LET’S say it as it is shall we: the Scottish Parliament’s committee system is not the best example of democratic independence and robustness, so it’s always good to see an SNP politician break ranks and tell the government what they really think. I’m referring to Michelle Thomson, MSP for Falkirk East.
Ms Thomson was speaking at a meeting this week of the finance committee where she expressed her concern about the financial planning for the Scottish Government’s new National Care Service. She was surprised at the lack of detail, she said, which amounted to the government writing a blank cheque for the public purse. “What is screaming out to me are the huge risks,” she said.
You can see where Ms Thomson is coming from. The Scottish Government says the costs of establishing its new service will be somewhere between £644m and £1,261m over five years. However, an independent analysis by Holyrood researchers puts it closer to £1.3bn (for starters). Ms Thomson’s point is that a lot of the factors that will affect the cost, such as IT and staff, don’t appear to be in the planning, not to mention the fact that our population is ageing faster and faster.
The other problem is one that affects a lot of the Scottish Government’s ambitions, particularly post-independence. What they’re proposing is an entirely new system, a massive bureaucratic overhaul, new procedures and so forth and the inherent risk with that is that money is spent on setting up new systems, new logos, new uniforms, and all the rest of it when it could be spent on frontline services – on helping people.
However, there’s an even bigger issue at play and it’s one that goes to the heart of the care service’s founding principles. What the health secretary Humza Yousaf and others tell us is the new service is required because there’s a so-called postcode lottery in care. They tell us it means some people in Scotland get a different service to others and the discrepancy needs fixed.
But does it really? I spoke to the former MSP Andy Wightman about this recently and typically he didn’t hold back. The idea of a postcode lottery, he said, was one of the most intellectually bereft slogans in politics. Imagine, he told me, if a Prime Minister said there was a postcode lottery across the UK and that services in Scotland should be same as the services in England. There would, quite rightly, be outrage.
So why should it be different across Scotland? Yes, there are differences in the services councils provide but “postcode lottery” is the wrong way to describe it. What’s actually happening is councils are reaching different decisions – one might charge for a particular service and another might not – and that’s fine. Not only are local councils better placed than central government to know what’s required locally, if we don’t like it we can vote them out. That’s how the system works and the last thing we need is a minister to come in and “fix” it.
Sir Harry Burns, the former Chief Medical Officer of Scotland, effectively said something similar to another Holyrood committee. The risk, said Sir Harry, is that the new care service will be top-down and target-driven and a better way to get effective services, he said, was to ask frontline staff what’s needed and give them capacity to make decisions for themselves.
This is pretty much the crux of the problem. Sir Harry says the people on the frontline should be making the decisions but under the new system the key decisions will be made by central government. What’s worse is there will also be systems in place to actively suppress local decision-making and divergence. Donna Bell, director of social care, admitted as much when she told the committee that one of the aims of the new service was to “improve consistency”.
However, the problem is that consistency is the wrong aim and “postcode lottery” is a mythical bad guy. Councils and their staff should have the power and flexibility to work out what’s best for them and the people they care for – that’s not a lottery, it’s local decision-making. And one last thing. Don’t you find it just a little bit galling that a government that rails against “centralisation” by Westminster should be doing exactly the same thing to councils?
Read more by Mark Smith:
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