that procurement and commissioning exercise, is there scope to include minimum pay terms and conditions? Could that be built into the procurement and commissioning to allow us to help the workforce in terms of that? I would hope that Ms Webber in terms of the comfort that we have provided with the procurement note that I talked about earlier, that we can move to that ethical commissioning, which has fair work at its heart as well. We have drafted procurement rules here in Scotland in a way that enables collaboration and discourages competition based on price. They enable preliminary—I should not have even attempted to say that, convener—market engagement with providers before starting a tender process and prevent a public contract being awarded on the basis of price alone. We want to see high standards here. We want to see a situation where fair work is at the very heart of all that we do. That is vital as we move forward. There are some folks who say that it is difficult to do that in terms of current procurement rules. Those folks are more than willing to have conversations with my team or with the procurement team here to give them comfort on how they should move forward in that front towards ethical procurement. I am leading on the next session on commissioning, so I will not drill any further. I have one more on workforce. We have mentioned commissioning already, so if you want to go to your commissioning question, it makes sense. I have one more on the workforce, and then we will leave to take questions from others that want to talk about workforce, but just to let colleagues know a lot of you are wanting to ask about workforce if you can keep your question short. You have mentioned the issue of retention and recruitment in terms of the workforce, with a quarter of staff in the care sector leaving within the first three months of joining an organisation. What more can be done to stop that from happening and keep those people in those roles? I touched on that earlier, because it is absolutely right that folk take opportunities if they are getting better terms and conditions to move on. A lot of folk who are in the social care profession may be moving on after a period of time, but they are staying within the social care profession, but they are getting better terms and conditions. Again, for those employers who, at the moment, whose conditions are not the best, should be looking at that, because at the end of the day, every time they lose a member of staff, that is costing them in terms of recruitment costs and many other costs. It would be in their interests to act now in terms of improving their pay and conditions. I cannot remember off the top of my head what the number was, but CCPS did a calculation not so long ago around the cost of constant recruitment. We can provide the committee with that figure, but it was not insubstantial. Rather than forking out that constant money in recruitment for some employers, it may be best that they invest and put that in to pay and improve conditions, and then they may be able to retain a lot more of their staff. I should say once again, and I will probably caveat this a few times, that there are employers out there who are paying their staff well with good conditions, and they are retaining their people. I was going to move to commissioning, or is it still work force? Sorry. If you have lots of questions, I will come back to you. We have heard about ethical commissioning of care, and we also know that the services are commissioned and that people are almost shoehorned into what is available and what services are there, rather than being developed for them. How can we turn commissioning on its head to make the individual the centre of the decision making, rather than it being as it is now? In all that we do, whether it is the work of the Government, the work of IJBs, local authorities or NHS boards and all of that, we have to listen more to the voices of lived experience. Let me be quite frank with the committee. Some of the work that we are doing at this moment in time would not have been at the forefront of our minds, but issues have been brought to us by folks with lived experience. One of the key things for me around the national care service is ensuring that, as we move forward, the voices of lived experience play a real part in shaping services. I am going to be a little bit controversial here, convener—not like me, I know—but it is 10 years since I left local government a decade. I am looking at procurement now from this place, rather than from the local authority side, I can see some real changes that have happened over the peace in certain places. One of the frustrations that I have—and it is certainly a frustration for those who are supported in receive care—is the fact that, often in recent times, in terms of the formulation of the tender and the contract, there has been more involvement from the likes of the Kentons and the legal boards than there has been from front-line social care staff or from those folks who are receiving care. We need to turn that around in its head, quite frankly. Evidence to the Public Audit Committee, the Auditor General said that we know that social care workforce has been under immense pressure during the pandemic, and that was spoken about by the minister in his opening. Indeed, the Auditor General understood that that was a case even before the pandemic. In those remarks, the Auditor General also said that the Scottish Government needs to take action to improve working conditions for the vitally important workforce, otherwise it will not be able to deliver its ambitions longer-term in terms of social care. The Audit Scotland report has outlined what those pressures and challenges are, and it is clear that there is an immediacy and a need to resolve them. I am also interested in the exacerbation of those issues due to the cost of living crisis. It is very clear that many of those workers—very often women and very often lower-paid workers—are struggling to make ends meet and are struggling to be able to do the job that they are in, and that is because of rising costs of getting between their shifts, getting