Community Care Committee
7 November 2001
CONVENER opened the meeting at 09:35]
(Mrs Margaret Smith): Good morning, everybody. Welcome
to this morning's Health and Community Care Committee.
I begin, surprisingly,
with item 1, which is to ask whether the committee is prepared
to take the draft budget response in private. Is that acceptable
Members were asked whether they wished to have the affirmative
instruments debated. No comments have been lodged to that effect,
so I suggest that we do not formally debate them this morning.
Is that acceptable?
Care and Health (Scotland) Bill: Stage 1
We have with us representatives of Community Care Providers Scotland.
Good morning and welcome. Would you like to introduce yourselves
and make a short statement? My colleagues and I will then ask
(Community Care Providers Scotland): Thank you. It is
a pleasure to be here.
Community Care Providers
Scotland is the association for voluntary sector care providers.
I am the co-ordinator of CCPS and my colleagues are members of
the management committee. On my right is Shona Barcus, the chief
executive of the Scottish Association for Mental Health, and on
my left is Jim Jackson, the chief executive of Alzheimer ScotlandAction
I do not want to make
a lengthy statement, because we have already given you written
comments, but I will say something about who we are. Shona Barcus,
as well as being on the CCPS management committee, is a member
of Disability Agenda Scotland, which has also submitted written
evidence to the committee. Jim Jackson was a member of the care
development group. Although we are here on behalf of CCPS, you
are in some ways getting three for the price of one. If we can
help you with other areas, we would be happy to do so.
In your written submission you say that you think that a set of
general principles should be outlined in the bill, which is not
the case at present. Will you expand on that and tell us whether
you generally welcome the bill and think that it will improve
equity and fairness in the community care services?
We broadly welcome the bill. When we were last before the committee,
we talked about the Regulation of Care (Scotland) Bill, which
we were keen should outline a set of principles. In fact, we wrote
a draft set to put before the committee.
The Community Care
and Health (Scotland) Bill is slightly less straightforward. It
is a composite of different policy strands, whereas the Regulation
of Care (Scotland) Bill was about one clear area. However, two
principles come out quite strongly in the Community Care and Health
(Scotland) Bill. One is about the enhancement of rights of users
and carers through free personal care, direct payments and carers
assessments, and the other, in part 2, is about joint working.
We would be happy to see a set of principles in the bill. We thought
that the Parliament set a good example by
expressing in clear
terms in the Regulation of Care (Scotland) Bill what that bill
was all about.
We have some comments
about the principle of equity in particular. The majority of CCPS
members provide care not for elderly people, but for younger disabled
adults. We are concerned that the discussion about equity has
focused on income versus diagnosis, whereas the issue for some
of our members is age. Nothing in the bill excludes younger disabled
adults from the entitlement to free personal care, but we believe
that that will be a matter for regulation.
Hughes (Glasgow Rutherglen) (Lab): How did you consult
your member organisations and gather their views on the bill?
We held a consultation meeting. We had three or four weeks' notice
and we invited all our members to the meeting as well as the network
of local provider forums with which we are beginning to link in.
The local provider forums include some of the smaller agencies.
The membership of CCPS predominantly consists of the large, national
organisations. We have set up a system to link up with local provider
forums in Edinburgh, Glasgow, Grampian, Highland and Moray. We
sent our draft comments to them and, with all our members, they
were invited to the meeting. Some of them sent me e-mails. We
got round to almost all our members.
Do you think that the Executive has provided an adequate
opportunity for you to consult and take on board the views of
the people whom you represent?
Gunner: So far, yes. However, if significant issues are
to be taken forward in regulations rather than in the bill, we
want a further duty to be placed on the Executive to consult on
regulations. I am thinking of the definition of free personal
carewhat will and will not be chargeable. Another issue
relates to age limits, as I mentioned. It is not that important
to us whether those issues are addressed in the bill or in regulations,
but if it is going to be the latter, there needs to be something
in the bill confirming a requirement to consult. That was a slightly
tortuous way of putting it.
You said that you welcomed the notice that you were given
before coming before the committee, as that allowed you to consult
your members. However, the care development group's final report,
"Fair Care for Older People", was published on 14 September
and the bill was introduced on 25 September. Was that timing appropriate
given that it limited the period for consideration?
Gunner: The period was relatively short, but the different
elements in the bill had already been the subject of consultation.
The joint working
and direct payment
elements were included in the document "Better Care for all
our futures", which had been out for some time. The care
development group did a lot of consulting over the summer. Nothing
in the bill was a huge surprise; it contained nothing about which
we had not already had some opportunity to make our views known.
However, I agree that the time between the publication of the
report and the introduction of the bill was rather short.
Mr John McAllion
(Dundee East) (Lab): Good morning. In your initial comments
and in your submission, you raised the issue of age. You said
that the majority of the organisations that you represent deal
with younger disabled adults and that, although the bill does
not specifically exclude them from free personal care, it does
not specifically include them. Has CCPS assessed how many younger
disabled adults pay for personal care in Scotland? How can the
Executive best address that issue in the bill?
Gunner: We have not done that work, but we think that
(Community Care Providers Scotland): As a member of the
care development group, I should point out that our task was to
collect the background figures to find out whether free personal
care was affordable. We believe that a similar exercise needs
to be carried out in respect of younger people. We do not know
how large the problem is. In some cases, younger people can access
In terms of equity,
it seems wrong that someone aged 64 with dementia would not be
eligible for free personal care, whereas a person aged 65 would
be. That would apply to other disabilities and illness. We would
therefore like the Executive to put together a group that would
investigate the needs of the under-65s and the numbers involved
and calculate the cost of introducing free personal care for that
Let me be clear about this. You seem to be suggesting
that the work of the care development group was to establish whether
free personal care for the elderly was affordable. You say that
the group has done that, or thinks that it has, but that it has
not done any work on whether younger disabled people should have
access to free personal care.
The terms of reference of the care development group
were for people aged over 65.
Is it the case that we simply do not know whether we
can afford free personal care for younger disabled adults within
the Scottish Executive's budget?
That would be my answer, yes.
You have said several times this morning that you believe
that there should be a duty to consult on the regulations that
will define who gets access to free personal care and who is charged
for care. Those regulations are already subject to parliamentary
scrutiny. Are you suggesting that, over and above that parliamentary
scrutiny, there should be a duty on ministers to consult organisations
such as yours?
We believe that there should be a duty to consult before
parliamentary scrutiny so that, by the time the Parliament is
asked to scrutinise, information on what is generally felt about
the proposed regulations will be available to members.
So even before the regulations are introduced, you want
ministers to have a duty to consult relevant organisations.
That is what we would like. If my memory is correct,
the Regulation of Care (Scotland) Act 2001 contains various requirements
for the Executive to consult. We think that a similar provision
should be introduced into this bill.
Is it your impression that young disabled adults will
be given access to free personal care through the regulations?
Do you think that that is the Executive's intention?
Our impression is that young disabled adults will not
be given access to free personal care. That seems to be what the
policy memorandum says. The policy memorandum refers to older
people's services pretty much all the way through.
Do you suspect that that is on the ground of cost?
I do not know what it is on the ground of, because it
is not even discussed.
Let us hold on to that question for another half hour.
We shall ask the minister.
