The National Care Service (Scotland) Bill (NCS) has made unsteady progress through its first Parliamentary stage,since its introduction in June 2022. More than 18 months on, stage 1 scrutiny is on the verge of completion, with a debate in the Scottish Parliament on 29 February. Much of this progress has been covered in SPICe blogs in a hub for NCS material
This blog provides a brief look back at some of the issues that caused concern at the start of the Bill’s passage through Parliament, presents a timeline of key events and documents up to the present, as well as outlining some of the key changes to the Government’s proposals over time which have led to revisions to the stage 1 deadline and ultimately a Committee report that not all members could sign up to.
A range of views and concerns from the outset
When the Bill was introduced, there was immediate objection from COSLA, in part, because of the proposal to move accountability for social care to the Scottish Government, while statutory duties remained with local authorities. There were also concerns that the proposals could impact a large number of local authority staff, assets and funding.
The Scottish Parliament’s consultation process also received submissions expressing concerns about various aspects of the Bill, including:
- its framework nature and lack of detail, which made it difficult to comment on and understand
- scepticism that the Bill’s provisions would be sufficient to provide the reforms required to improve quality and consistency in social care
- concern about major structural change, given the fragile nature of social care with serious staffing issues including recruitment, pay and conditions as well as the sustainability of services
- that the Bill would not address the long-standing problems in social care
- concern that the underlying mechanisms and commissioning and procurement for social care delivery would not change
- that the Bill proposals could not guarantee that human rights would be fully respected or enshrined
- that the full costs of implementation would extend beyond the costs provided in the Financial Memorandum, and that there was a lack of detail on the potential costs
- that it was unclear what co-design means and what it would entail – whether it was about structures or service redesign
- how the legislation would impact the integration of health and social care.
Those who supported the Bill anticipated that the Bill would achieve its aims to improve quality and consistency in social services, and therefore social care and support delivery. According to supporters of the Bill, this would be achieved through accountability and duties moving to the Scottish Ministers through the establishment of care boards, which would be accountable to Scottish Ministers.
The table below shows some key dates and documents relating to the Bill’s context and journey so far
Date | Activity or publication |
2019 | |
2019-20 (impact of COVID-19) | Social Care Inquiry, Health and Sport Committee |
3 February 2021 | |
7 September 2021 | Programme for Government announcement to bring forward legislation |
10 February 2022 | |
20 June 2022 | |
8 July – 2 September | |
3 November | |
Autumn/Winter 2022-23 | |
17 March 2023 | Initial Stage 1 deadline |
30 June 2023 | Second Stage 1 deadline |
31 January 2024 | Third Stage 1 deadline |
May and October 2023 | |
22 February 2024 | |
Stage 1 debate | 29 February 2024 |
Current Stage 1 deadline | 1 March 2024 |
Timetable and proposed changes to the Bill
The date for the completion of Stage one proceedings has been put back several times. The original date for completion of stage 1 was 17 March 2023. Early in 2023 the Health, Social Care and Sport Committee received correspondence from a number of stakeholders calling for a pause to the Bill. Scrutiny by the lead committee (the Health, Social Care and Sport Committee) and other committees carried out through the autumn and winter of 2022 also highlighted concerns with the Bill.
The Scottish Government requested that the Stage 1 deadline be deferred. On 8 March 2023 the Parliament agreed to an extension to Stage 1 to 30 June 2023. On 7 June 2023 the Parliament agreed to a further delay to the Stage 1 deadline, agreeing that Stage 1 be completed by 31 January 2024. The final, current date (1 March 2024) for completion of Stage 1 was agreed to by the Parliament on 17 January 2024.
Over the summer of 2023, co-design work on aspects of the Bill were undertaken along with talks between the Scottish Government, unions and COSLA. The Minister wrote to the Committee on 12 July 2023 detailing these developments. These included reference to:
“a partnership approach that will provide for shared legal accountability…a new structure of national oversight (a national care service board) …would provide Scottish Ministers, local authorities and NHS boards with overarching shared accountability for the care system. Local Government will retain functions, staff and assets.”
Scottish Government
Scrutiny of the Financial Memorandum
The Finance and Public Administration Committee published their report on the Financial Memorandum on 1 December 2022, but took further evidence in January 2024. Given the Committee’s concerns, they requested a revised FM prior to the completion of the original date for Stage 1 completion (17 March 2023). In a letter written by the Finance and Public Administration Committee to the Minister on 8 February 2024, concerns were still expressed, while revised costings were welcomed. It was also acknowledged that implementation of the Bill is being rephased over a longer period.
“Given the ongoing co-design and continued uncertainty regarding the final policy detail relating to the Bill, although the variance in costs has reduced considerably, we are not confident that the figures presented in the updated FM and the accompanying shared accountability paper are an accurate reflection of the final costs of the Bill.”
Finance and Public Administration Committee
Impact of proposed changes
Stakeholders argued that this shift to a partnership approach would require substantial amendments to the Bill at Stage 2 and rendered the Bill in its current form difficult to understand.
Some stakeholders expressed dismay at the change in accountability arrangements, believing that their hopes for better consistency and clearer accountability and escalation processes would be reduced, or remain unchanged from their current experience.
The Health, Social Care and Sport Committee undertook more evidence gathering during October 2023 and then wrote to the Minister in November 2023 stating that it did not have sufficient information about the implications of the shift to shared accountability. To enable the Committee to recommence consideration of its Stage 1 report the Committee requested information and detail on the purpose and effect of the amendments the Government intended to bring forward at Stage 2 on many parts and sections of the Bill.
The Minister responded on 6 December 2023 referring the Committee back to the Policy Memorandum before answering the questions in some detail. However, many of the responses remained general in nature, acknowledging that amendment would be required.
It had been agreed that a National Care Service Board would need to be established to manage and oversee the new shared accountability arrangements, which does not appear in the Bill as introduced.
There is also reference to amendments that would be made to the Public Bodies (Joint working) (Scotland) Act 2014.
The Stage 1 report was published on 22 February 2024. On a number of issues, and recommendations, the Committee was not in unison. There was dissent from the Recommendations on the general principles of the Bill from both Conservative and Labour members on the Committee and there were a series of divisions on proposed amendments to these recommendations. Annex B to the report details these.
A Motion was lodged by Jackie Baillie on Tuesday 27 February, “That the Parliament agrees that the National Care Service (Scotland) Bill be referred back to the Health, Social Care and Sport Committee for a further report on the general principles of the Bill”.
This was supported by the two Labour members on the lead committee (Carol Mochan and Paul Sweeney), as well as another Labour member, Martin Whitfield and Liberal Democrat member, Alex Cole-Hamilton. It will be debated in the Chamber on 28 February 2024.
Anne Jepson, SPICe Research