public transport or in their car. What is the minister's assessment of what needs to be done immediately to deal with some of that? There is a fair amount in there, convener. First of all, I would highlight the point that the Government has in the last year raised pay twice for social care staff, with a minimum pay being £10.50 an hour from April of this year. That is an increase of 12.9 per cent for the workforce, for those workers, over the course of the year, which is much greater than that south of the border and much higher than what has happened in Wales. I agree with Mr O'Kane that the cost of living crisis is having an impact on everyone, including folk in the social care workforce. I appeal to the UK Government, to the Chancellor of the Exchequer, to get the finger out, get on with an emergency budget and ensure that we are doing our level-based for individuals and families right across the country who are being impacted by the rise in fuel prices, the rise in energy costs and the rise in their weekly shop. My appeal is that the Chancellor gets the finger out and takes action there. On the specifics that Mr O'Kane talked about in terms of transportation costs and mileage, I would highlight the point that there are 1,200 employers out there. The Government is not the 1,200 employers, but it needs to step up to the plate as well. We, the Government, do not set the mileage rates paid to social care staff as they are agreed and set by their own employers. However, I would say to Mr O'Kane and convener and to the committee that we are actively engaged with our partners, including local government, to understand what the impact the increase in fuel prices is having across Scotland and how social care providers can support their staff through this period to ensure that they can continue to deliver the invaluable support that they provide. We, as a Government, have a long-standing commitment to the principles of fair work for the social care sector, and we are fully committed to improving the experience of that workforce, including, as I pointed out, increasing the levels of pay. As we move forward, we are delivering consistent fair work conditions to staff working within social care in Scotland. However, there is not a lot that I can do, Mr O'Kane. There is not a lot of power that I have to push the 1,200 employers into some actions, but the committee can be assured that we will continue that active engagement with local government to see how we can move forward on that front. A number of other colleagues want to come in on the workforce. Stephanie, do you still have a question on that? Yes. Thank you, convener, and good to see you this morning, minister. In the 2019 fair work convention report, the recommendations in that went way beyond paying conditions. Are you able to provide us with some examples or some information around future plans of how you will involve social care workers in the design, development and delivery? There is a lot going on in terms of fair work. As part of our on-going work in setting minimum standards across both paying conditions, as we move forward. The fair work and social care group, which we established, will continue to explore across the entire spectrum of social care work. The work of the fair work group and social care group is critical. We are working on the objectives as agreed with the group at the start of last year. I understand, and I am going to look to my right and to my left here, just to see if I am right that the fair work and social care steering group are meeting tomorrow. Is that right? To agree new priorities, moving forward. If it is not tomorrow, I will correct myself later. Very soon, we will say. Very soon to look at the new priorities. As I have already pointed out earlier, we are taking action now with partners in local government and sector to accelerate improvements, including, as I have highlighted, the levels of pay. We are also in discussions with COSLA on how we will take forward the next steps on workforce developments. Members may be aware that COSLA leaders took a paper to their final meeting of the last local government session on those issues. We will revisit that with the new and reinvigorated COSLA as we move forward, as they appoint the new leadership in spokespeople. We are fully committed to working in partnership with trade unions, staff and providers as we go on, including areas such as the focus on recruitment, leadership at all levels, pay, terms and conditions, learning and development, as I have touched on earlier, and career pathways. We will specifically focus on the commission sector in the first instance, but we will reach across the whole of adult social care. I am sorry if I am going on too long, but I was specific about the 2019 fair work report. From that, and as part of our commitments there, we are ensuring that we move forward in terms of effective voice within the workplaces. We have included the requirement to consider effective voice measures as part of fair work first procurement guidance. That includes having appropriate channels such as trade union recognition. I could go on at great length about that, but you are probably going to stop me. I am going to stop you because we have one more question on workforce, but I think that it will be probably bleeding into quite a lot of our questions anyway. Sandesh Gohani, and then we will move on to be talking about our next theme, which I have forgotten. Thank you, convener. I will give you an example, but unfortunately, this example is all too common. It is from a Home Help staff member and she told me that she gets 15 minutes per client, and she uses the term client as do quite a lot, in fact everyone in this sector, not patient but client. This 15 minutes that she gets is for personal care. She gets to put food in the microwave, she gets to give medication and pills that are required, and basically do everything except give that personal touch, the sit down and holding of hand and just a gentle chat with the person, and that might be their only contact of that day with another human. Then she is in a huge rush to get out to the next client, as this is not