A forum on the proposed National Care Service heard from the Cabinet Secretary for Health and Social Care that lived experience will be the “golden thread” throughout reforms which all social care sector leaders have responsibility to deliver – but that the “fundamental” impact of Westminster’s decisions in Scotland cannot be ignored.

Health and Social Care Minister Neil Gray told attendees that while he often hear how “life-changing” investment in social care is, he is also acutely aware of the need for change to improve services:

“We have heard time and again that things need to change – things need to improve.  Social care reform is one of the most important challenges this government and many other governments are facing.

“We have a responsibility to deliver meaningful change to the people of Scotland. And I say “we” advisedly. Of course it is government’s responsibility to lead on this change, on this reform, but we all in this room and beyond have agency, have a responsibility to deliver that change. 

“That’s why working with and listening to people with lived experience has been so vital in the work we’ve done together to design the National Care Service.”

Responding to concerns around council leaders’ withdrawal from the Bill, Mr Gray said he recognises that there are “differences of opinion” around the Bill but that everyone needs to work together to craft the future of the service:

“I respect the fact that there are strongly held views in local government and the trade union movement. I want us to get back round the table and discuss those areas of concern and move forward.

“We’ve all got a responsibility – whether we’re in government, local government, or the trade union movement – to be delivering for the people who receive social care.

“I think it’s fair to say that collectively we’re not doing enough and there’s room for improvement.”

While echoing his earlier call for social care leaders to “get back round the table”, the minister said “we’ve got a responsibility to leave behind our personal or organisational biases” and act in the best interest of the workforce and those receiving care:

“I believe there’s still room for negotiation, discussion and compromise to move forward so we can deliver a National Care Service. That’s my ambition, it’s the ambition of government and I hope we can all rise to that challenge.

“So that’s my offer and the door is open from myself, from Maree [social care minister] and from government to move forward and I would encourage those that you’ve mentioned to take that opportunity.”

Embedding lived experience

Speaking via video-message, First Minister John Swinney told the forum that the National Care Service is Scotland’s opportunity to “fundamentally transform” the way social care is delivered and relies upon placing people at the heart of the system:

“We’ve listened to the thousands of you who have given us your views. We will make that change happen.

“We will ensure greater transparency in the delivery of care, and greater accountability at a national and local level.

“We will strengthen the role of the workforce and provide enhanced support for unpaid carers.”

This comes as the latest census figures revealed that the number of people providing unpaid care has grown by more than 25% in Scotland.

In response to carers at the event raising concerns around lack of funding and consistency of services – especially in rural areas – Mr Gray reflected on his own family’s experience of access social care in island areas:

“I recognise that while self-directed support works for my dad in Orkney, it doesn’t necessarily work in all local authorities.

“A National Care Service is about providing greater consistency for those who need and work in social care, and it’s about continuing the progress we’ve made.”

Mr Gray told the forum that people with lived experience of social care are the “real experts” and are crucial to the development and delivery of the National Care Service, adding that the government’s Expert Legislative Advisory Group has helped shape the government’s draft amendments:

“The group made it clear that people have a wide range of opinions. We will not always reach consensus, but it is important to have the opportunity to hear from all perspectives.”

However, some members of the group wrote to MSPs to distance themselves from many of the government’s amendments.

Mr Gray said he wants to ensure the people with lived experience remain the “golden thread” running through the National Care Service.

Invest to reflect the value of care

A concern that many organisations have raised time and again around the “fundamentally changed” NCS Bill centre around the need to properly invest in social care workforce and services.

Mr Gray told the forum that government “simply cannot afford not to” deliver social care reforms, but recognised the outstanding financial pressures:

“In terms of the importance of the UK budget at the end of the month, the decisions taken at Westminster have a fundamental impact on the decisions taken in Holyrood and by extension those in local government.

“Part of the reason we’re feeling the pressure across social care is because of not just austerity, but the impact of Brexit on our workforce.

“I want to see an investment and valuing of public services above the economic narrative we’ve seen previously.

“You cannot have a strong economy without thriving public services and you cannot have thriving public services without a strong economy. You need to invest in both.”

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