The Scottish government is pushing ahead with plans to ‘centralise’ adult social care and a range of other services without proper evidence for the changes, the body representing Scotland’s councils has warned.

Leaders of the local government organisation COSLA say they had just a few hours’ notice that proposals for a National Care Service were going to go beyond the Feeley report recommendations on adult social care.

They say millions that could be used for frontline services will end up being spent on structural changes over the next five years.

The expanded National Care Service, which was put out to consultation last month, would take in children’s services, community justice, alcohol and drug services and social work elements of mental health services.  Ministers have promised legislation to introduce an NCS will be introduced by June 2022, with the new body up-and-running by 2026.

The Scottish government’s minister for social care has responded by saying the process is in its early stages and he will continue to work with councils to ensure improved and consistent standards of care are delivered across the country.

Local service delivery by the National Care Service will happen through new government-funded community health and social care boards, replacing integration joint boards that were introduced five years ago.

Local councils will still have representation on these boards but their role will 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.”

Councillor Gail Macgregor, COSLA’s Resources Spokesperson, said the 250,000 people working for Scotland’s councils are concerned about what the future holds for them, as questions about their future employers and terms and conditions have not been answered. 

“This affects staff morale. They are not understanding why the role they do every day, and do it incredibly well, is being challenged in this way and I think this is going to be another huge challenge.”

Councillor Macgregor says little consideration seems to have been given to upscaling ‘great local work’ that brings together different council services teams to provide prevention and early intervention programmes and identify children, women and families who need support.

“We will be making clear in our response,” said Councillor Macgregor, “that we will not achieve improved outcomes by spending millions on a structural reform when it could be better spent on investing in, and developing, our workforce to better carry out their roles and deliver a service for our service users that is really top-notch.

“In respect of funding, if I’m being very blunt, if we’d been sufficiently funded to-date and we hadn’t had the budget cuts that we’ve had over the past 10 years, we might be delivering the service they want us to be delivering.”

The COSLA leaders, speaking at a joint briefing, said local government wants to work constructively and collaboratively with the Scottish government, instead of ‘simply rushing for structural change’.

Councillor Evison admitted that she didn’t expect the Scottish government to halt the consultation but called for greater transparency:

“I think, at the moment, people think the national care consultation is about one thing but in fact the scope of it means that it is about an awful lot more.

“It is about how we do governance in Scotland. It is about the viability of local services. It is about that connection between care and housing and the environment and everything that makes up our local communities. It is about all of that but that is not made clear in the consultation.

“So, a key ask would be for greater transparency, openness, and a longer period of time for people to actually understand and respond to these key issues because, at the moment, the way that the consultation came out, that transparency is not there.

“That sense of what it’s all about is not there and it is really important that people across Scotland are able to respond appropriately and put forward their views on such big topics.”

COSLA Vice President, Councillor Graham Houston was concerned at Scottish government’s track record where it has created new national organisations - specifically Police Scotland - too quickly.

He also questioned the central principles of the National Care Service that are being proposed:

“We asked a former chief executive of the NHS to have a look at the National Care Service, and, guess what, he comes up with something that looks like a National Health Service. There’s a surprise. The consultation we have got, the questions actually say: here are the choices and if you come up with the right answers you get a National Care Service that looks a bit like the National Health Service.

“And the bureaucracy that surrounds the National Health Service we know is enormous, so we must avoid that.”

Responding to COSLA’s comments, Social Care Minister Kevin Stewart said the National Care Service will help improve the provision and consistency of care services across Scotland.

“This consultation is an opportunity for everyone to have a say in building a social care system that delivers what people need. 

“The recent independent review of social care made its recommendations earlier this year following extensive engagement with people who are actually in receipt of care services. We will deliver on these recommendations. We 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.

“We continue to welcome our ongoing engagement with local government on these matters and their participation in this consultation process. We will work with local government as we develop new ways to deliver improved and consistent standards of care across the country.

“We are still very early in the consultation process, and we look forward to considering all feedback when the consultation closes later this year.”

Read more: Details of National Care Service revealed; Top down’ care review plans branded ‘huge mistake’; Review member questions cost of care reforms

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