allocated time. Let us look at what the other side of that coordinate coin is, the patient perspective. The patient tells me that they feel rushed. They feel as though there is no time for them, and they feel as though they are a burden. This is an example, but this is a common place and throughout our social care workforce. If both sides are saying this, is it acceptable? Secondly, I am assuming that you are going to say that it is not, how can we improve this so that in the short term we can do things for people and not wait for these big changes to occur? I think that there are a number of things there. First of all, I would say that that rushed example is not a good one either for the person working in care or for the person who is being supported. Although I have had exactly the same examples as Dr Gilhane, I also have other examples of where it works well for both the folks who are working in the sector and those who are receiving support and I think that what we need today is to look at those good examples and to export them right across the board. Let me give you probably the best example that I have come across, where I recently met with Aberdeen Granite Care Consortium, which is a group of third and independent sector organisations who came together to bid for a home care contract in Aberdeen. During the course of the pandemic period, they have done what I hope that others will follow and I have been encouraging others to follow suit, whereby they have given their front-line staff the independence and autonomy to step up or step down care to meet the needs of the folk that they are supporting. As Dr Gilhane, the committee will understand, there is more stepping up of care than stepping down of care. However, that person-centred approach with the independence given to the person in the know, who is the person who is going in on a day-in-daily basis often, who can see the needs of a person, is, in my opinion, the right way forward. That independence and autonomy of the front-line staff is what we should have more of. Some would say, what difference does that make? What evidence can you provide in terms of the difference that that can make? We know, convener, that we have some difficulties in terms of delayed discharge across the country. In some areas, delayed discharge rates are much higher than others. As Dr Gilhane will know from his medical experience, the best way of stopping delayed discharge is to keep people out of hospital in the first place and provide for their needs at home if that is at all possible. If you look at delayed discharge in Aberdeen, for example, as at 26 April, it is at 19.19, which is very, very low compared to many other parts of the country and is particularly low compared to the other cities. The work that has gone on there by the granite care consortium and others has meant that, with that flexibility, stepping up care where it is required, it has meant that fewer folk have had to go into hospital. That flexibility, that autonomy to the front-line, that level of understanding of meeting the needs of folk makes a real difference, and that is what we need to be doing as we move forward. We are going to move on to talking about retention of senior leaders, Emma Harper. Thanks, convener. Good morning, minister and to your officials also. A couple of questions about leadership in the Audit Scotland report. It talks about the health and social care sector needs stable and collaborative leadership to address it on-going challenges. We have had evidence previously at a previous health committee talking about how we support leaders. I know that the Scottish Government can lead on leadership, so I would be interested to hear what the Scottish Government is doing to help to support and address the challenges for retaining senior leaders in social care. As always, there are always challenges in retaining some folk. The Government places great importance on its relationship with senior health and social care leaders. My officials meet regularly with integration joint board chief officers. I have been meeting chief officers on almost a monthly basis since I took office. Those meetings cover a wide range of topics, including leadership development and barriers to integration. Officials met with the executive group of chief officers recently to discuss further support that might be required, whether that is more capacity to provide peer support and learning, coaching and mentoring for individuals or more structured programmes of support. We have also discussed engagement with wider staff groups to encourage participation in local and national strategic activity with succession planning in mind. The meetings that we have with chief officers also give them the ability to articulate what they are doing well and where they are having difficulties. There is peer support as well, which is extremely important. At some points in the pandemic, folk have felt that there has not been enough time for that. All of those things are important as we move forward. My role in all of that is to listen to what is being said by chief officers, what the barriers exist for them, to see whether we can get rid of those barriers and to provide a forum to bring folk together to provide the support that is required. During the pandemic, everybody has worked really hard and there is a lot of pressure and a lot of emotional stress and fatigue. Part of that peer support is to look at developing resilience among the leadership and how we are going to expand the pool and be more inclusive to procure more people into leadership positions. Resilience is a part of that. There is absolutely no doubt about that. In terms of some of the discussions that have been had, a lot of the focus has been on how we are all supporting one another during what has been very difficult and stressful times for many of us. There have been lots of discussions about the mental wellbeing support that we have put in place, for example. There have been examples of good practice in terms of mental wellbeing support that have happened at a local level that has been talked about within that national group, which folk have then moved on