(North-East Scotland) (SNP): You have given a fairly
detailed account of the definition. I think that you are saying
that you would be happy for the definition of personal care either
to be in the bill or in regulations, but only if there is consultation
on those regulations prior to parliamentary scrutiny. Is that
Scanlon (Highlands and Islands) (Con): You acknowledge
the extension and expansion of direct payments and we note that
you have set up a working group to examine that in more detail.
What are the remit, membership and time scale of that working
The group is an internal one set up by CCPS and composed
of CCPS membersorganisations that are care providers.
When are you likely to report your findings?
Probably in January or February. We are about halfway
through our deliberations.
The bill will probably be completely through Parliament
by then, so your report will be of little use to us, even though
you represent so many organisations. As you told Janis Hughes,
you have had plenty of time to consult. Is not it possible for
you to represent your organisations and advise us?
We can probably give you some kind of interim report.
The working group is a purely internal exercise. We have been
concerned that providers have not been considered in the context
of direct payments and we feel that the way in which direct payments
operate has significant implications for care providers. The group
is something that we have set up, resourced and decided to do
completely by ourselves, which puts certain restrictions on how
soon we can report.
Given that very few people in Scotland have taken up
direct paymentsI think that it is 129 in totalI would
not have thought that the exercise was huge. In the Highlands,
only three people have taken up direct payments. What is your
response to direct payments for those recovering from drug and
alcohol addiction, for those fleeing domestic abuse and for all
others who may benefit? Will direct payments address choice? You
have said quite a bit about the voluntary and independent sector.
Will direct payments increase the uptake of the service providers
that you represent? Do you have any concerns about section 7 of
the bill, which amends the Social Work (Scotland) Act 1968?
We broadly support direct payments, because choice and control
for service users is fundamental. At the same time, we cannot
ignore the fact that there will be implications for service providers,
which we must examine. The route that we are taking is to consider
how providers can adapt to accommodate service users who want
to use direct payments. As few people use direct payments at the
moment, we have little experience of service users directly purchasing
services from us.
That is the nature
of the group. We will consider how to adapt our processes for
the possibility of dealing with hundreds of individual purchasers
rather than one block purchasera local authority. Our systems
will have to change considerably to cope with that. We want to
payments, but we must
be ready for them.
I have forgotten the
end of your question about section 7.
Section 7 is all about direct payments. Given that direct
payments are likely to increase choice and uptake for the people
whom you represent, I hoped for better feedback, which would allow
the committee to pursue the issue.
I hope to draft a report for the working group by the
beginning of December, so we could let the committee have the
draft as soon as it is ready. We had not planned to publish that
report, simply because of logistics and resourcing, but we can
certainly help the committee if it would find a draft report helpful.
More generally, what have been the obstacles to individuals
taking up direct payments? Why have people not used them in great
My understanding is that many people do not know that
direct payments are available. Local authorities have discretion
about whether to establish a scheme. If they do not establish
one, there is no way in which a service user will know that direct
payments are an option.
The bill will entitle
individuals to ask for direct payments, which will make a big
difference. Service providers must ensure that they are ready
for that, especially as most people currently use direct payments
to employ personal assistants. It is almost unheard of for people
to use direct payments to purchase services from an agencyit
is certainly very rare.
The bill will also
allow service users to purchase services directly from local authorities,
which so far they had been prevented from doing. In CCPS's experience,
several organisations support individuals in their use of direct
payments and their employment of personal assistants, but not
many organisations sell services to individuals. If the scheme
expands, as the bill enables it to, that might raise an issue,
as we would move into uncharted territory. We are taking the initiative
to prepare ourselves for the situation.
You say that your organisation represents people and
encourages them to take up direct payments. I have been closely
involved with one of the three people in the Highlands who receive
direct payments. Her application was rejected twice because it
had a spelling error, and she was asked to take on the responsibility
of being an employer. I hoped that, rather than considering only
the providers, CCPS would make the case for increasing direct
payments, which can only come from carers. I hoped for advice
on that. If carers cannot take up direct payments, there is no
point in your examining better provision.
I cannot disagree with that.
I think that you are dealing with what you consider your
end of the bargain and looking ahead to ensure that services are
available. As you said, that will include ensuring that people
have information about what is available from your organisations.
Is that correct?
Yes. The committee might want to get in touch with the
people involved in a new project called direct payments Scotland,
which was established with a Scottish Executive grant. The remit
of that project is to increase the take-up of direct payments.
I do not know whether the committee has taken evidence from those
involved. If not, I would be happy to give you a contact address.
The project was established explicitly to promote direct payments
to individuals and local authorities. It might be useful for the
committee to speak to that group.
The clerk will talk to you about that after the meeting.
(Kilmarnock and Loudoun) (Lab): I will follow on from
that point with a question on promoting choice for individuals.
We have discussed one area this morning, but what is your group's
view on the inclusion in the bill of the deferred payment scheme
and the opportunity to top up residential accommodation costs?
I am not sure that either of those issues was perceived to be
massive ones during our consultation.
Most of our members are not providers of residential
and nursing home care. Our interest lies in working with people
who may leave our services in order to enter such forms of care.
I understand that the bill acknowledges what is happening already.
Many families top up the cost of care; in some cases, the resources
of the person in residential or nursing care are also used. There
is some ambiguity about whether that is legal and we think that
the tidying-up measure in the bill is a sensible step forward.
Is it appropriate for the Executive to provide the various
schemes on promoting choice for the individual? Is your organisation
in a position to assist someone who has to make that choice?
There is a need for advocacy and brokerage schemes. An
implication of the expansion of the direct payment service is
that some groups of people, such as those who have learning difficulties
or dementia, will be able to benefit from direct payments only
if their carer can act on their behalf or if a broker or an organisation
can assist them to purchase the service that they require. That
is part of the challenge for
organisations in the
voluntary sector, not only because they are service providers
but because they will have to create new services to act as brokers
to support people who wish to benefit from direct payments. I
know that some organisations are keen to take up that challenge.
You are here as an umbrella group of service providers
but, wearing both your individual hat and your collective hat,
you have a lot of experience of dealing with users and their carers.
The bill provides for an independent right for carers to request
an assessment for services, irrespective of whether the person
for whom they care is being assessed. Does the bill adequately
provide for the needs of carers? An idea that came out of the
carers legislation working group was that there should be a duty
on statutory organisations to identify and deal with carers. Would
that be a useful addition to the bill or does the bill adequately
cover the needs of carers as it stands?
When we held our consultation meeting, we focused narrowly
on the care providers' perspective on the bill; strictly speaking,
the issue of assessing carers' needs did not fall within that
On a general policy
note, I know that in previous evidence-taking sessions there has
been some discussion of the usefulness, if you like, of a right
to an assessment if there is no right to receive services as a
result of that assessment. Mr McAllion has been particularly interested
in that point and we share his confusion over it. Service users
are in the same position.
On the provisions that relate to joint working, you express
your disappointment at the lack of recognition and involvement
of the voluntary sector at a strategic level. Can you outline
in what further ways you would like to be involved at that level?
Our experience of joint working is that we were brought in at
the end of the process. So far, we have experience of involvement
in specific projects, such as hospital closures or reprovisioning
projects. The voluntary sector tends to be brought in once all
the decisions have been made and all the resource allocations
have been decided. At that point, voluntary organisations are
encouraged to compete with one another to provide the services.
The nature of voluntary
organisation is to be service providers, but that is only one
part of our activity. We also have something to offer at the strategic
level, so we would be interested in considering the levels of
need in a particular community. Voluntary organisations often
focus on, for example, people with learning disabilities, mental
health problems or dementia. When an
organisation is brought
in at the end of a process to be a care provider, its expertise
and experience of the needs of a group are sidelined.
