PLANS to overhaul care services for some of Scotland’s most vulnerable people will create “a state of flux” and leave current provision “truly unstable”, MSPs have heard.

Holyrood’s health committee was also told a proposed “charter of rights” for people in care was a mere “presentational device” repackaging rights people already had.

It was “unhelpfully vague and subjective” and had not been “scrutinised, examined, or explained” as existing legal concepts had been, one expert said.

The evidence coincided with a parallel hearing by Holyrood’s finance committee into the cost of the National Care Service (NCS), which Nicola Sturgeon has hailed as the biggest public service shake-up since the foundation of the NHS in 1948. 

The spending watchdog Audit Scotland said the Scottish Government had to be “much clearer” about the “price tag” for the NCS.

The Government has estimated the cost could rise to between £240m and £527m a year by 2026/27, but a large number of its components have not been costed.

An independent review of adult social care services in 2021 recommended reforming social care in Scotland and strengthening national accountability for social care support.

The National Care Service (Scotland) Bill seeks to consolidate social care services under a national body divided into regional boards in a set-up similar to the NHS.

Councils have branded it a power grab that will take care services out of local control and hand them to a less accountable centralised service.

MSPs were today alerted to concerns from figures in local authorities, primarily over uncertainties around future planning, as well concerns from legal experts.

Isla Davie KC, from the Faculty of Advocates, warned a lack of information on transition to the NCS in the legislation would result in “obvious difficulties” in the social care sector.

She said there would be “some difficulties” around issues such as staffing and improving outcomes due to there being “some big decisions to be made”.

She added: “In the interim, there’s not a great deal in the Bill about transition – perhaps for obvious reasons – because decisions haven’t been made, but it means that there will be a state of flux for a period of time.

“And I think there are going to be some obvious difficulties with that, where you have people working in the sector – some of whom will remain exactly the same people – but with different structures placed on top of that.”

Frank Jarvis of the Scottish Human Rights Commission said the “charter of rights” proposed by the Bill explicitly ruled out giving people any new rights.

“At present, the bill doesn't provide an indication of how delivery of the charter will be monitored, or what the consequences would be for care providers if it's not fulfilled.

“Section 11 make clear that the charter neither creates nor alters existing rights and responsibilities. 

“It's not clear how that would support accountability, and it rather suggests that the Charter is a presentational device of repackaging rights that care users already hold.”

He said there should be independent monitoring of how the charter was being delivered and redress where rights were not being realised. 

Language in the Bill about human rights was also “unfortunately and unhelpfully vague”, he said, as it didn’t reference well-understood international treaty standards. 

Eddie Fraser, chief executive of East Ayrshire Council, said social care services were “truly unstable” in the current circumstances.

He told the committee: “We have no certainty as local authority leaders on what services are going to look like in the next three to four years, and the current circumstances are truly unstable for social work, for social care, but also for the rest of the council.

“There seems to be a real lack of understanding about how intertwined different parts of the council are. How to deliver good social care – you need to be linked to housing – how our social work services and our education services work together. How our legal services, our HR services have, everything down to our transport services within a council.

“They are all interrelated in terms of doing that. So we have no certainty where we are going forward in this framework of the bill, in terms of planning for it.”

Councillor Paul Kelly, health and social care spokesman for the council umbrella body Cosla, said some of the issues about lack of detail in the plans were “very, very significant”.

He said: “We’re being asked to consider it without the proper details.

“We know how important the services are that we deliver at a local level, how important they are to our communities, so it’s critical that we get that detail correct.

“We still haven’t confirmed that the terms and conditions, we haven’t talked about pensions, etc. The worry that is creating among staff that I’m talking to on a regular basis is significant.”

 

Meanwhile, at the finance committee, Audit Scotland’s Mark Taylor told MSPs that lessons should be learned from the creation of other bodies, such as Social Security Scotland.

He said: “I think those same lessons need to be applied in this case. Government needs to be able to be much clearer, at a much earlier stage about its financial plans.”

Responding to a question from SNP MSP Michelle Thomson, he said the purpose of the National Care Service was to improve standards and consistency.

But he went on: “What’s not clear, and understandably so, is the price tag that will ultimately be associated with that. If that is to be levelling up – to use that politically loaded phrase – if it’s about areas where the quality and consistency of the service falls below a certain standard, does that have a price tag attached to it?

“What’s the price tag, what’s the cost associated with that service redesign? I understand at this stage of the process that it’s very difficult to get a sense of that, but that’s the hidden cost here.”

More clarity on this from the Government would be increasingly important, he said.

Written evidence from Audit Scotland said the Government’s costings were “likely to significantly understate” the range of costs from the Bill, partly due to using outdated assumptions about inflation in the coming years.

Emma Congreve, of the Fraser of Allander Institute, said her organisation had required additional information from the Government in order to produce their own analysis.

She said: “I think what comes across most is a large amount of money will need to be spent on the set-up of the National Care Service, which is what the Bill is about.

“And there’s a lot of uncertainty within that number, there’s a big range in terms of the recurring costs even once it’s been set up.”