to implementing in their own areas. That coming together, that period to talk about those things, can often be not only good learning but can also be quite cathartic. During the past period, many of us have felt a little bit alone. That is happening to me, but when you talk to others, you find a similar position. How do we help one another through all that? I want to talk about data. Annie Gunnar Logan talked about citizen leadership when she gave us evidence. That is what you are talking about, where you identify people with lived experience, people who are unpaid carers, or who are using care services. Is there any work that the Scottish Government is doing to promote or enable citizen leadership? Is that something that has been taken forward? If you look at the work that we have done in terms of the social covenants steering group, I would say that that is citizen leadership, but it is not just at that level with those folks who will be helping us to co-design NCS as we move forward. Not just Government, but the public sector as a whole, as we move forward here, need to listen to the voices of the very articulate experience folk out there who know how the system works. They know what works well, but they also know where the system does not work, where there has been failure for many of them. We need to listen to people as we move forward in order to shape the right care system for all as we move forward. Minister, we always seem to come back to data. It is vital for anything that we do, especially if we are looking forward to making changes. I have two real questions to ask about it. One of the messages that we got from Audit Scotland was that it is an unwillingness for an ability to share information along with a lack of relevant data. That means that there are major gaps in the information that is needed to inform improvements in social care. With that being the case, what data are you looking at and how are you responding to Audit Scotland for your push forward for a national care service if we do not have this information? I think that I have been quite frank in terms of some of the answers that I have given previously on data, particularly to Ms Mackay in the chamber, who has been pretty vociferous in asking numerous questions in that front. We have implemented a data improvement programme that is working together with local and national partners, which should challenge the issues around it about social care data quality and consistency and the issues that exist with data sharing and address gaps such as unmet need, workforce data and modelling future demand. That programme is developing and I am more than willing to come back to the committee or to inform the committee of the improvement work that is going on in the short to medium term. We have got to get that right in terms of the transition to the national care service. As part of that work, we have been working with Public Health Scotland, IJBs, NHS boards and local authorities to improve management information on pressures in the health and social care system. That will enable us to respond collectively to pressures and issues arising as well as improving planning for the future. The other aspect of this convener, which is vitally important, is our proposals in terms of the national care record because one of the key issues for many people accessing care is the amount of times that they have to repeat their story, which is often very frustrating and can often be triggering because they are having to repeat difficult stories again and again. The national care record will make a real difference in terms of ensuring that we get it right for people as we move forward. More than happy as we move forward, convener, to continue to update the committee on what we are doing to improve data. Sandesh, do you have anything else? I would like to know briefly about the timeline for the data that you have told us about the work. I will write to the committee with indicative timelines. I do not want to be specific about any of that because, as the committee will be well aware, this is an ever-moving feast. I am also, as my officials are, reliant on other partners in all of that, but we will give you indicative timelines. On data, the consultation for the national care service, in the report, many respondents highlighted issues such as the length of the questionnaire, the short space of time in which they could prepare a response, the lack of detail around proposals, the nature of some of the questions that were thought to be leading the respondents to a particular answer. 33 per cent of respondents said that they were dissatisfied with the consultation process. Without being the case, data is again important. With consultation with this type of feedback, how do you respond to that and how do we go forward to ensure that we get the information that we want? There are lots of different views around the national care service consultation, and it would be fair to say that I have heard them all. Some folk thought that the consultation was too long, some folk thought that the consultation was too short. Others felt that some of the questions that they wanted to see were not there and the list goes on. However, the consultation itself, the NCS consultation, is not the end of the engagement here. I have made it very clear right from the very beginning of all of this that, as we move forward, we must continue to talk to, listen to, consult with stakeholders and, in particular, hear the voices of lived experience in order for us to get this absolutely right. That is why, convener, this work will continue throughout. It will work as the bill progresses, it will go on beyond the bill as we are shaping NCS. It is not just about the legislation or the regulation, it is also about the cultural change that is required. That will continue to be engagement all the way through. I have said to this committee time and time again, and I will probably continue to do it as we move forward. I am very keen that we need to hear the voices of lived experience as we shape social care for the future. I move on to talking about financial planning and everything that you have