Scotland's national care service expansion labelled 'attack on local communities'

A vision to expand Scotland’s new national care service further than first anticipated and take control of drug and alcohol services, children and young people and social work has been described as an attack on local communities.

The service is a flagship policy of the SNP that has wide support across Holyrood, but it was initially planned to only take control of adult social care.

However, a consultation document published by the Scottish Government details plans that could broaden the body’s responsibilities to include social work, children’s services, community justice and alcohol and drug services.

Drug-related deaths have risen across Scotland. Picture: Andy Buchanan

The 147-page document lays out government thinking on the care service – although none of the proposals are set in stone – asking for input from the public on the plans.

But Scottish Tories social care spokesman Craig Hoy expressed concerns at increased centralisation of social care, saying his party would strongly oppose any plans that threatened local services by “taking power away from local communities”.

Cosla president Councillor Alison Evison also accused the consultation of cutting “through the heart of governance in Scotland”.

“Councils know their communities and all the evidence suggests that local democratic decision making works,” Ms Evison said.

"Councils have shown time and time again during the last 18 months of the pandemic that we can deliver for the communities we serve when we are trusted and resourced to do so.

“It is deeply concerning that the consultation is also a considerable departure from the recommendations of the independent review set up to look at Adult Social Care.

“The lack of prior engagement with local government is not new – the partnership between the Scottish Government and local government, which we have been seeking to build, continues to elude us in practice and it is the communities we serve who are losing out.”

Social care minister Kevin Stewart said the Scottish Government hoped to create a “create a comprehensive community health and social care service that supports people of all ages”.

“I believe, however, that it is right for this consultation to look beyond simply the creation of a national service for adult social care,” he said.

“The ambition of this government is to go much further and to create a comprehensive community health and social care service that supports people of all ages.

“We are also committed to ensuring there is strong local accountability in the system.”

Local accountability, the government says, would be created in the new body by scrapping the current integration joint boards and replacing them with community health and social care boards, which would bring together elected representatives, people with lived experience and healthcare professionals.

Scotland is in the depths of a drug deaths crisis that has seen the highest death rate in Europe.

Figures released at the end of last month show 1,339 people died in 2020 – the highest figure on record in Scotland.

Now the Scottish Government proposes to take control of specialist drug treatment out of the hands of local partnerships and potentially make it the responsibility of the new service.

The document said: “We are also considering whether it would be more effective for the national care service to commission specialist provision, such as residential rehabilitation services, on a national level.”