Our fear is that the
bill, as we understand it, will not be about joint working on
specific projects but about joint working across the board as
a matter of course. We are concerned that care providers in the
voluntary sector will be looked on as nothing but care providers
and the range of our other activities will not be harnessed. That
would be a missed opportunity for local authorities and health
boards that might find us useful. The issue is as simple as that.
Your submission suggests that the bill be amended to
include a requirement to involve voluntary sector providers. CCPS
was involved at the strategic level in the Regulation of Care
(Scotland) Bill. When I spoke in the chamber in support of your
amendment, which had been lodged by Dr Richard Simpson, I was
told that it had been withdrawn. When you lodge an amendment and
want to be involved at that level, do you not think it courteous
to tell MSPs that you have withdrawn an amendment before we stand
up to support you in the chamber?
I agree. We had a long conversation after the event and we apologised
unreservedly for that. At this stage, we just want to discuss
the idea of an amendment rather than write one and have it lodged.
In England and Wales,
the care trust mechanism has been set upif organisations
want to work jointly, they have to follow that route. In Scotland,
decisions on joint working are left much more to individual and
local discretion. Organisations need to work jointly, but it is
up to them to work out the mechanisms. At the national level,
it would be difficult for the bill to insist that the voluntary
sector be involved strategically because, presumably, each local
arrangement is going to be different.
We wanted to float
the idea that the voluntary sector should be involved in local
partnership arrangements. However, I am not a bill draftsman so
I do not know whether that can be doneit is just an idea.
The danger is that, if we do allow for that, the voluntary sector
will be sidelined once again. Voluntary organisations believe
that they have a lot to offer at the strategic level of decision
Mr Jackson, I want to return to the answer that you gave
the convener about the opportunity to top up residential accommodation
costs. You said that most families already do that and that the
bill is simply tidying up that reality. My understanding of the
provision in the bill about top-up costs is that it allows people
to pay for extras
over and above the
basic care package in any residential accommodation. Is not it
a reality that many families have been asked to top up costs because
of inconsistencies between local authorities in financing places
in residential accommodation?
There is an example
in my area, where an elderly person was placed in a home just
over the boundary from the local authority where she was resident.
The charges agreed by the other local authority were higher than
the ones that Dundee was prepared to pay and so the top up had
to be paid by the family. Is not that an abuse of the opportunity
to top up residential accommodation costs? Should not there be
one charge for the basic care package throughout Scotland?
One charge would be attractive if there were sufficient funding
to pay whatever the local charge is for residential and nursing
home care. However, in practice, local authorities have made individual
decisions about how much they are prepared to pay for publicly
It is my understanding
that in exercising choice, a significant number of families will
say that they would prefer their relatives to go into a home that
is either near the family or near their friends and relations.
That means that the nearest home might charge at a higher rate
than the local authority is prepared to pay. I understand that,
in those circumstances, families would pay the top-up costs.
There has also been
some ambiguity about whether residents can pay top-up costs using
their capital assets, even although they are eligible for publicly
There is concern about
residents of any type of care home being asked to contribute toward
extra care from their personal allowance ofI think£14
a week. That is an abuse of the idea of top-up. However, I understand
thatthrough the Regulation of Care (Scotland) Act 2001,
in conjunction with the Adults with Incapacity Act (Scotland)
Act 2000there will be some oversight of the finances of
residents who are incapable of making their own decisions. That
might be a way of preventing possible abuse.
Does the voluntary sector believe that there should be
a national charge for the basic care package, which would apply
wherever the local authority happens to be? If there is not, different
rates in different local authority areas will be paid for the
same care. That might reflect the individual circumstances of
a local authority, but is hardly fair on the user.
Some local authorities have different rates because of the local
market. In the City of Edinburgh, for example, the cost of care
is much higher on average in nursing and residential
homes than it is in
other parts of Scotland. Local decisions are made by local authorities
to reflect local markets, but if people are to have choice there
is still a need in some cases for families or the resident to
The issue must be considered
carefully and the devil is in the detail. There are legitimate
fears that the top-up facility will be used to undermine the intentions
that lie behind free personal care or a local authority's funding
policy. However, that seems to be a reality and it is better to
bring it into the open. Other forms of legislation can be used
to investigate and minimise possible abuses for adults in respect
of whom powers are misused.
Before I ask about monitoring, I ask Jim Jackson to tell
the committee about the extent of abuse of the personal allowance
in Scotland. Do you have evidence that people having to use their
personal allowance to top up is widespread?
We do not have statistical evidence, but we have anecdotal evidence.
Age Concern Scotland also has anecdotal evidence. People say that
abuse occurs, but I do not have a research study or a source of
statistical information at my fingertips to substantiate that.
Perhaps we should contact Age Concern Scotland; such
abuse concerns me.
On monitoring, you
stress the need for the inclusion of adequate monitoring mechanisms
to evaluate the effectiveness of legislation. Should such mechanisms
be included in the bill or can they be accommodated in the current
regulatory framework? Could there be a role for the Scottish commission
for the regulation of care, for example?
We were talking about that before we arrived. The Royal Commission
on Long Term Care originally recommended that the national commission
should consider the quality and volume of care for older people.
In respect of the Regulation of Care (Scotland) Bill, the Executive
made a commitment to include that function in the scope of the
Scottish commission for the regulation of care.
Some of the draft regulations
for the Scottish commission for the regulation of care are being
published. It is not immediately apparent to us that the bill
has come out of that work. The Scottish commission for the regulation
of care does not officially come into being until 1 April, so
it will be difficult to see how much of its activity will examine
the overall monitoring pattern. So far, that does not seem to
have been given a high profile in the work of the Scottish commission
for the regulation of care.
We mentioned monitoring
because one of the
key findings in the
Health and Community Care Committee's report on its inquiry into
the delivery of community care in Scotlandpublished about
this time last yearwas that under-resourcing is one of the
significant problems in community care. The committee recommended
a full audit of all the resources that were going into community
care and how they were being spent. I am not sure whether that
has been done. Our concern is this: if under-resourcing is the
fundamental problem in community care, how much will the bill
address the real problem?
That is a slightly
roundabout way of putting it. One of the key problems that the
voluntary sector faces is that local authorities are unable or
unwilling to fund the full economic cost of care. Therefore, the
voluntary sector must subsidise that cost in a variety of waysfor
example, by paying its staff less, cutting service availability
or raiding reserves. If it does not do those things, the long-term
future of the services is under threat. That is our key problem.
Although we support the bill, none of its provisions address the
clear and fundamental problem that the full economic cost of services
will not be met from the budget. We therefore mentioned monitoring
not to find out only whether the bill allows direct payments to
expand and carers assessments to take place, butat a much
more basic levelto find out whether the bill addresses the
underlying difficulty with community care in Scotland.
I have posed the question,
but I cannot begin to answer it. It plays on our minds that we
are not able to secure the resources to provide the services that
we want to provide.
Are you confident that the Executive has made sufficient
financial provision to fund free personal care? From what you
have just said, you are not confident that we have the financial
package to provide adequate funding for community care services
in general. Is that a fair comment?