talked about today, whether it is national care service or the improvements that you are currently making, Stephanie Callaghan. Minister, we have known for quite a long time that we have looked at the Christchurch report and so on, that there needs to be a shift from critical care to preventative care, which we can all probably agree on. Have we looked into the level of unmet need and what it would cost to meet those needs, rather than just looking at meeting substantial and critical needs just now? In reality, is there a greater cost in not meeting those needs from a preventative point of view in keeping people well? Crisis costs a lot of money, and there is also the human cost of not dealing with things early. I think that the move to the preventative approach will save a lot of money that can be reinvested and also stop some of the human costs of not getting this right. We know, because we can hear it from people themselves, where the focus has been on prevention. That has been much better for people and is, over the peace, much less costly on the public purse. It is very difficult for me to read stories because I do not really want to identify people, which is always a danger. Having heard stories of folks who have moved from a situation where it was almost a constant crisis to a situation where self-directed support has worked for them, which means that crisis is very rare now. That makes the odds for folks and it is less costly. As we move forward, we have to analyse and carry out tests of change to see what the financial impacts are on those changes. Beyond just listening to the day-to-day stories of people's lives that move to prevention lessons and the difficulties that folk have, stop some of the horror stories that we have all heard and is much less costly than crisis intervention, which costs a lot. Just following on from that, you gave a really good example earlier on when you talked about Granite Care Consortium. I hope that I have that right there and about front-line staff being able to step up care to prevent going into hospital as well as step down care. If we are going to be looking at investing in the preventative side of things, how do we look at measuring the effectiveness of that and building the evidence so that we are able to deliver that across the board nationally? Sometimes it is difficult to build that evidence case because I have given the example of the step up, step down care that is happening. Could the folk in Aberdeen now tell you how many folk they prevented from going into hospital? That is a very difficult thing to do. It is not so easy to work out what that stepping up has or has not done. We know that it has been helpful for people. We could make the broad assumption and would not be far off the mark that it has probably saved a lot of folk from going in to hospital front door. It is one of the reasons for the lower number of delayed discharges in Aberdeen compared to many other parts of our cities. Sometimes it is particularly difficult to measure in the short term, but broad assumptions would not be off the mark in terms of the fact that that is helpful in terms of keeping folk out of acute services. Has there been any work or interest in looking at having a dashboard of well-being indicators where we will get feedback from individuals on how they are doing? I am stealing that from the Education and Skills Committee. Data coming back to the evidence can be so hard to measure and it can be difficult to get that information. Have you looked at it or considered it in the future? I am not afraid of pinching, stealing, plagiarising Ms Callaghan. I think that what I would say to you is that we all have a look at the dashboard that education is using and have a look at that and consider whether that will be useful to us as we move forward. We are going to give over the remaining time that we have for questions from colleagues around the national care service, which is inevitably peppered. Everything that we have talked about so far is in the backdrop of everything that we are talking about. Those questions will be led by Gillian Mackay. One of the criticisms of the public consultation on the NCS was that there needs to be more public engagement and more involvement from clients and people accessing care and support. I know that we have touched on that a lot already this morning, but how does the minister respond to that and what work is being done to ensure that more people are involved during the consultation and implementation process? We continue to listen to focus as we move forward. I gave the example of my meeting yesterday and I will continue to do that. Officials are continuing that in a day and daily basis. What might be useful for the committee is that we can provide you with an idea of what has gone on in the last month or two, from my perspective and also from the officials' perspective. Some folk have said that they have been quite quiet during the course of the pre-election period, and there are obviously various things that we cannot say there, but even during that time we have continued to talk to stakeholders, to listen to stakeholders and to take on board what they have to say. At the very heart of all that is listening to the voices of lived experience, which is the key thing, as far as I am concerned. One of the other issues that was raised by respondents to the consultation was that the paper focused on organisational restructuring and did not focus so much on the transformative cultural change that is needed and prioritises person-centred services. What is the minister's response to that and how will you ensure that structural change is matched by the cultural change that is needed? I think that we often concentrate on the legislation and the regulation. Sometimes it is difficult to legislate or regulate for cultural change, but we know that we have a job of work to do in terms of changing culture, particularly in certain areas. I do not mean by that geographic areas necessarily. One of the main ways that we change the culture is to make sure that the voices of lived experience remain at the heart of all that we do, not only at a national