EXPERTS have challenged a key justification for Nicola Sturgeon’s shake-up of the care system - that is needed to end a “postcode lottery” in standards. 

Jackie Irvine, chief executive of the Care Inspectorate, told MSPs that leadership and engaging with the people using services were more important than structures.

Claire Burns, director of the Centre for Excellence for Children’s Care and Protection, said there seemed to be a misleading assumption that structural change per se was beneficial.

The First Minister has described the National Care Service (NCS) as “arguably the most significant public service reform since the creation of the National Health Service” in 1948.

It is intended to “oversee local delivery of community health and social care, ensuring consistent and high standards and embedding the principles of fair work for care workers”. 

It is proving increasingly controversial, with councils calling it a power grab, Audit Scotland warning its costs are “significantly understated”, and experts querying its lack of detail.

However care minister Kevin Stewart this week rejected opposition calls to pause the plan.

When SNP health secretary Humza Yousaf launched the legislation to establish the NCS, he said: “We are going to end the postcode lottery of care in Scotland.

“Through the National Care Service we’re going to ensure everyone has access to consistently high-quality care and support so they can live a full life.”

But at Holyrood’s education committee, which is looking at child social work services being part of the NCS, that basic premise was called into doubt.

Ms Irvine said the Feeley report into care in Scotland, which was the springboard for the NCS, spoke about “having more consistent provision” to avoid a postcode lottery.

Asked by Tory MSP Stephen Kerr if that was possible without including children’s services in the National Care Service (Scotland) Bill, she replied: “If children’s services weren’t included you’d still have the impetus to do that for adult services and old people.

“Our inspection evidence shows us that, actually regardless of the structure, in some areas [where children’s services are integrated into health and social care] you’ll get good results and you’ll get some areas where there’s improvement needed.

“You also can go into areas where it’s not integrated into health and social care, children’s services, and you’ll see very good results. You see the same mixture on both sides.

“The important factors have been around leadership, around how people are using data, engaging with children and young people and families to think about what they need to design services that meet their needs.

“So there’s not one answer on either side, but it is around leadership, engaging, looking at what your third sector partners can provide.”

Ms Burns added: “The NCS has the potential to deal with some of the issues and challenges that we've got in children’s services, but at the moment we only know it has the potential to do that, because we don’t have the detail to be able to say.

“One of the things that concerns us, and certainly concerns the sector, is there seems to be an underlying assumption that structural change in and of itself will bring about those changes, and I think it won’t.”

She also said the Feeley report had stressed the importance of science-based evidence, and without that the desired changes in care quality wouldn’t happen.

She said leadership was "critical" and a key challenge facing services was helping families early before they hit a crisis.

More investment was required, she said.

Former SNP Health Secretary Alex Neil this week called the NCS plans “nonsensical” and called on the project to be scrapped.