Michael Matheson: National Care Service delay due to ‘misunderstanding and misinterpretation’

Problems with the National Care Service (NCS) Bill are due to “misunderstanding and misinterpretation”, health secretary Michael Matheson has said.

But there is now “greater clarity” around the intention behind the legislation, he said, and ministers are “confident” consensus on the contentious bill can be reached.

The NCS Bill was introduced to the Scottish Parliament in June 2022 but has not progressed beyond the first stage of parliamentary scrutiny due to concerns about centralisation, governance and funding.

The Scottish Government paused the bill in March to allow for a series of engagement events to take place. It is now expected to complete stage one by the end of January.

In an exclusive interview with Holyrood, the health secretary insisted the NCS is still the right approach in order to “make sure that we have a sustainable health and social care system”.

Matheson said: “Some of the things that we are taking forward as a result of pausing the bill and taking a bit more time is to try to help to give more of a focus towards what we’re trying to achieve as the outcome from the creation of a National Care Service, rather than overly focus on process.

“I think there’s been some misunderstanding and misinterpretation of what’s intended with the legislation. But, you know, it’s clear from discussions we’re having with Cosla and that I've had with some of the trade unions there’s now greater clarity around that.”

Cosla, the umbrella body for Scotland’s councils, had previously warned the NCS “poses a serious risk” to services because it would “transfer local authority functions, staff, property and liabilities” to a new national body.

But a new deal agreed between Cosla and ministers in July will mean care staff will remain employees of local authorities, while legal responsibility for the service will be shared between councils, the NHS and the Scottish Government.

However, concerns remain over the lack of clarity around the cost of the bill. In December last year, Holyrood’s Finance Committee concluded it was “difficult to assess whether the proposed National Care Service is either affordable or sustainable”.

But Matheson said setting up the NCS within the confines of the Scottish Budget is “perfectly feasible – with the right collective leadership, with a clear focus on what you intend to achieve with it, and to make better use of what is a huge amount of money that presently goes into social care.”

He added: “I am confident that we will get to a point where we will get a greater level of consensus on the approach that we take in the bill.”

On the challenges facing the NHS, he blamed a “combination” of backlogs, staffing issues and a greater burden of disease.

And on the matter of long-standing public health issues facing Scots, Matheson said Westminster decisions had “undermined” policies pursued by the Scottish Government.

He said: “We have made progress but I’m also conscious that some of that progress has not been as effective as it could have been as a result of decisions that have been taken at UK Government level, which have undermined the impact that some of these policy options that we’ve taken forward would have otherwise had.”