Warning that National Care Service Bill could create ‘tug of war’ for services

Care services could find themselves caught up in a “tug of war” between councils and the Scottish Government, with social workers hitting out at the “wrangling” between the two.

The Scottish Association of Social Work (SASW) issued the warning as it called on ministers to pursue reforms in other ways, rather than through legislation to establish a National Care Service.

The creation of such a service was seen as a flagship reform by the Scottish Government in the aftermath of the Covid pandemic.

But in a letter to MSPs on the Health, Social Care and Sport Committee who are considering the delayed and revised legislation, the SASW said that as it stands the National Care Service (Scotland) Bill could have “far-reaching consequences for local democracy” in Scotland.

A letter from SASW national director Alison Bavidge, together with SASW committee co-chairs Toyin Adenugba-Okpaje and Caroline McDonald, said that was because the legislation would give ministers “additional powers” over council spending.

They stated: “From the outside, it has increasingly felt like this Bill is being seen as a solution to the wrangling between national and local government, giving ministers additional powers to direct local government spending.

“Our members fear this could have far reaching consequences for local democracy.”

They added that if the legislation was introduced as currently set out “social work and social care will likely find itself at the centre of a tug of war” – adding that “neither our workforces nor the people we support can afford for this to happen”.

They insisted: “If ministers distrust local government to spend effectively on their citizens, the Scottish Government should grasp the nettle of local government reform in an open and transparent manner.”

Their comments came as the local government body Cosla said that changes the government proposes to the Bill would have the “cumulative effect of eroding local decision-making and role of local government within social services”.

The Scottish Association of Social Work and the local government body Cosla raised concerns about the National Care Service Bill with MSPs on Holyrood’s Health, Social Care and Sport Committee (Jane Barlow/PA). PA Media

Paul Kelly, the local government body’s health and social care spokesperson, insisted that the revised legislation from the Scottish Government did not “effectively represent a clear model of shared accountability”.

He also insisted there “remains insufficient evidence” for ministers to include children’s, justice social work and homelessness services within the remit of the new National Care Service board.

Mr Kelly went on to warn that such a “structural change” could run the “risk of distraction from improvement efforts currently under way in these areas”.

The councillor said there was “a strong appetite across Scotland for improvement in our social care, social work and community health system”, adding that the Bill had highlighted the “critical role” of care services in supporting people across the country.

However he said: “This has not yet translated into care being appropriately valued, as those accessing and working in care support face ever-increasing financial sustainability and workforce pressures.”

Meanwhile the SASW said that “rather than pursue this Bill as it is proposed” the Scottish Government should focus on those areas that “will have the greatest impact in improving social services”.

Here it was suggested ministers carry out a “complete overhaul of eligibility criteria and resourcing” for care services “to ensure people and their carers get the help they need when they need it”.

In addition, the SASW said that “delivering on the basics of reducing poverty and addressing the housing crisis” would help to reduce demand on public services.

A Scottish Government spokesperson said: “Those who work and use social care have clearly said the way the system is delivered needs fundamental transformation and sustainable change if it is to meet the needs of people and provide the high standard of care that people should rightfully expect.

“People who receive support through social care, their families and communities must be involved in planning and delivery at local level and it’s crucial we ensure those who use or work in the social care, social work and community healthcare services are at the heart of our reforms.

“We want shared accountability which ensures local government and the NHS retain their functions, assets and staff and the National Care Service Board will be where that shared accountability is realised and focused on improving outcomes for people.

“We remain committed to establishing a National Care Service that delivers clear, consistent national care standards before the end of this parliamentary term.”