We do not question the sums that have been done for free
personal care; we have not done any sums of our own that suggest
that the Executive's sums are not right. The question is whether
the funds will be used in the way in which they are supposed to
be used. That brings up ring-fencing. We know to our considerable
cost that, if funds are not ring-fenced, they do not always find
their way to the group at which they are targeted. Our experience
of that relates to resource transfer, which is the great bugbear
of community care. In resource transfer, money comes in from health
boards after hospital closures, for example, and the voluntary
sector then provides the reprovisioned services. We find that,
for example, some of the money that is uplifted for inflation
at health-board level is not
uplifted for inflation
when it gets out to the providers. That has been a huge problem
We have no reason to
question the amount of money that has been calculated, but we
have concerns about whether it will be spent on what it is supposed
to be spent on. We mentioned that in our submission.
The indication is that the money would be ring-fenced,
but would after a number of years be re-examined to find out whether
we could move instead to a system of outcome assessments.
I know from previous evidence-taking sessions that the
committee has, because a funding gap exists in other areas, been
concerned about that. Will some of the money for free personal
care be channelled towards plugging the gap elsewhere? There does
not seem to be any doubt that the gap exists. That is what I am
trying to say. If under-resourcing of community care overall is
a key issue, how far will the bill go towards addressing it?
The other funding issue that you touched on in your written
submission is the question of standardisation of charges. From
previous work that the committee has done, we are aware of the
wide range of charges throughout Scotland; people are paying very
different amounts depending on where they live.
The Convention of Scottish
Local Authorities has been doing work on that, which you describe
in your submission as a "purely ... internal exercise".
You suggest that the committee should do what it can to ensure
interests are involved (or at least consulted)."
Will you expand on
We obtained a copy of the early workvirtually by subterfuge,
I have to say. If one works in this area, one comes across documents
that have been drawn upwe did not receive the document officially
for consultation and we were not involved in the process. Clearly,
charging by local authorities is a matter for local authorities.
However, once again in the spirit of joint working, we feel that
other interests ought to be brought in when drafting the proposals.
One of the matters
that we drew to the committee's particular attention in our submission
was something that is being dictated by certain local authorities
to voluntary sector providers, to the effect that those voluntary
organisations will have to collect charges directly from service
users. Anybody who has worked in the voluntary sector will understand
how difficult it is to ask voluntary
organisations to do
that. We would like to see provision that will address that in
the charging guidance that comes out.
Perhaps our written
comments came out as being slightly snide in relation to COSLA.
They were not meant to be so. Charging is such a huge issue that
we think that COSLA should work on it with other interest groups.
Have we covered everything that you wanted to put on
I would like to make one more point about joint working. We talked
about the involvement of the voluntary sector at a strategic level.
I would like to leave the committee with the thought that so far,
all the discussion about joint working has been about how people
who are employed in the health service will work with people who
are employed by local authorities and all the difficult issues
that surround that.
We have set up our
own working group to consider the potential for the voluntary
sector to provide some integrated services as commissioned services
under contract, which is not a word that I like to use very often
because people complain about it so much. That is another area
on which the committee might like to work with us in future.
We are talking only
about health boards and local authorities. What is the scope for
the voluntary sector to employ health-care staff and social-care
staff simultaneously, and to offer that kind of integrated service?
I cannot answer that because we are in the middle of working out
what our potential to do that is. I leave the committee with the
thought that in all the discussions about the issue, the voluntary
sector's scope to offer that service has not been considered.
That is a real missed opportunity.
(Community Care Providers Scotland): A number of voluntary
organisations already employ significant numbers of nursing and
social work staff, although nurses are not employed in that capacity.
We have experience of working with people from different cultural
backgrounds and different disciplines and of managing their transition
into the voluntary sector.
Some of us also have
experience of working in partnership with local authorities and
trusts. A particular example of that regards the use of European
social funds in situations where staff who are employed by a national
health service trust earn more than staff who manage them and
who are employed by the voluntary sector. We can contribute our
experience to the joint working aspects of the bill. We would
be willing to do that at strategic level.
Thank you for your contribution.
I am sure that colleagues
will be interested to see what your two working groups come up
with regarding that matter and regarding direct payments, which
we touched on earlier. Thank you very much for your contribution.
There will be a short
adjournment before we hear from our next set of witnesses.
Our next set of witnesses is from the Scottish Executive.
We are joined by the Deputy Minister for Health and Community
Care, Malcolm Chisholm. Good morning. Before we move to questions,
would you like to introduce your team and to make a statement?
Minister for Health and Community Care (Malcolm Chisholm): I
will introduce my team, which I have been known to forget to do
in the past. For that I offer retrospective apologies.
I have three people
to protect me this week, compared with two last week. Perhaps
that is a reflection on my performance last week. Thea Teale,
on my right, is head of the community care division. On the far
left is Gerry McLaughlin, who is the bill team manager. On my
immediate left is Peter Stapleton, who is also on the bill team.
There is so much to
say about the Community Care and Health (Scotland) Bill that I
think it will be better to go straight to questions, otherwise
my opening statement might go on until half past 12.
During your evidence to the committee on the Regulation
of Care (Scotland) Bill you argued that it was not appropriate
to include a statement on the bill's principles in the bill. However,
members might recall that, following amendments, the act that
was passed included a statement on general principles. How do
the provisions of the Community Care and Health (Scotland) Bill
uphold its general principles?
I am sorry, but I thought that you were going to ask
me a question about the general principle of having a statement
on principles in the bill.
We are a principled bunch here.
I was slightly more relaxed about that issue, because
there is a tradition of not including a statement on principles
in a bill. However, a new tradition is developing in the
Parliament that makes
that possible, so I do not rule out including a statement on general
principles in this bill. You asked about another matter at the
end of your question, which I did not grasp.
We are concerned that general principles are not included
in the Community Care and Health (Scotland) Bill.
This is a piece of classic legislation, which might be
a virtue or a defect. Members can express their views on that.
However, strong principles underlie the bill and those have been
welcomed generally. One can divide the principles into issues
about improving rights and services for individuals through free
personal care, issues about direct payments and issues about help
for carers. There are also process issues, which will result in
better services. Part 2 of the bill is about the joint-working
The strong principles
that underlie the bill are stated in accompanying documentssuch
as the report of the care development group, which the Executive
has accepted in full. The bill must ensure that those fine principles
and aspirations are enacted in legislation. I know that it is
a bit frustrating to have to refer to the National Assistance
(Scotland) Act 1948, the Social Work (Scotland) Act 1968 and the
Mental Health (Scotland) Act 1984. However, as John McAllionwho
is objectingknows better than most because of his long years
of experience at Westminster, if we do not do refer to those acts,
we cannot deliver the policy. I hope that everybody accepts that
that must be done.
The issue is whether
one can also include general principles in the bill. I will not
take a hard line on that matter. If people present general principles
that can work in legislation, I am happy to consider themas
I was in the matter of the Regulation of Care (Scotland) Bill.
I feel a sense of déjà vu, because we discussed
the issue during the passage of the Regulation of Care (Scotland)
Bill. You seem to be saying that you are not opposed to general
principles being included in the Community Care and Health (Scotland)
Bill. No one would argue that the principles are not present throughout
the bill, but a school of thought believes that the principles
should be enshrined in the bill. Much of the bill's detail will
be introduced via secondary legislation. Is there a danger that
future ministers will implement proposals that are at odds with
the current principles?
