National Care Service: Fife Council concerns over ‘ambiguity and lack or clarity’
Fife Council has raised serious question marks over the Scottish Government’s controversial plans to create a new National Care Service.
Local authorities were invited to submit their views as part of a wide-ranging consultation on the proposals, which could significantly change the way social care is delivered across the country.
But while Fife says there is a case for a new NCS that could drive national standards and performance, council chief executive Steve Grimmond insists much more work needs to be done given areas of “uncertainty, ambiguity and lack of clarity” about the plans moving forward.
In its formal response, the council is also highly critical of moves to reduce the role of local authorities, and the absence of any detail on additional funding or firm commitments on staff pay and conditions.
The SNP’s proposals for a National Care Service, which emerged on the back of an independent review recommending improvements to social care, cover adult social care services at a minimum, but its scope could encompass all age groups and a wider range of needs including children and young people, community justice, alcohol and drug services, and social work.
Existing Integration Joint Boards would also be reformed into Community Health and Social Care Boards (CHSCBs), which would be the local delivery vehicles for the proposed NCS, although - crucially - ministers would be accountable for the national service.
“We recognise and support the need for improvement,” Mr Grimmond acknowledged.
“We welcome the focus on a human-rights based approach and strengthened focus on prevention.
“We support provision which is tailored to the level of complexity and need and provides a ‘No Wrong Door’ approach to accessing care and support.
“We support the consideration of establishing a NCS which can drive national standards, assurance and performance.
“However, we do not support, in the absence of a detailed consideration and assessment of options, the transfer of a wide range of local government responsibilities from adult social work, through children and families and community justice as part of the NCS.
“Simply relocating functions alone seems unlikely to drive significant improvement and, further, it risks absorbing time, focus and resource which could be better invested.
“Transferring accountability to ministers and implementing structural change will not address the broad context within which social work and social care services operate.”
While noting that a range of issues with the current arrangements have been accurately identified as part of the consultation, Fife Council’s response underlines the fact these are largely a result of what it calls “chronic under-investment”.
“If the proposed entitlement-based model is developed and the associated investment in services is made, improvements can be delivered better, more quickly and more effectively within existing structures, retaining critical linkages with other local government services,” Mr Grimmond added.
If the National Care Service is taken forward, legislation would be needed next year ahead of suggested implementation in 2026.
However, many Fife councillors believe far more work needs to be done before then.
Council co-leader and Labour councillor David Ross called Fife’s response to the consultation “robust, balanced and well-argued”, but branded some of the ideas included “frankly scary”.
“The consultation document itself is pretty poor and it seems designed to support decisions that have perhaps already been made,” he added.
“It’s obvious to everyone that social care is in crisis and locally the health and social care partnership lacks the resilience to cope properly in the current circumstances.
“With the right funding, a lot of investments could be made now rather than waiting for a National Care Service to be set up.”
Mr Ross was also critical about the current ambiguity on what would happen to staff, suggesting that around 2,500 employees may have to transfer over to a central agency with no details on what it would mean for terms and conditions, pensions and VAT.
Liberal Democrat group leader Councillor TIm Brett urged the Scottish Government to consider Fife’s response carefully.
And he noted: “During times of restructuring, your senior staff are continually looking over their shoulder, wondering if they are going to have a job, asking ‘is it going to be here or is it going to be somewhere else?’
“So instead of focusing on the immediate crisis, the whole service goes into a state of flux while these decisions take place.”
Conservative councillor Tony Miklinski described the proposals as “pretty appalling” in their current state, adding: “To chronically under-fund social care then propose that ministerial control will fix that at a sweep is disrespectful and plain wrong.”
Council co-leader and SNP group leader Councillor David Alexander welcomed what he described as a “balanced” response to the consultation, but sought to address the funding criticisms.
“I’ve been a councillor a long time and 20 years ago we were talking about the demographic timebomb - that timebomb is here,” he stressed.
“COSLA’s report into this did mention that social care had received a 13% real term increase in funding but this increase has not been enough to keep pace with the increase in demand due to demographic pressures.
“We need a system that deals with that, and how we get there is the debate.”