A Bits And Pieces Care Bill

Nick KempeLast week the Scottish Government announced it was dropping Part 1 but hoping to retain Parts II and III of the National Care Service Bill subject to the agreement of the Scottish Parliament. This change is even more drastic to what we recommended last October in our policy paper Tackling the Care Crisis after the Scottish Government had ignored our proposals for Fixing the National Care Service Bill published last summer.The Scottish Government’ list of proposed amendments show that it wants to delete in their entirety 35 of the 44 substantive clauses and four Schedules approved by the Scottish Parliament at Stage 1 of the Bill.Discarded along with the disastrous proposals to create a new centralised care system, are clauses on research, training, ethical commissioning, intervention with contractors, complaints, advocacy and the National Care Service Charter. In truth most of these proposals were window dressing and would have changed nothing; that is well illustrated by the Scottish Government’s statement that it can adopt the proposed NCS Charter anyway without legislation.The Minister responsible, Maree Todd, has persisted in describing the miscellany of measures that are left as delivering “a Scottish National Care Service”.The truth, however, as we explained in the Sunday Herald, is that the Scottish Government has managed to alienate most of stakeholders who wanted to see a real National Care Service in Scotland and at enormous expense.So where next?Maree Todd’s statement to the Scottish Parliament highlighted four areas which will remain in the draft bill without mentioning two others currently contained in Part III, procurement and regulation of care services. Presumably those too will remain as they are not included in the list of clauses to be deleted. What remains should rightfully be renamed as the “Care (Miscellaneous Provisions) (Scotland) Bill 2025 and is now open for amendments from MSPs until 12 noon on Wednesday 19th February.If the Scottish Government is trying to rush the remnants of the bill into law by Easter they will face serious difficulties in doing so. Assuming the Scottish Government’s deletions are accepted, what remains is unfit for purpose legislatively. This is because some of Parts II and III of the bill are not standalone but refer to Part 1 and various NCS structures which will no longer exist. Most notably Part II of the bill introduces arrangements for Information Sharing between the NHS and the National Care Service which was to be created in Part I of the Bill. If Part 1 is deleted, much of Part II becomes meaningless without further amendments.More, when the Scottish Government published the amendments it wished to make at Stage 2 last June, after it had "consulted" an “Expert Legislative Advisory Group”, these included a number of amendments to Part II and Part III of the bill. These included modifications to the Procurement Reform and Regulation of Care Acts. So far, the Scottish Government has not clarified whether it wishes to proceed with those amendments or not.The level of legislative incompetence all this demonstrates is breathtaking.While these issues should in theory be relatively easy to fix, there are other more substantial issues which still need to be addressed. Two of the areas remaining in the bill and highlighted by Maree Todd as being of crucial importance, Anne’s Law and a “right to unpaid breaks for carers”, concern rights. Unfortunately, in neither case does the bill as currently worded create any new rights that would address the problems relatives and unpaid carers face.Care Home Relatives Scotland has been calling on the Scottish Government for named carers to be given the same status as care workers in relation to care homes. Maree Todd has apparently still not agreed to that and instead claimed in her statement that “Core elements of Anne's Law are already in place”. That is highly misleading because, should a care home deny access to a relative, there is still no effective means of redress.As for respite, the bill as drafted introduces a complex suite of tweaks to existing carers legislation which are impossible for the ordinary person to understand. The likely consequence appears to be ever more complex and bureaucratic assessment procedures, without any enforceable rights being created. It is difficult to see how it will make any difference to the current situation where many full-time carers who desperately need a break are being completely ignored when they ask for help.The other two measures mentioned by Maree Todd were improvements to information sharing and reform which “future proofs’ social work. The latter appears to be a reference to the proposal to create a National Social Work Agency. This is not in the current bill but was going to be added to Part I which is now to be deleted! Another example of extraordinary incompetence!As for Information Sharing, Part II of bill still contains a provision for Scottish Ministers to make regulations criminalising health and care workers who fail to share information, a draconian measure, instead of addressing the underlying reasons why information sharing is so difficult. The source of the problem is that different organisations and parts of organisations procure and operate proprietary software provided by private companies that is designed not to communicate with other proprietary software except at great expense. This has made it impossible for staff to share information effectively and efficiently The solution, which the Care Reform hope to say more about in due course, is the creation of personal data stores operated by open source software which can then be shared according to an individual’s wishes.The controversy about the NCS Bill is far from over yet!