level, but also at that local level. That is why I am keen to ensure that the voices of lived experience have a role and a vote on care boards. I hope that that will come to fruition. I think that that will change the dynamic a great deal. I know that, in many parts of the country, folks with lived experience are already at the table, but I want them at the table with a vote. I think that that will make a real difference in terms of cultural change. The Scottish Government published an analysis of stakeholders' responses in the NCS consultation, which showed that 77 per cent of respondents felt that the main benefit of the national care service was taking responsibility for improvement across community health and care services, and that would mean more consistent outcomes for people. Is the minister confident that there will be more consistent outcomes for people and can that be achieved? Yes, I think that it can be achieved. That is the reason for doing all of that. The postcode lottery has had a real impact on some folks. It is quite bizarre, and I have touched on that before in committee. Even within local authority, health and social care partnership areas, there can be differences in service delivery, which can be really frustrating for people. I gave an example from your constituency previously, convener, where somebody who lived in your constituency was absolutely and utterly annoyed at the fact that service delivery for them was so much different from Peterhead, which is not in your constituency. That is in the same local authority area and in the same health and social care partnership area. My confidence in the service delivery improving and getting it right for all is down to the fact of bringing in national quality care standards, so that the folks who are delivering and supporting people know what is expected of them, and the folks who are being supported know what they should expect as they move forward. For probably everyone around this table, those inconsistencies in delivery of service has probably led to a fair amount of correspondence in your mailbags and inboxes. We need to get rid of that. That is one of the main reasons for doing it, and I am confident that we will get those national care standards right and create a fairer situation for all. I should also say that some people have argued that the standards in their area are already the best, and they feel that NCS might pull that back. We will be aspiring to reaching those highest standards as we move on. Audit Scotland is particularly concerned or interested in the learning that can be taken from previous public sector reform. I have highlighted in its analysis that very often expected benefits are not always clearly defined, and even where they are, they are not always delivered, particularly in that short-term period. How confident is the minister that the benefits have been defined and can go on to be delivered? We have given a really good outline of what we want to do here in terms of defining benefits. Who are we defining the benefits for? For the public service itself, for people, the list goes on. We need to continue to work and to define what all those benefits are. We will continue to analyse all that as we go forward. The key thing for me in all of this—we can go back to Christy—is looking at that joined-up approach, getting rid of the silos that unfortunately still exist. No matter what is in or what is out of national care service, making those transition phases much better for people is a major benefit in getting that right. I think that there is a huge amount that will benefit people without doubt, a huge amount that will benefit the public sector as a whole. We will continue to work in all of that, and I am quite sure that Mr O'Kane will continue to scrutinise whether those benefits become a reality or not. However, I am very hopeful that we will make some real change here, particularly for the good of folks. I certainly will. I think that scrutiny is the job of all of us to get that right. I wonder whether I can just perhaps scrutinise in terms of those benefits and the understanding of those benefits for those who responded to the consultation. We have already heard that the Government's own analysis acknowledges that there are quite a large number of criticisms in the consultation process in all formats of submission. Two of the principal reasons, given the complexity of the issues and the lack of detail in the proposal, is that we have just talked about the benefits that people are struggling to engage in and understand what those are. I know that, in his previous answer, he is committed to that further engagement work, but it is very clear that people want to see that detail and that continued conversation. Mr O'Kane talked about the complexity of the consultation. Others said that it was not complex enough. I recognise that folks always want more detail, but at the same time when there was detail in the consultation, some folks said, well, you have already made up your mind on that particular issue. You can win sometimes in those regards, but I think that where folk do recognise where the Government is going with all of this, there is a recognition by most stakeholders out there that the consultation is only one part of this, and we will continue to discuss with stakeholders and the voices of the experience around where we need to go here, including the discussion around the benefits as we move forward. That is going to be beneficial for all. I am absolutely convinced of that. We need to grasp the opportunity here to ensure that we are doing the right thing in shaping the future of social care in Scotland. Evelyn, you wanted to pick up on something, and I will come to Sundesh. How many people has the Scottish Government estimated could benefit from care where it is not in place now? I have that number somewhere, but whether I can... Oh, Ms Bell is much more on the ball than I am. The independent review in adult social care estimated that approximately 36,000 people do not have access to social care support at this moment, people who would benefit from access to the support. 