Care service ‘fudge’?

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A planned new National Care Service could result in ‘a fudge’ with as many as three different sets of employers, council executives have claimed.

Argyll and Bute Council’s deputy leader, Conservative councillor Gary Mulvaney, expressed concerns about multiple employers during discussion at a recent meeting.

And the authority’s executive director Douglas Hendry admitted it was ‘a real possibility’ that there could be more than one employer, should proposals by the Scottish Government go ahead.

Council chief executive Pippa Milne also said the council had raised that issue in its draft response to a government consultation.

Currently, health and social care matters in Argyll and Bute are managed by the area’s health and social care partnership, which is managed by its integration joint board (IJB). Health services are provided by NHS Highland and social care services are provided by the council.

The council’s draft response to the consultation was unanimously approved by councillors.

Councillor Mulvaney said: ‘I don’t share the Scottish Government’s centralising agenda. We have seen it with the police and the fire brigade and we see the influence, or lack of it, that we have on service delivery in our communities. We have good relations with our local police inspector, but that is not the same.

‘Having said that, if this is something that is going to happen, we need to get something that is absolutely fit for purpose. By that I mean from an organisational point of view, in terms of delivering outcomes for our constituents, patients, carers and those who need the services we currently provide.

‘Is there any danger we will end up where we are just now, which is a halfway house, with two different organisations coming together? Could we end up with that sort of fudge instead of one employer, one service delivery and one set of outcomes that are pan-Scotland?

‘My real plea is that if we lose the argument on principle, and the government go ahead and do what they will, what impact can we have to ensure we don’t end up with a halfway house that doesn’t deliver for those who we represent?’

Mr Hendry responded: ‘The short answer is that there is no guarantee that the scenario Councillor Mulvaney fears is not going to be what happens.

‘The arrangements we currently have are a halfway house by the HSCP under the guidance of the IJB, but the employees remain under NHS Highland. It is not clear what the proposed final outcome would be if the proposals went forward.

‘So there is a real possibility that unless the Scottish Government were prepared to cut the ties with local authorities and health boards and put in whatever the new bodies are, it will be a fudge to an extent.’

Ms Milne added: ‘We have tried to bring out in the consultation response that at least some staff would be directly employed by the HSCP as a halfway house.

‘What we have highlighted is that it could go from two sets of employers to three, which adds to the complexity, so we have tried to address that point.’

A Scottish Government spokesperson said: ‘We are committed to delivering a National Care Service by the end of this parliament in order to end the postcode lottery in the provision of care services in Scotland.

‘The Independent Review of Adult Social Care found the current way of working have not fully delivered the improvements intended to be achieved by integration of health and social care.

‘We understand there is often a need for a different approach for people living in island and rural areas and the National Care Service will help ensure that is delivered.

‘A full range of impact assessments, including the Island Communities Impact Assessment and Fairer Scotland Duty Assessment will be carried out in line with our statutory duties and commitments.’