SUBMISSION TO SCOTTISH PARLIAMENT’S HEALTH, SOCIAL CARE AND SPORT COMMITTEE (STAGE 2 SCRUTINY)
30 September 2024
Introduction
Social Work Scotland is the professional body for social work leaders, working closely with our partners to shape policy and practice, and improve the quality and experience of social services. When a ‘National Care Service’ (NCS) was first proposed in 2021, we gave it a cautious welcome. Public sector reform is needed, and the development of a NCS represented an opportunity to put Scotland’s social work, social care and community health systems on a road out of their current crises. An opportunity for Scotland, ahead of any other part of the United Kingdom, to get to grips with the fiscal, demographic and governance challenges which are already seriously impacting the availability and quality of services across the country. An opportunity to decisively shift power and resources down towards the front-line, creating the conditions for more preventative, person-led, rights-enabling support.
Sadly that opportunity has receded. Circuitous political negotiations and staccato policy development have sapped stakeholders’ trust and energy and resulted in proposals for which there is little enthusiasm among stakeholders. Moreover, as the debate over the NCS has progressed Scotland’s fiscal situation has deteriorated. But significant and sustained investment in social work, social care and community health is an essential pre-requisite to reform, and the necessary condition for the changes that are needed. Without increased resources for existing and new, preventative services the current NCS proposals will amount to little more than an expensive and disruptive restructure. A restructuring which will absorb the time of leaders when their focus is needed more than ever on supporting their workforces, safeguarding existing provision and overseeing improvement.
Furthermore, the amendments proposed by Scottish Government do not address the core deficiencies of the original Bill. Rather than pushing power and control down to supported people, the current (June 2024) NCS Bill either pulls power up to Scottish Ministers or cements existing power dynamics between local authorities and the NHS. Instead of setting the fiscal foundations for a sustainable social care system over coming decades, the Bill creates more budget-sapping bureaucracy. On priority issues such as eligibility, the shift to prevention, or personalisation, the revised NCS Bill remains silent.