I understand your general point, but regulations are
not issued from St Andrew's House without anybody noticing. Perhaps
that happened sometimes in the past;
however, every regulation
would come before the committee. Although regulations would all
be subject to the negative procedure, as the bill is drafted,
I am open to making some of them subject to the affirmative procedureespecially
those that relate to issues that are of most concern to the committee.
As members know, not
even an amnesic shellfish poisoning order can be passed without
my coming to the committee to speak to itnot that such an
order would be unimportant. There is no way in which an imaginary
minister could suddenly decide to remove the principle of personal
care from the bill: the committee and the Parliament would not
allow that to happen. That is an unnecessary fear. Our discussion
should focus on whether regulations will make better legislation
and deliver the policy better.
I note that when representatives
of Carers Scotland came to the committee, they thoughtbecause
some of the details might require to be changedthat it was
a virtue that the definition of personal care was going to be
introduced by regulations. That is not because of some great reneging
by the Scottish Executive; it is just the nature of it. We are
breaking new ground with some parts of the bill. Although similar
things have been done in England, such provision for personal
care has certainly not been made by the Westminster Parliament.
We are setting up an
implementation groupthat was one of the key recommendations
of the care development groupwhich will have a lot of work
to do on the detail of the way in which the policy will work in
practice. That is just the reality of the situation. Although
I understand the desire to include a definition of personal care
in the bill, there could be some dangers in that. If the definition
is not clear in the bill, it will not be interpreted by the Parliament,
but by the courts. It is up to us to get all the details right
so that we, not the courts, decide the policies. We would have
to work out exactly how even the excellent definition of personal
care that was produced by the care development group would work
out in legislation, so that it would not be left to the courts
to interpret it. There is more work to be done by the implementation
group on working out the nuts and bolts of the matter.
(Glasgow) (SNP): I am glad that you are not hostile to
the idea of including the general principles in the bill. Perhaps
we made some progress on that during the passage of the Regulation
of Care (Scotland) Act 2001. All bar one of the organisations
that have given evidence to us so far have said that they would
like the general principles to be contained in the bill. In the
light of that and what
you said about the need to get the definition right, if we choose
to go down that road, will you give an undertaking today to lodge
an Executive amendment to that effect at stage 2? After all, you
have a team of advisers and lawyers who are more likely than anybody
else properly to draft an amendment. Are you swayed even a bit
by those arguments, and do you feel that it is incumbent on you
to lodge an amendment?
That depends on what the general principles are. At least
two sets of witnesses were opposed to including the definition
of personal care in the billthe carers and the Convention
of Scottish Local Authorities. There might have been others, but
those are the two groups that I remember.
The carers were supportive
of the general principle of carers being partners in care, which
I accept completely. Although our draftsmen might have comments
to make on that, I do not think that such a declaratory principle
would do any harm. One could ask what good its inclusion in the
bill would do and what it would change; however, I do not see
any immediate problem with it. We should be absolutely clear about
the effect of including any principles in the bill and we should
ensure that they do not create problems when it comes to interpretation
and implementation of the legislation.
The committee has questioned
others about the time scale of the policy. We are committed to
delivering free personal and nursing care by April 2002; committee
members know better than anybody does what a tight time scale
we have. If things go according to schedule, we will consider
the first section of the bill in about a month. We want to ensure
that the bill can be implemented by April, but we also want to
ensure that we get all the details right. That also becomes part
of the argument about whether things should be included in the
bill or introduced by regulations.
All that is very interesting. However, with respect,
I am not sure whether that was a yes or a no to my question.
I cannot give you a yes or a no, because there are various
Come on, minister. You can say whether the Executive
will consider lodging an amendment at stage 2. That is a fairly
simple question, which can probably be given a fairly simple answer.
It depends on what principle you are talking about. I
am always happy to consider suggestions but I am not minded at
the moment to introduce an amendment that defines personal care
or makes some statement about
am not quite clear what is being asked for. You may be surprised
to hear that I have been considering such an amendment, but I
also refer to the other option that has been mentioned, which
seems less problematic. One might ask what would be added to the
bill in terms of delivery for carers if the definition were included.
Is that a yes?
I am perfectly happy to consider anything that the committee
suggests. Why would I say anything else?
It is likely that our stage 1 report will indicate what we would
like to happen with regard to the general principles. You have
already touched on the principles surrounding personal care, joint
working and carers. We hope that, in a spirit of co-operation,
the Executive will seriously consider the proposals in our report.
You mentioned that there was a problem with the time scale. That
reinforces the point that the Executive, which is backed up by
legal draftsmen and more civil servants than we have at our disposal,
has more chance of getting this right than the committee has.
The onus is therefore on you.
Time scale was not my leading argument in relation to
personal care. My main point was to do with the continuing work
of the implementation group and the fact that we have to make
sure that we have taken in all of the details. The definition
of personal care has been broadly accepted but it is still fairly
general. We may have to be careful about how it is interpreted
because, as soon as the bill is passed, someone can challenge
the law in court and we will have to rely on the judgment of the
Some people think that
things are put in the regulations rather than in the bill so that
they can be changed for a bad reason but, equally, they might
be put in the regulations so that they can be changed for a good
reason. The committee should consider the positive reasons as
well as the possibly negative reasons. Consider the nature of
the Scottish Parliament. Hypothetically, someone could come along
and change the nature of free personal care but everyone knows
that the political reality is that that will not happen, which
means that the issue of placing the definition in the regulations
should not influence the committee's decisions too much.
This morning, we discussed with Community Care Providers
Scotland whether details should be in the bill or in regulations.
The point was made that, if details are to be in the regulations,
ministers should have a duty to consult widely before the Parliament
scrutinises the regulations. Would the Executive be prepared to
consider such a duty?
We always consult on regulations. In relation to the
Regulation of Care (Scotland) Bill, there was a great deal of
discussion and consultation on various regulations and some are
still being consulted on. Again, however, having decided that
we want to get through this process quickly and that everything
should be ready by 1 April
That means that you will not consult widely.
The consultation will be, of necessity, truncated, but
there will be consultation.
Would the Executive support an amendment that placed
a duty on ministers to consult before introducing regulations
That duty does not need to be in the bill as we would
consult anyway. We had this discussion in relation to the Regulation
of Care (Scotland) Bill and ended up including something about
consultation. I do not object to the idea in principle.
I will take that as a no.
Chisholm: I think that you should take it as a yes.
In its original response to the Sutherland report, the
Executive stated that the proposals for free personal care would
benefit only 7,200 people. Do you still believe that that number
is correct? If not, what work has convinced the Executive that
the number of beneficiaries has changed?
Chisholm: That figure related to self-funders in care
homes. Clearly, however, there are a large number of people in
the community[Interruption.] I am sorry?
I am laughing because that was the argument that people
made at the time but it was rejected by your colleagues.
It is nice to win an argument occasionally.
A much larger number of people are receiving personal
care in the community. Also, in the normal course of things, the
number of self-funders will increase over time, given the marked
increase in home ownership that has taken place over the past
20 years in Scotland. That figure was arrived at in good faith
with regard to existing self-funders in care homes. Clearly, others
will be affected by the policy.
If you have considered that more closely, can you put
a figure on it now, minister?
Somebody else may have
a better memory of
this, but I do not think that the care development group came
up with a precise figure for the number of people in the community
paying for personal care. We took a percentage of the total amount
of charges that were levied45 per centas being personal
care. That was based on smaller studies of the extent to which
charging for home care was attributable to personal care and the
extent to which it was attributable to domestic care. We did not
include such a figure in the care development group report because
it is not easily obtainable.
