THE body representing Scotland’s councils has launched a scathing attack on SNP plans for a new National Care Service in what ministers say would be the biggest public sector reform since the birth of the NHS.
Cosla said a consultation launched by the Scottish Government represented an “attack on localism” that could spell “the end for anything other than central control in Scotland”.
The Government said its proposals would ensure everyone could expect the same standards of care, wherever they live in Scotland.
It said “at a minimum” the new National Care Service will cover adult social care services.
However, it revealed its scope could also be extended to other groups such as children and young people, community justice, alcohol and drug services, and social work, sparking an angry backlash from Cosla.
Earlier this year, an independent review prompted by the catastrophic impact of the coronavirus pandemic on care homes called for the creation of a National Care Service on “an equal footing with NHS Scotland”.
Councillor Alison Evison, Cosla’s president, said: “The consultation launched today cuts through the heart of governance in Scotland – not only does it have serious implications for local government – it is an attack on localism and on the rights of local people to make decisions democratically for their place.
“It once again brings a centralising approach to how decisions which should be taken locally are made.
“We welcomed large parts of the Independent Review of Adult Social Care and have been keen to get on and deliver, however the vision this consultation sets out goes beyond the [Derek] Feeley report.
“It isn’t evidence based and will take years to deliver – years when we should be making improvements which will benefit all users of social care services.”
She added: “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.
“Let’s be clear – this is not a “thinly veiled” attack on local government – there is no subtlety to it and, sadly for local communities, the ‘onion peel’ of local government services by this Government shows no sign of letting up.”
Ms Evison said Cosla will “engage constructively with the consultation process”, adding: “People may be surprised by the extent of services covered by this consultation and I would urge as many as possible to respond to it, as this could really be the end for anything other than central control in Scotland.”
The 137-page consultation sets out some of the options for delivering social care. None of the proposals are set in stone.
It says community health and social care boards, which would bring together elected representatives, people with lived experience and healthcare professionals, would be the “local delivery body” for the new service.
Among other proposals, the Scottish Government suggests taking control of specialist drug treatment out of the hands of local partnerships and making it the responsibility of the new service.
The consultation says: “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.
“The aim of this would be to increase accessibility of rehabilitation programmes and aid in developing good practice on referral pathways, and ensuring funding models are clear and deliver value for money.”
Launching the consultation, SNP social care minister Kevin Stewart said: “The importance of our social care services has never been clearer.
“We owe an enormous debt of gratitude to our nation’s carers, paid and unpaid, for the commitment and compassion we have seen throughout the pandemic.
“The Scottish Government commissioned the Independent Review of Adult Social Care during the pandemic, because it was clear we needed to do things better in future.
“We have already made significant improvements, with reforms such as the integration of health and social care, and implementation of the real living wage policy for adult social care workers and this year the Scottish Government pledged £64.5 million to fully fund the pay increase.
“But we can go further. What we are now proposing is the biggest public sector reform for decades, since the creation of the National Health Service.
“I am committed to implementing the recommendations of the independent review and staying true to the spirit of that report by building a system with human rights at the heart of it.
“The review recommended the creation of a National Care Service, with Scottish ministers being accountable for adult social care support.
“I believe however that it is right for this consultation to look beyond simply the creation of a national service for adult social care.
“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 a ensuring there is strong local accountability in the system.
“Absolutely vital to this is ensuring that our invaluable social care workforce feel happy, respected and fulfilled in their role.”
Insisting ministers are at the “beginning of a journey to improve social care in Scotland”, he added: “I want to hear from as many people and organisations as possible over the next couple of months, so we can build a better system together.”
Scottish Conservative social care spokesman Craig Hoy said: “We will look closely at the SNP’s proposals but remain firmly of the view that local delivery is key in social care and social work services.
“The Government’s plans go far further than the Feeley review’s recommendations.
“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.”
Alex Cole-Hamilton, the Scottish Lib Dem health spokesman, also raised questions about local accountability, adding: “Rather than building a new organisation at the beck-and-call of ministers, we should be focusing on improving care with 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.”