36,000 people is the number. I am truly concerned with the recommendations that new community health and social care boards would be in charge of GP contractual arrangements. Integrations are important, but with a few exceptions, the HSCPs have failed to really engage well with practices that GP contract is a national, not a local one. This is social care that we are talking about, not GP practices. I am just not entirely sure that we are asking the right person about this. Have you got a social care aspect to this? This is in the national care consultation. The Scottish GP committee has said that it was not consulted on the recommendation, and that it is against it, and I believe that the RCGP is against it as well. So my question would be why would you want to make the changes and what benefits do you envisage with those changes being made? We have asked a number of questions in the consultation to get the views of stakeholders, including the likes of the BMA, but also the views of the folks with lived experience there. What I would say to Dr Gohani is that, at this moment, there has been no decision taken around about that move. I am sorry for my confusion there. I just thought that you were going on to GP contracts, and I thought that it was maybe better for the cabinet secretary, but I apologise if I got that wrong. I have a final question from Sue Webber. You mentioned earlier, minister, that your intention is to increase the spending on social care for the length of this Parliament by 25 per cent. I am just looking to find out where that money is coming from, given that there is the new money in inverted commas from the national insurance consequentials, which could be up to £1 billion. I am just wondering if that money was intended to be ring-fenced and might be over and above that 25 per cent. We have committed to that enhancement of £800 million. What I would say to Ms Webber, and maybe she can be helpful here for the Scottish Government, is that we have no indication from the UK Treasury around what we are likely to get in terms of that national insurance rise. If Ms Webber wants to have a word in the shell like of Rishi Sunak to see how Scotland will benefit and we finally get some numbers out of him, then maybe I would be in a better position to answer that question, but we have committed to that £800 million. Emma, do you want to come in before we let the minister go? Just a quick question that is reflecting on what Sandesh Galhany has asked you about questions that have been asked in the consultation. Is it right, though? We ask difficult questions sometimes in order to elicit what would be maybe out-of-the-box thinking or different changes or new ways of working. Would that not be the processes that we would follow to ask questions that sometimes folk might not like? Absolutely. A lot of the questions that were within the consultation were suggestions and views from those voices of lived experience. That is the way that consultations work. We do ask some difficult questions. It has to be said that in terms of the GP contract aspect of that, that was actually a direct recommendation from the independent review by Derek Feeley. Others would have said that if we hadn't asked that question, that we ignored a Feeley recommendation. I thank the minister and Ms Bell and Ms Barkley for their time this morning. We will have a very short suspension while we allow the minister and his officials to leave. Our third item on our agenda is consideration of a negative instrument. That instrument is the genetically modified Food and Feed Authorisation Scotland Regulations 2022. That instrument authorises five new types of genetically modified maize and soybean projects for use in food and animal feed sold in Scotland. It also renews authorisation for continuing use of four genetically modified maize products. The Delegated Powers and Law Reform Committee considered that instrument at its meeting on 10 May 2022 and agreed to draw that instrument to the attention of Parliament under the general reporting ground in respect of an error in paragraphs 4 brackets 2 of schedules 3, 4 and 7. The document reference number is incorrectly stated to be EURLVL0417VP rather than EURLVL0312VP. In response to correspondence from the DPLR committee, the Scottish Government acknowledged that there was a referencing error in the instrument but does not propose to correct it. So no motions to annul have been received in relation to this instrument. Do any members have any comments that wish to make? Gillian Mackay Thank you, convener. The genetically modified Food and Feed Authorisation Scotland Regulations 2022 authorised nine GM food and feed products, making them available for consumption in Scotland. The Scottish Greens have long-standing concerns over the environmental impact of genetically modified crops that are not properly addressed in those regulations, and our concern is that our status as a GM-free country is being eroded by this decision. I would also like to note a strong concern over the constitutional implications of this and indeed other decisions over GM products. Scotland should have the power to make the decisions that it sees fit to protect the environment and the public, but the reality is that it does not matter what decision we make here today over the regulations or any future authorisations for GM food or feed, because, even if we were to withhold authorisation, that would have no material impact because the UK has already allowed access to those products, and due to the UK Internal Market Act, the Scottish Parliament could not choose a different path. Okay, thank you. That is on the record. Does anyone else want to make any comments in relation to this instrument? Okay, so we propose that the committee itself does not make any recommendations in relation to this instrument, notwithstanding that Gillian Mackay has put her views on the record. Does any member disagree with that? Okay? I do not have any disagreement at all. At our next meeting on 24 May, the committee will begin to take evidence as part of our inquiry into health inequalities, and that concludes the public part of our meeting today. Thank you, everyone.