Are you concerned that the bill was drafted before the
care development group reported? Have you had any representations
on that issue from any organisations?
I do not think that we have had any such representations.
That is almost an inevitable consequence of the time scale of
the care development group's work and the proposed introduction
of free personal and nursing care. Inevitably, work was done on
the bill at the same time that the care development group was
working. It was already quite a challenge for the care development
group to carry out its work in six months. I do not think that
there was a way round some of those time-scale problems.
Much of the bill amends the Social Work (Scotland) Act
1968. Does the minister understand why that has led to confusion
about definition? I appreciate that some of our discussion has
concerned personal care, but paragraph 18 of the policy memorandum
refers to free nursing care and free personal care. Paragraph
"the Bill provides
powers for Ministers to prescribe in regulations which aspects
of social care shall not be charged for."
I understand what personal
care is, but can you tell us what social care and nursing care
That is a very good question, if I may say so. This is
a very technical billin a way, it is a classic bill, in
that it repays detailed study by people who are interested in
how legislation works. People are frustrated by some of it, but,
as I said, we have to do it this way or we will be caught.
is a good term to home in on, because it does not exist in the
1968 act. One of the key terms in that act is "accommodation",
and many of the current arguments surrounding the tenant's allowance
are connected with what accommodation is. When I first considered
the attendance allowance regulations, I thought that they were
just dealing with accommodation as you or I would understand it,
and that there would not be a problem.
In the 1968 act, "accommodation"
personal care and nursing
care. Section 2 is, in a way, the pivot of the whole bill, because
it takes out what we would call housing and living costs in care
homeswhich will still be charged for under the 1968 actand
separates social care from that. Social care, therefore, is everything
else in the 1968 acteverything except what we will clarify
as being accommodation in the regulations under section 2. We
will have a normal, commonsense definition of "accommodation".
Personal care, nursing
care and domestic care all come under the umbrella of social care.
Because the 1968 act gives local authorities discretion about
charging, we have to change that and say that social care will
be subject to what we at the centre decree. Equally, we must pull
away personal and nursing carewhich are parts of social
carefrom accommodation, or we will be caught by the Social
Work (Scotland) Act 1968 and will still have to charge for them.
I am not sure whether that has clarified the situation. In summary,
social care is a new construct that covers all the services in
the 1968 act, apart from what is defined as accommodationbasically,
housing and living costs in a care home. Everything else is social
care and personal and nursing care are subsets of that.
The care development
group report addresses the question of what nursing care is. We
did not want to define nursing care, because there is a continuum
between personal care and nursing care. There is an argument for
collapsing the two into each other, because in going for free
nursing care we are following a sort of international definition
of nursing. We are saying that nursing care is to do with the
more intensive levels of carethe higher-dependency end of
the spectrum. We know that definitions of nursing care in Englandthat
which is done by nurseshave caused some difficulties. With
the new roles that people are adopting, that becomes difficult.
We will stick with Scottish problems.
I think I understand a bit better.
Paragraph 19 of the
policy memorandum says:
"the Bill provides
powers for Ministers to prescribe in regulations which aspects
of social care shall not be charged for"?
What did your bill
team have in mind when it wrote that?
That paragraph refers to section 1. Because social care
covers nursing care, personal care and domestic care, the purpose
of section 1 is clearly to separate out those aspects of home
care that will be charged fordomestic carefrom those
aspects of home care that will not be charged for, which are
personal care. Section
1 separates out the bits of social care that will continue to
be charged foralbeit with new guidance or controls from
the centre to address the unevenness of chargingfrom those
bits that will not be charged for.
Are you saying that someone living in their own home
whose care fulfils all the criteria for the definition of personal
care and whose personal care will be paid for will still have
to pay for some social care?
Taking into account the definition given by Sutherland,
it has always been accepted that that will be the case. We are
separating out personal care from domestic care in the case of
someone living at home and from housing and living costs in the
case of someone living in a care home. That has always been part
of Sutherland's approach, which we followed.
Can you give an example of what aspects of care in their
own home people whose care meets the personal care definition
will have to pay for?
That is precisely the territory that we must go into
in the regulations. We must ensure that we get that absolutely
right, because there will be some grey areas. That is why we must
be careful about whether we formulate things in regulations, as
we propose to do, or in the bill, as some members of the committee
might wish. We all know what is obviously personal care and we
all know, perhaps, what is obviously domestic carehelp with
housework and so on. Some issues could arise where the two meet.
We must get those absolutely right in the regulations.
If people have no mobility or memory or cannot feed themselves,
dress themselves and so on, will you charge them for their housework
and for someone to do their shopping?
That has always been proposed under the definition of
personal care. People can put up a contrary argument and say that
all home care should be free. That is not being proposed at the
moment. If someone did propose that, it would increase the cost
of the policy.
An organisationI think it was Age Concern Scotland,
although I may be wrongput it to us that changing the definition
of accommodation might be the way round your spat with Westminster
about attendance allowance payments. It seemed to me that that
might be too simple a solution. Do you believe that, by changing
the definition of accommodation in Scotland, you can change the
application of UK social security legislation?
Obviously, I have considered that possibility, as I am
considering every possible way around the problem that we face.
My first superficial
reading of the regulations suggested to me that we would not have
a problem, because we will still charge for accommodation as normally
understood by the public at large. However, as I have explained,
accommodation includes personal and nursing care. At issue here
is the general principle of whether we can amend legislation on
reserved matters. The basic answer to that question is no. However,
there is also a problem of detail, because we are changing the
definition of accommodation for the purposes of charging. We are
changing the definition of accommodation in part VII of the 1968
act for the purposes of charging, but the attendance allowance
regulations refer to accommodation as described in part IV of
the act. The option to which Nicola Sturgeon referred will not
get us round the problem that we face either in principle or in
Can you provide us with our regular weekly update on
the continuing discussions on this issue that are taking place
between you and the Department for Work and Pensions?
I do not think that we are any further forward than we
were last week. My answer to Nicola Sturgeon's question in the
chamber last Thursday indicated the point that we have reached
When is your next meeting with the Department for Work
and Pensions scheduled?
The negotiations are being conducted in various ways.
The First Minister is leading on this issue and various channels
are open to him. I do not know when he will next speak or write
about the issue, but negotiations are continuing.
I would like to ask about more general resource issues.
Are you confident that the Executive has made sufficient financial
provision for free personal care?
We took account of more factors than the Royal Commission
on Long Term Care for the Elderly did. The biggest difference
between our report and the Sutherland report was that we factored
in a significant sum of money for the development of services
in the community. That was a desirable thing to do in itself,
but it also recognised that people who do not receive services
at the moment might respond to the new policy by seeking servicesthat
is the issue of unmet needand that there might be some switching
from informal to formal care. I know that
David Bell dealt with
that issue when he gave evidence to the committee at the beginning
of October. He was very involved in producing the relevant calculations.
To some extent, the figure of £50 million for new services by
year 3 is the result of the research that David Bell headed up.
That gives us some protection, as one of several criticisms of
the Sutherland report was that it did not take account of the
factors that I have mentioned.
