Scottish Government 'unable to articulate' how National Care Service would operate

Controversial plans to overhaul Scotland's social care system have received the tentative backing of Holyrood’s health committee despite members warning that the government is unable to “articulate and communicate” how it would work in practice.

Drawn up by First Minister Humza Yousaf in his former role as health secretary, the National Care Service plan envisions bringing adult social care under the control of a single, NHS-style service managed by local boards, with the aim of ironing out differences in provision across the country.

It came in for immediate criticism when it was published in 2022, with economic research organisation the Institute for Fiscal Studies saying it would exacerbate rather than reduce differences in service quality, and local authorities and opposition parties saying it would represent an expensive “power grab” on the part of the government.

Parliament’s Criminal Justice Committee also raised “extensive concerns” about the proposal to include criminal justice social work in the new service while the Finance and Public Administration Committee has raised repeated concerns about how it would be funded.

Yousaf committed to overhaul the plan while running for the leadership of his party last year and, after replacing Nicola Sturgeon as first minister in March, his government held a number of regional forums to help inform what changes are required.

Having completed its stage-one scrutiny of the National Care Service Bill, the Health, Social Care and Sport Committee today issued a report saying the majority of its members recognise the need for wide-ranging reforms, but are concerned about the Scottish Government’s "inability to articulate and communicate a model of how the proposed National Care Service would operate".

The committee also noted that it was unable to fully scrutinise the bill due to a lack of detail from government.

Committee convener Clare Haughey said the majority of members welcome the bill’s "underlying intentions" but would have to reserve judgement overall until further detail has been provided.

"Our stage-one scrutiny has undoubtedly been affected by changes to the original proposals, meaning we will have to reserve final judgement until we have had an opportunity to scrutinise the detail of those changes as part of a reinforced stage-two process," she said.

"We welcome the Scottish Government taking on board the views and concerns of stakeholders and its plan to revise the original proposals, but it is essential details of these revised proposals are shared with the committee in a timely manner and sufficient time is allowed for the committee to undertake substantial further scrutiny ahead of formal stage-two proceedings.

"It is on this basis that that a majority of our committee has concluded that it recommends that the parliament should agree to the general principles of the bill."

Noting the "glaring deficiencies" highlighted by the report, Scottish TUC General Secretary Roz Foyer said it "remains firmly unacceptable that at this stage Scotland’s workers still have no clarity on how a National Care Service will operate in practice nor the overall cost of the project".

"A new National Care Service must be one that puts workers and service users before profit," she added. "Social care staff are the lifeblood of our community and residential care system, they need the government to take action to support them now."

It comes after the Auditor General for Scotland, Stephen Boyle, today released a report saying the government must develop a clear national strategy for health and social care to ensure the financial sustainability of the health service. 

The report noted that, while the Scottish Government has a range of strategies, plans, and policies in place, it has no overall vision for health and social care.

In the absence of both a plan and a clear strategy on how to deliver it, health boards will be unable to plan for change, he said.

Commenting on the health committee’s report, committee member Emma Harper – an SNP MSP – said the proposed strategy would help the government achieve its goals on social care.

"This takes us a step closer to improving the quality, fairness and consistency of social care provision across Scotland, easing pressure on our NHS and representing a huge investment in those who deliver and receive care," she said.

"Scotland can and will build a National Care Service that meets the needs of the people it will serve, and this bill is instrumental in achieving that goal."