Alex Cole-Hamilton said plans for a “centralised ministerial takeover” of Scotland’s care services would remove accountability, and pledged to spearhead opposition to the plan to “prevent ministers whose disastrous decisions saw thousands of untested and Covid-positive patients discharged from hospitals and into care homes given permanent powers over the direction of social care services”.
Mr Cole-Hamilton, who leads a group of four MSPs in the Scottish Parliament, said he agreed with the concerns of the Convention of Scottish Local Authorities (Cosla) that the National Care Service was “an attack on localism” that could “spell the end for anything other than central control in Scotland”.
The introduction of a National Care Service (NCS) was pledged by both the SNP and Scottish Labour parties during the May Holyrood elections, with the Scottish Government launching a consultation on its plans in August.
The Scottish Government plan would see legislation introduced in the first year of the new parliamentary term, with the new service operational by 2026, backed by a 25 per cent increase in spending, and providing services “on a truly universal basis, free at the point of use”.
Nicola Sturgeon is expected to reveal plans for the NCS legislation in her Programme for Government in Holyrood on Tuesday – along with a new Referendum Bill and a draft Bill to alter the controversial Gender Reform Act.
Despite broad support for an NCS, Alex Cole-Hamilton accused the government of over-reaching as its consultation on the plan not only included adult social care services but children’s services, community justice, alcohol and drug services and social work elements of mental health services.
Council leaders have also warned that millions which could be used for frontline services will end up being spent on structural changes over the next five years should all services come under the NCS.
Mr Cole-Hamilton said he would rather see the introduction of new national entitlements to drive up the quality of care for users and new national fair work standards for staff to improve pay, conditions and career progression.
He said: “The Scottish Government’s proposals cut local accountability out of the process and give ministers the power to dictate how things must be done.
“As a liberal I want to give people more control over their care, and to make the organisations who delivery it accountable. I don’t believe that a minister in Edinburgh knows better than people who use these services day-in day-out.
“It was Scottish Government ministers whose disastrous decisions saw thousands of untested and Covid-positive patients discharged from hospitals and into care homes with tragic consequences, despite warnings from care homes themselves. Now ministers want those powers to be permanent, and they’re eyeing up control of social work and residential rehab too.
“Rather than taking local decision making out of the process and building a new organisation at the beck-and-call of ministers, we should be focusing on improving care in a way that will actually make a difference to people on the ground.
"That means national standards and entitlements for users, and by ensuring that the hard work of staff is recognised with a step change in pay and conditions.
“We have seen how previous SNP exercises in centralisation fair with the police and fire service. I will fight tooth and nail to ensure that local communities and service users control of care services, not arrogant SNP ministers.”
The Scottish Government has already revealed it provided £64.5 million to the integration authorities to deliver the Real Living Wage commitment – ensuring at least £9.50 per hour for social care staff delivering direct care, with remaining funds allowing providers to distribute uplifts across their wider workforce.
The Scottish Conservatives have also been wary of support, with its social care spokesman Craig Hoy also raising concerns about centralisation. “We will strongly oppose any SNP plan which threatens local services by taking power away from local communities or which increases centralisation and reduces accountability,” he has said.
The plans in the consultation would see local service delivery by the NCS through new government-funded community health and social care boards, replacing integration joint boards that were introduced five years ago. Councils would still have representation on these boards but their role would be dramatically reduced.
Cosla President, Alison Evison, says the ‘mammoth scale’ of the changes – which she said represent the biggest change since local government reorganisation in 1996 and the biggest reform of the public sector in decades – require a constructive and comprehensive joint discussion over much more than just the 12-week consultation period:
“This is a direct attack on localism. We are very concerned at the expanded scope of the National Care Service consultation, expanded beyond any evidence base about why it should be expanded.
“There is no evidence to suggest that centralisation of decision-making in this way would lead to the better outcomes that we all want.”
A Scottish Government spokesperson said: “We are committed to delivering a National Care Service by the end of this parliament in order to help improve the provision and consistency of care services across Scotland.
“Our consultation is an opportunity for everyone to have a say in building a social care system that delivers what people need. We will deliver on the recommendations of the recent independent review of adult social care and are determined to keep the voices of service users at the centre of our planning, as it is their needs we are seeking to meet.
“There will continue to be strong local accountability through the proposed Community Health and Social Care Boards. People with lived experience and local elected members will sit alongside professionals on these Boards so there will be a strong voice for the local population.”