The amount that will
be needed to reimburse people in care homes and people in the
community who currently pay for personal care is much easier to
calculate. Taking the various factors together, we can be pretty
confident that we have enough money to fund free personal care
in the immediate future. People can question whether the sums
are right to deal with the situation in 15 or 20 years' time,
although very few have. Given the criticism to which the Sutherland
report was subjected, I thought that our projections would also
be analysed and criticised. Members may have heard Lord Lipsey's
exchange with Nicola Sturgeon on "Newsnight". Although
he was very critical of our policy, he said that the care development
group had produced a good report and did not question our costings.
The care development group report calculations assumed
a 2 per cent per annum real increase in the cost of care. We would
expect a general upward pressure. To what extent has the Executive
budgeted for costs increasing at a greater rate?
We are now on to three-year budgeting, which is a relatively
recent development, and the next round of the comprehensive spending
review is not far away. Although we make projections for the next
20 years, we do not set budgets for the next 20 years. The 2 per
cent rate is our best prediction, based largely on the advice
and work of David Bell, one of the leading economists in Scotland.
Other people may arrive at a different figure, but I am happy
to accept David Bell's judgment on the matter, because he is such
a good economist.
Another question that has been asked by many people who
have given evidence is whether the resources should be ring-fenced.
In the past, the committee and others have been concerned about
the funding gap. COSLA is very concerned about the resources being
ring-fenced, but this morning we heard that providers and service
users and so on see that as a way to mitigate the continuing funding
gap. How will the Executive work with local authorities in moving
from a ring-fencing system towards outcome assessment? Can you
comment on the work that COSLA is doing on the standardisation
We meet on the middle ground of outcome agreements. I
know that COSLA is not very happy about the recommendation that
the money should be ring-fenced initially, but it is happier with
the intention to move towards outcome agreements. That is what
we did with the first £100 million that was announced by Susan
Deacon last October. We have outcome agreements with COSLA for
some of the objectives in that announcementfor example,
members will remember the 22,000 extra weeks of short breaks and
the provision for intensive home care and rapid response teams.
The care development
group report included the bold intention to hand out all money
for older people on the basis of outcome agreements. That is quite
an ambitious aim, but it is one that COSLA goes along with. We
will have to see how it works. Ultimately, if outcome agreements
do not work, the momentum to go further will become strong, if
COSLA did some work
on charging towards the end of last year. However, it put that
work on hold during the work of the care development group. There
was some sense in doing that because COSLA could not produce a
charging proposal without knowing what its basis would be. COSLA
has now resumed that work. We will let COSLA propose solutions
to the difficulties resulting from the wildly different approaches
to charging in different parts of Scotland. The bill gives us
the power to regulate that if we so wish. That may be controversial
from COSLA's point of view, but we hope that COSLA will come up
with something that is acceptable to their members and the wider
Most of us are in favour of some standardisation. However,
on a recent visit to Shetland, I learned that the council had
set up a welfare trust from its oil funds and that very few elderly
people in Shetland pay anything for their careit is paid
for through the welfare trust. Would you recommend that those
people should now pay for their share of care, given that it is
standardised across Scotland, or would you allow the council to
use its oil funds to help pay for care for the elderly?
We want to see what COSLA proposes. I think that everyone
will be inclined to think that it is important that we ensure
that people are not overcharged, rather than that we ensure that
they are not undercharged. I understand your point, but the important
thing is to even it out at the top end. Let us see what COSLA
comes up with in that regard.
Before I ask about deferred payment schemes, I would
like to ask about evidence that we heard earlier from Community
Care Providers Scotland. The witnesses pointed
out that the care development
group's costing for free personal care was based solely on access
to free personal care for elderly people, and that there was no
indication of whether the Executive intended younger disabled
adults also to have access to free personal care. Has any work
been done on that? Will younger disabled adults have access to
free personal care?
I understand why people might think that younger disabled
people ought to have access to free personal care, but I do not
understand why anybody in Scotland is asking a question about
it. For the past nine months, every statement about free personal
care has been about free personal care for older people. That
was the care development group's remit. Since January, there has
been absolutely no doubt about what the policy is. I fully accept
that people will campaign for provision to be extended, but there
is no doubt about the existing policy.
So no regulations will be introduced to extend free personal
care to younger adults?
You raise an interesting question, which relates to whether
things should be in the bill. The policy is for free personal
care for older people and that is what is in the bill, so regulations
would also be about free personal care for older people. However,
if people such as you campaign for free care for younger people
and win the argument, it would be easy to change the situation
through regulations in future. I have just thought of that argument
for free personal care in regulations, so I hope that it will
Your answer was clear, but I do not think that it has
That could leave the Executive wide open to legal challenges
of agism. Will you reconsider the point that John McAllion has
I do not suppose that anybody in Scotland is against
extending provision in principle, but we are putting up a very
large sum of money for free personal care for older people. You
have asked whether it is enough money and I think that it is,
but we will have to see how the policy works out over the next
year or two. At the end of the day, politics is about choices
andcertainly in the Scottish Parliamentabout how we
allocate money from year to year. We should implement our existing
policy and see how it goes. There will obviously be demands for
it to be extended and that is something that I am sure the Parliament
will discuss in time, but it would be unwise to try to start everything
simultaneously, as that would make more expensive what is already,
by any reckoning, quite
an expensive policy.
If the only difference between two individuals at joint
assessment is that one of them is 63 and the other is 65, that
leaves you with a legal difficulty.
We will have to wait and see. I have not heard anyone
make that point before, but it may be a valid one.
In its written evidence, Unison drew attention to joint
working criteria, such as staff who are employed by different
I am sorry to interrupt, but I thought you wanted to
ask another question about people with disabilities.
No, John McAllion covered the point that I wanted to
It is understandable that, under deferred payment schemes,
local authorities will be required to create loans against the
security of the user's house to fund the revenue costs of their
care. COSLA has described the scheme as one that it is "not
appropriate" for councils to become engaged in, because interest
rates are likely to rise over time from the current historically
low levels. That will have a cost implication for local authorities,
for which there is no budget in the three-year funding that is
available to them.
I know that the Executive
argues in the policy memorandum that no interest will be charged
on the additional amount paid by the local authority while the
agreement continues. Who is right? Are the local authorities right
to say that there will be a cost to them and that you have not
budgeted for it, or are you right to say that there will be no
Of course there will be a cost. That is why local authorities
have been given £3.5 million a year in the current three-year
periodto pay for that. That is more than enough. You will
remember that the policy was first announced by Susan Deacon in
October 2000, when there was no intention to deliver a policy
of free personal care and more people would have had to sell their
There is more than
enough money in local authority budgets to cover the cost. Obviously,
a much smaller number of people might now be unable to pay their
housing and living costs in a care home. First, the money is there,
but secondly, we are not making the agreement binding on local
authorities in the first instance, precisely so that we can see
what the demand is and how much money will be required. We are
starting the policy very gently, to see how it works out and to
let local authorities have some discretion over it. Given that
the money is in their budgets, there should not be a problem in
the next three years.
You are telling us that the money is in the budgets.
COSLA's submission to the committee said:
"contrary to the
Executive's assertion in the policy memorandum for the Bill, there
is no budget for this purpose in the three-year local government
settlement (2001/02 - 2003/04)."
Who should we believe:
you or COSLA?
On this occasion you will have to believe me. Not only
was the money announced, but we can refer to the circular that
went out with it. It was part of a larger sum of money for various
purposes. I am sure that you will all remember the details of
the 5 October 2000 statement; £3.5 million of that money was for
Is the Executive in discussions with COSLA about this?
I am not aware that COSLA has raised the matter directly
with us, but I am sure that we will be meeting COSLA soon, so
if it wishes to raise it, I am sure it will.
