Where Next for the National Care Service Bill?

Nick KempeEarlier this week Common Weal produced a briefing for the Stage 1 reading of the National Care Service (Scotland) Bill in the Scottish Parliament which is scheduled to take place at the end of the month. The briefing was designed to highlight to MSPs ten major flaws/omissions in the draft bill, starting with its failure to set out the purpose of a National Care Service and ending with its failure to review the mass of social work and social care legislation which affect how care services operate. Unless those omissions/flaws are addressed we do not believe the bill can deliver the type of comprehensive womb to tomb National Care Service we set out in Caring for All.Normally, all the major questions about a piece of legislation, including its scope, cost and intended outcomes, are supposed to be addressed BEFORE the Stage 1 reading. The relevant Scottish Parliament committees seek information about those fundamental questions, before the lead Committee produces a report on the bill. The Stage 1 reading which follows then becomes a debate about whether or not the Scottish Parliament wishes in principle to proceed with a bill, with detailed consideration of the various clauses in a bill taking place as part of the Stage 2 process.These well-established Scottish Parliament processes have not been followed with the Scottish Government’s draft NCS bill. As a result of widespread concerns about the bill and in response to calls from Common Weal and the STUC among others, the Scottish Government paused the draft bill to allow for further consultation. This, it was claimed, would enable the NCS to be co-designed with stakeholders. Despite, however, signing the “Verity House Agreement" with COSLA which means local authorities will retain responsibilities for care provision and makes Clauses 2 and 3 of the bill redundant, the Scottish Government is asking the Scottish Parliament to proceed with the NCS bill on the basis of reassurances that these clauses will be removed at Stage 2, but at Stage 1 the bill itself would remain unamended.The Scottish Government is proposing to make amendments as part of the Stage 2 process but without saying what most of them will be. At the same time, despite considerable probing by MSPs through the Committee system. For example and with reference to the the financial implications of the NCS including the set-up costs, the Scottish Government has released very little information. It has even refused to tell MSPs on the Health, Social Care and Sport Committee what its “Target Operating Model” will be (Common Weal asked for this in a Freedom of Information request two years ago and was refused the information on the grounds the work was not complete). In short, no-one outside the Scottish Government knows the intentions behind the NCS bill.This left MSPs on the Health, Social Care and Sport Committee, who under parliamentary procedures are responsible for producing a report on the Stage 1 Bill, in a very difficult position. Should they allow the bill to proceed on the basis that it could be extensively amended at Stage 2, which would set a new and potentially dangerous precedent, or should they recommend the Scottish Government goes back to the drawing board?The answer to these questions was published yesterday in a 200 page report. The report covers a long list of issues about the NCS bill which the Committee believes still need to be addressed which Common Weal will consider properly in due course. It ends, however, by recommending the bill should be accepted in principle at the Stage 1 reading and proceed to Stage 2.Basically the five SNP and 1 Green MSP on the Committee have accepted Scottish Government assurances that the Committee will be given adequate notice before being asked to consider amendments and adequate time to do so. Opposition MSPs are less convinced and a number of proposals designed to require the Scottish Government to publish their proposed amendments and revised supporting information BEFORE the Stage 1 reading were defeated.It now appears likely the Scottish Government will maintain its majority for the forthcoming Stage 1 reading meaning we are on uncharted constitutional territory with the possibility that the bill that emerges at the end of Stage 2 may look very different to that that is agreed in principle at Stage 1 or, perhaps more concerningly, it may remain more or less as it is.Assuming that the bill is passed at Stage 1 the crucial issue is whether enough time is allocated to enable major amendments proposed by both MSPs and the Scottish Government to be properly considered. That is why we produced our briefing to MSPs. MSPs will need at least six months and quite probably more if they are to create a NCS worth of the name and to allow for consultation and responses to the new proposals. If the Scottish Government try to force the NCS bill through more quickly than this the calls to scrap it and start again can only get louder.Given the time the NCS bill has taken so far, it would have been perfectly possible for the Scottish Government to withdraw it 18 months ago and then re-present an amended bill which incorporated changes prompted by the co-design process and the agreement with COSLA. That might have kept the various stakeholders onside rather than alienating them. Whatever else it turns out to be the NCS Bill has been a public relations disaster.Meantime, the crisis in care provision is deepening as a result of austerity. The Health and Social Care Partnerships for Scotland’s two largest cities have announced huge budgetary black holes, £86m in the case of Glasgow and £67m in the case of Edinburgh. Incredibly, a recent paper to the Edinburgh Integrated Joint Board, which oversees the HSCP, reported: “Equality and integrated impact assessment 27. There are no specific implications arising from this report; Quality of care 29. There are no specific implications arising from this report.”Unfortunately, the NCS bill, as drafted, will do nothing to change either those budgetary shortfalls or the callous management culture that is implementing these cuts. The sooner that responsibility for care provision returns to local authorities, where there is at least some financial transparency and an element of democratic accountability for services remains, the better. That should not absolve the Scottish Government from responsibility for funding care services properly.You can hear more about our briefing and the issues surrounding the NCS bill on the Common Weal podcast.