It could become, according to Nicola Sturgeon, one of Scotland’s greatest achievements.
Three years on, as MSPs prepare to vote on the National Care Service (NCS) for the first time, even supporters fear it risks becoming one of Scotland’s greatest white elephants.
The years since the then First Minister promised a revolution in social care in 2021 have been long ones for those of us - unions, councils, health boards and civil servants - discussing how the NCS might look and how it should work. They call it co-design, although other words are available.
We have spent years submerged in agendas, minutes, paperwork, and paraphernalia but if all the talk has gone anywhere, it has not gone very far.
There remains a dismaying lack of detail around some of the most basic functions of the proposed NCS.
It is, of course, intended to improve social care for those who need it and improve conditions for those delivering it but those straightforward ambitions have become bogged down in blether and the busywork of bureaucrats.
In the most interminable meetings, it is hard to believe any of this will ever benefit those who matter most; those in need and the care workers doing their very best for them despite poor pay and escalating pressure.
All this talk is not cheap, with £17 million spent by the end of last year and 160 civil servants reportedly now involved. That investment in effort, time and resource would be worthwhile if steady progress was being made, but it isn’t.
The NCS is an opportunity to do things better, to deliver care differently, and we have engaged constructively, trying to ensure plans are shaped by the expertise, experience and ambition of our members, the people actually, currently delivering care on the frontline of our communities and residential homes.
When four out of five of those members are considering quitting, however, we need far more than warm words, airy promises and more meetings. If MSPs back the NCS bill on Thursday, this legislation must include far more detail and have far firmer foundations before they are asked to vote on it again.
Improving standards in care will only be driven by improved pay and conditions for staff and the voice of workers must be clearly heard in this new service and their unions must have a full role on the governing Care Board.
Equally, sectoral bargaining must be more than an aspiration and the commissioning of services has to be rooted in the Scottish Government’s Fair Work guidelines.
The current Integrated Joint Boards delivering health and social care, meanwhile, need reform too since the notion of shared accountability between Cosla and the Scottish Government has become a shared enthusiasm for buck passing.
The National Care Service has been busy going nowhere and our engagement in the planning process is hanging by a thread. It is not a thick thread.
Louise Gilmour is GMB Scotland secretary
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