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REPORTS of the death of the Scottish government’s National Care Service Bill are, as Mark Twain might have put it, an exaggeration.
The Scottish government announced on Thursday that it is pausing but not abandoning its Bill. It is the latest episode in what has become Holyrood’s longest-running farce.
The Bill is currently at stage two of its parliamentary progress. This involves consideration of the Bill by a parliamentary committee (in this case, the health, social care and sport committee).
This is accompanied by a “call for views” (consultation) by the committee about the government’s proposed amendments. Relevant organisations and individuals then submit comments and proposed amendments to the Bill. After all this, the committee decides whether it wants the Bill to proceed and, if so, what changes it wants to make.
On Thursday November 14 the Scottish government announced that it didn’t wish the committee to make its decision on the Bill, as the government wished to “fully reflect” on the views of the “committee, stakeholders, members of the public and political parties.”
This last brought forth the hollowest of chuckles from long-term watchers of this parliamentary farrago.
Part of the Scottish government’s response to criticisms of the Bill was the establishment of an expert legal advisory group (ELAG). This was set up following a recommendation of the health, social care and sport committee to provide guidance to the government in drawing up amendments. It consisted of 61 people, most representing organisations, including Unison and other trade unions.
There were seven meetings, each lasting only an hour. The group was not shown drafts of the Scottish government’s amendments before they were published, and so had no chance to comment, far less alter what the Scottish government had produced.
There were complaints afterwards that reports produced after meetings would include comments like “most people agreed” when, in fact, there were no votes taken, so the view of the ELAG as a whole could not be accurately discerned.
Despite its title, the National Care Service (Scotland) Bill was never aimed at setting up an NHS-style body to deliver care. Rather, the aim was for the national care service to be an organisation that does not deliver care itself but merely commissions and contracts.
The Bill, as originally published, couldn’t be called controversial, as that implies disagreement — and there wasn’t any. No-one liked it.
To get the Bill through its stage one vote, the Scottish government had to abandon whole swathes of its plan. There are no longer immediate plans to take all of social work and community health out of councils and (where necessary) the NHS.
However, the Scottish government has not abandoned that ambition — it has merely been forced to abandon the original planned mechanism.
A small but telling detail that has been provided is the intention that all services commissioned and procured by the national care service will be badged as “NCS services” — regardless of whether they are provided by local government, the NHS, voluntary or private-sector operators — thereby disguising any movement towards outsourcing or privatisation.
This is where the Bill being on life support, rather than dead, becomes crucial. There are elements of the Bill which attract no controversy whatsoever: a right to visitation in care homes (“Anne’s law”) and enhanced rights for unpaid carers. All of which have been extensively examined over the Bill’s more than two years’ “progress” and could easily and quickly be put through as stand-alone legislation.
It is these it seems the Scottish government hope to use as Trojan horses to pass less the acceptable parts of the legislation. This lifeline has been thrown to them by the Scottish Greens, who, at their recent conference, backed away from opposing the Bill full stop (a motion to that effect was ruled out of order). Instead, they point to elements they wish to see in a revised Bill.
Cynics (that is, everyone who has followed this saga) now expect a long delay before the Bill is presented for a vote and for it to contain much that remains toxic as well as those elements that the Greens support — thus giving SNP-coalition-friendly Green MSPs the perfect excuse to support selling public services because the alternative would be to fail to advance carers’ rights.
That the Scottish government has reached such a sorry pass with this Bill is a testament to the campaigning on this issue by a broad range of groups and bodies, although it would be unfair not to acknowledge the considerable incompetence of the Scottish government itself. Much has been achieved and further action can see this measure face its final curtain.