LEGISLATION to establish a National Care Service (NCS) in Scotland has been published, with the Scottish Government suggesting it will "ensure the best possible outcomes" for people accessing support.
Ministers have insisted the NCS – which they want in place by the end of this parliament – would end a "postcode lottery" of care.
It would make Scottish ministers accountable for adult social care in Scotland – stripping it from local government – which the Scottish Government says is a change "strongly supported" by those responding to a consultation on the plans.
However, many councils – including those headed up by an SNP administration – made it clear they did not support the proposal.
Renfrewshire councillors unanimously slammed the plans last year, with then deputy leader Jim Paterson branding it a "slap in the face" for social care workers, arguing councils could react quickly to issues locally.
The response from the council said there was "no evidence" the changes proposed would deliver the improved outcomes people want to see in the wake of the pandemic.
Paterson said: "These proposals are a slap in the face for the workforce. They've been commended on TV [during the pandemic] and then these proposals are saying 'you did a really great job but we’re just going to centralise everything because we can do better'."
Under the proposal, councils would no longer be involved in decision-making in relation to the allocation of funding to adult social care.
The Scottish Government says the Bill provides the foundation for the NCS, and enables the fine detail of the new service to be co-designed with people who have direct experience of social care services.
Plans have also been published to explain how that collaboration will work.
Ministers say the aim is to:
- Support people in their own homes or among family, friends and community wherever possible, with seamless transitions between services.
- Create a charter of rights and responsibilities for social care, with a robust complaints and redress process.
- Introduce rights to breaks for unpaid carers.
- Introduce visiting rights for residents living in adult care homes, giving legal force to Anne’s Law.
- Ensure fair employment practices and national pay bargaining for the social care workforce.
- Focus on prevention and early intervention before people’s needs escalate.
- Create a new National Social Work Agency to promote training and development, provide national leadership and set and monitor standards in social work
Cabinet Secretary for Health and Social Care Humza Yousaf said: “This is the most ambitious reform of public services since the creation of the NHS.
“People have told us they want an NCS, accountable to Scottish Ministers, with services designed and delivered locally. That’s exactly what we are going to deliver.
“The design of the NCS will have human rights embedded throughout, and the actual shape and detail of how the NCS works will be designed with those who have direct experience of accessing and providing social care.
“We are going to end the postcode lottery of care in Scotland."
Social Care Minister Kevin Stewart added: “When this Bill passes we will be able to have the new NCS established by the end of this parliament. In the interim we will continue to take steps to improve outcomes for people accessing care."
The legislation, however, stops short of preventing private health companies from profiting by providing care.
Unison, the country's largest trade union, has warned the proposals will remove legal responsibility for social care from councils in favour of quangos, with no attempt to remove the market or the profit motive from the sector.
In contrast to the NHS, social care is largely provided by private companies that follow local authority guidelines. Some argue this has created a "postcode lottery" across the country, with standards varying depending on where you live.
The GMB Union said it was unclear how care staff would benefit from the "fag packet plans".
Keir Greenaway, GMB Scotland Senior Organiser, said: “Care staff and their fight for £15-an-hour haven’t even been an afterthought in drafting the bill, they’ve been totally left out.
“Care staff who worked on the frontline throughout the pandemic and continue to care for our most vulnerable cannot afford to wait for improved terms and conditions.
“It’s unclear how, if at all, care staff will benefit from these fag packet plans.
“The Scottish Government is in danger of overpromising on a National Care Service.
“If they truly value care staff, they need to deliver £15-an-hour and outline mandatory industry minimums across the public, private and third sector.”
The Scottish LibDems have said the Bill amounts to "nothing more than an SNP takeover".
Leader Alex Cole-Hamilton said: "This Bill takes the name of the National Health Service in vain. It amounts to nothing more than an SNP takeover and a top-down reorganisation of care.
"Just as with the police, it will waste money and reduce services.
“It would be terrible for care services if authority was to be taken away from local councils and permanently handed to the same Scottish Government ministers who were responsible for sending untested and Covid-positive patients into care homes at the start of the pandemic."
Meanwhile, the Scottish Conservatives have claimed the Bill "will result in up to £1.3billion being diverted from frontline social care to bureaucracy".
The party said the SNP’s own figures reveal establishing the NCS could cost £1.3billion over five years in admin costs with up to 700 civil servants required to staff it.
Shadow social care minister Craig Hoy has urged the SNP to scrap the plans.
He said: “The SNP have spent years hollowing out local councils with savage funding cuts and now they are mounting a direct assault on them with their plans to scrap local accountability and impose total ministerial control via a National Care Service.
"Social care provision in Scotland is in crisis. But the last thing we need right now is a major bureaucratic overhaul of the system.
"The SNP Government’s own figures show that establishing an NCS could cost an eye-watering £1.3 billion in admin costs. We simply can’t afford to see that sort of money diverted from frontline local services."
