National Care Service: SNP's Michelle Thomson 'no confidence' in cost plan

The total costs of the Bill over the five year period 2022-23 to 2026-27 are estimated at between £644 million and £1,261 million," said the memorandum.

However a Holyrood analysis of the SNP's flagship policy to integrate health and social care services,released earlier this month, said it could cost up to £1.3 billion to deliver over the next five years and warned the figure could "change considerably".

Ms Thomson claimed a lack of scrutiny over the planned expenditure amounted to the Scottish Government signing a "blank cheque for the public purse."

Addressing a government representative during a parliamentary finance committee meeting today she added: "If it was your money you wouldn't be risking it."

Health Secretary Humza Yousaf introduced the National Care Service (Scotland) Bill into Holyrood on 20 June this year with the purpose to improve the quality and consistency of social services in Scotland, better integrate these services into health care and end a "postcode lottery" in the care sector.

The memorandum acknowledged there were uncertainties including the range of services to be transferred to the NCS, the nature of the delivery model to be introduced, the phasing of introduction of the new model staffing requirements and the extent to which staff will transfer to new bodies.

Ms Thomson, MSP for Falkirk East, said: "How do we end up in the position where a financial memorandum does not even begin to cover the fundamentals and for us as a committee, speaking personally I can no confidence whatsoever, based on my experience mostly in business that the FM represents any level of accuracy and therefore value for money whatsoever.

"How did we get here?

"How are you going to mitigate for the risk of significant cost over-runs?

"We've got VAT, we've got pensions, we've got assets, we've got staff, we've got IT.

"What is screaming out to me [in the financial memorandum] are the huge risks.

"At the moment from a financial scrutiny I'm looking at a blank cheque for the public purse and I find that deeply worrying."

READ MORE: Warning issued over cost of £1.3 billion National Care Service 

Donna Bell, Director of Social Care and National Care Service Development, said there was "significant work" to be done to examine costs and said the risks "were very much at the front of our minds."

She said: "The costs that have been supplied are based on publicly available information. There are ranges set out...but it is true that there is more work to do.

"There will be clear business cases developed for the detail of the plans which will allow parliamentary scrutiny.

"We are very aware of public value and the cost to the public purse." She said the full business case would provide financial clarity.

Kenneth Gibson, SNP MSP and convenor of the finance and public administration committees, said the aim of the bill was to improve social care services.

But he added:  "It’s like [using] a sledgehammer to crack a nut.

"It just seems to me that there is a monumental risk to have a bill of this nature with all the financial implications because a few service providers are not up to scratch.”

In response Ms Bell said a "huge amount of research" had been carried out which concluded that centralising services was the best way to improve the consistency and quality of care.

READ MORE: Thousands 'fear for their jobs' in Scots national care revolution 

Liz Smith, the Scottish Conservatives Finance Spokesman asked the government representatives if they accepted the “excoriating criticism” from the convener.

Responding to Michelle Thomson’s comments, Scottish Liberal Democrat leader and health spokesperson Alex Cole-Hamilton said:  “Michelle Thomson and I agree on virtually nothing, but she is absolutely right to call out the lack of clarity over the costs of this bureaucratic ministerial take-over of social care."

Earlier in a separate parliamentary committee, Sir Harry Burns, Scotland's former Chief Medical Officer shared his concerns that the new National Care Service will be "too top down". 

He said: "Since I gave up being a surgeon, which was a great many years ago I have focussed on how we create wellbeing in our society.

"Operating on people in the East End of Glasgow made me very much aware that what they did not need was more surgery, what they needed was wellbeing.

"What worries me about this bill as it worries me about any bill that comes into the health service in Scotland is that it will be very top down and it will have targets and indicators to go along with it.

"There is question that the way in which you get effective change happening is to ask frontline staff what is needed, give them capacity to make decisions for themselves."

Professor John Glassby. Professor of Health and Social Care at the University of Birmingham, also warned that services are likely to get worse rather than better "in the short term."

He said: "If you manage it well it can take 18 months or two years after the change to get back to where you were before.
"So there is something about planning for the long term and a recognition that some things may get worse rather than better in the short term."

He said research on the integration of health and social care services had shown that medical services can dominate over social care and said there were "still questions" to be answered over the integration of some areas including children's services.