The Scottish Government has published its proposals for a National Care Service. The three-month
consultation period ends on 18 October 2021.
The aim is for primary legislation to be in place by summer 2023 and for the National Care Service to be up
and running by the end of the parliamentary term in 2026.
The National Care Service proposal is based on the recommendations of the Independent Review of Adult
Social Care (the ‘Feeley Review’). This was established in response to the crisis in care homes and the scale
of Covid-19 related deaths amongst residents.
However the proposals go far beyond the Feeley Review. The National Care Service will be a
comprehensive health and social care service for all ages, from infants to the elderly. Its remit includes not
only adult residential and home care services, but:
- ALL adult AND children’s social work and social care, including;
- alcohol and drug services and mental health services;
- community justice services and prison social care;
- ALL community health services including general practice (GPs).
The proposals are far reaching and complex and will affect UNISON members across several different
service groups and sectors.
Potential future NHS Review
The Scottish Government has said that reforms to the NHS may be considered once the outcomes of the
National Care Service consultation are known. This could include any necessary changes “in structure,
integration and alignment for and with the NHS.”
The Scottish Parliament was previously told that the formula used to allocate funding to health boards
would need to be reviewed in the run up to the creation of a National Care Service.
UNISON policy on Care after Covid
UNISON will submit a comprehensive response to the consultation. However, our views on a National Care
Service are already clearly set out in our publication Care After Covid.
We said our aspiration over time is to deliver most social care on a publicly funded not-for-profit basis,
bringing social care up to equivalent levels of equity and access as those associated with the NHS.
In moving towards this the interim steps must include:
- a timetable for the introduction of a Social Care Sectoral Bargaining arrangement that covers wage
rates and terms and conditions across the sector, starting with the consolidation of the Scottish
Living Wage but developing a timescale for raising pay levels to the equivalent of health and local
government over an agreed period of time.
- A national workforce plan for social care, based on the principles of Fair Work and including a
strategy for immediate training and professional development.
- Substantial extra investment in social care as a matter of urgency, including funding for councils to
begin to rebuild in-house capacity. Social care is not a cost but an important economic sector.
- A reformed model of commissioning and procurement that ensures care is only purchased from
providers who are transparent about their operations, pay their taxes, recognise trade unions, and
demonstrate compliance with workforce requirements. The level of profits that can be extracted
from contracts should be capped.
Our views are predicated on existing policy in favour of stronger local democracy in the delivery of public
services. We have consistently argued for greater powers and resources for local government and for the
insourcing of social care to be part of community wealth building strategies across Scotland