Are there any similar schemes in the United Kingdom,
so that we can see how such schemes operate? I understand that
there may be a similar scheme in Wales, which is not working effectively.
A deferred payment scheme was passed in, I think, the
Health and Social Care Bill in England and Wales, so in effect,
the scheme is being applied throughout the United Kingdom. However,
our circumstances are different. Far more people will seek to
use the scheme in England and Wales because, in the absence of
free personal care, more people will have to sell their homes,
so more people will seek a deferred payment.
You said that the scheme would not be a requirement on
local authoritiesit will be at their discretion. You seem
to be beginning to create a situation in Scotland in which local
authorities who are strapped for money simply say, "We will
not implement this," and other local authorities, in a better
financial position, say, "We will implement it." As
a result, elderly people throughout Scotland will have differential
access to the scheme.
We expect all local authorities to implement the policy
next April and we are holding a reserve power to direct them to
do so. The money is there and we expect them to implement the
So they do not have discretion; in fact, if they do not
implement the policy voluntarily, you will require them to implement
You have to say yes or no.
The intention is that people who wish to use the scheme
should be able to use it. We are giving some discretion, for example
on how many people the local authorities apply the scheme to.
That gives them some discretion if they plead financial difficulties.
They are allowed discretion to do what they are told.
John, you are making this sound sinister. We are the
Scottish Executive and the Scottish Parliament, which have a great
Discretion usually means that you can make up your own
mind whether you implement something. You seem to be saying that
local authorities have to implement it.
Chisholm: We have a great deal of democratic legitimacy
in the new Scotland. Not only are we saying that we want to have
free personal and nursing care, but we want to avoid anybody having
to sell their house immediately. Deferred payment means that the
payment will have to be made eventually. We are saying that it
is an important policy, which we want to implement, and that local
authorities can pace it. They should start the policy and we will
see how it works out. If they feel that too many people are asking
for deferred payment, they can draw that to our attention and
we can sort it out in future financial rounds.
Local authorities should
start implementing the policy. In doing so, they will have a little
discretion in the initial stages. If the policy is implemented
satisfactorily, we will continue with it.
Will you provide the committee with the details of the
additional money that was identified in the budget, so that we
can tell COSLA that it is wrong?
I have told you that the additional amount is £3.5 million.
I do not know how I can be more specific than that. If I can give
more information, I will send the convener a letter, just as I
did this week in relation to the question that Mary Scanlon asked
Will you give us a copy of the memorandum that was sent
to local authorities?
It is possible that the specific amount of money may
not have been ring-fenced for deferred payments.
That answers part of my question, which was whether the
Scottish Executive ring-fenced the £3.5 million for the area that
the minister just described to John McAllion.
Margaret Jamieson knows how money goes out to local authorities.
We say that the money must be used for a particular purpose, but
only a little of the money from the community care budget is ring-fenced.
We have outcome agreements, but ring fencing is a rare thing.
Indeed, if we ring-fenced the money, we would have even more complaints
Since 1999, concern has been expressed to the committee
about the delivery of community care. There is a groundswell of
opinion that moneys should be ring-fenced. In fact, we have asked
to be provided with a table that indicates the percentage of grant-aided
expenditure that is spent. We are concerned that some councils
may exceed the GAE and that others may divert the money. That
is why we raise the issue at almost every meeting that we have
Local authorities probably think that I am far too much
on your side of that argument, but
You were a member of the committee.
Apart from the £125 million, we will not go down the
route of ring fencing, although arriving at output agreements
is a step in that direction. We have sent out clear signals, not
least in the care development group report, that we are concerned
that the money that goes out through GAE for older people's services
is not all spent on those services. It would be quite difficult
to ring-fence the £3.5 million, because the money will be used
in response to demand. It may be the case that few people will
want to use the arrangements, so it may not be an ideal use of
ring fencing, even if people support that approach. Equally, if
we do not ring-fence the money, we may have a problem, as local
authorities may pretend that the money does not exist if it is
mixed in with other money for older people's services.
Can I take you back to the implementation timetable?
Last week, we heard evidence from COSLA that indicated that it
does not believe that local authorities will be able to meet the
implementation deadline of April 2002. The COSLA witnesses cited
the difficulty of ensuring the creation of the infrastructure
that local authorities must have in place, in particular an appropriately
audited process for making direct payments. Is there any way we
can reach a compromise with COSLA on a sensible, phased implementation
That is what we are going to do, as we have no intention
of implementing the direct payment section of the bill in April
2002. I refer you to the wording of the billsuch wording
is quite common at the end of billsat sections
24(2) and 24(3):
"(2) This Act,
except this section, comes into force on such day as the Scottish
Ministers may by order appoint.
(3) Different days
may be so appointed for different provisions and for different
We accept that certain
transitional issues must be dealt with. Local authorities have
made some reasonable points about how those should be managed.
How will the committee be advised of the phased implementation
To an extent, we will be influenced by what people tell
us. There will be pressure from people who want local authorities
to adopt the new arrangements for direct payments. I do not know
whether there will be questions about that. We think that the
new arrangements are a positive step forward and work is being
undertaken to prepare for them.
April 2003 might be
a more realistic date, but a final decision has not been made.
We will have to see how local authority preparations go and what
representations are made. We do not need to decide about that
while the bill is going through Parliament, but I would be interested
to hear people's views on a desirable starting point.
COSLA raised that concern with us when it gave evidence.
It was unaware that such slippage would be available to local
authorities. You may need to re-examine the issue when you consult
That is fair enough.
I will rewind to local authorities meeting their agreed
community care outcomes. What action will be taken if they do
not achieve those outcomes?
That is a good question. The relationship between central
and local government is a live issue in relation to many policies.
As local authorities keep reminding us, they have their own electorates
and systems of accountability, so difficulties exist.
Ministers have a power
of direction, to which section 23 refers. We can direct local
authorities as a last resort, but sensitivity is required in deciding
what we can impose and what should be left to local authorities
to decide. If outcome agreements do not work, we will probably
move into a different phase of ensuring that local authorities
deliver on the strategic objectives of the Scottish Executive
and the Scottish Parliament. Local authorities know that.
Some recommendations of the
Scottish carers legislation
working group were not included in the bill. What progress is
being made on those recommendations, particularly the recommendation
on a requirement to identify carers?
I spoke to someone from the group, who also appeared
before the committee, two or three weeks ago. I understand the
concerns. Everyone accepts that a right to an assessment, irrespective
of an assessment of the cared-for person, is a big step forward.
People who have that right must know that they have it. Providing
information to carers is vital. We will take steps with local
authorities through guidance and other means to ensure that.
I think that the group
was thinking mainly of the NHS in its recommendation to go further
with a duty to identify. I found that difficult, because I was
not sure how such an obligation could be expressed in law, where
it would bite in the NHS and how it would be enforced. I think
that the group was thinking of general practitioners. Most of
the issues that relate to GPs concern negotiation and contracts,
and negotiations about GP contracts continue.
I am not sure how the
duty would be implemented in legislation or how it would work,
but I fully accept that we must do everything we can to use GPs'
knowledge about carers. Some good initiatives exist. The Princess
Royal Trust for Carers has been involved with individual GP practices
in identifying carers. We should spread that good practice. Local
health care co-operatives could be pivotal to that. Primary care
has an important role to play in identifying carers, but I am
not clear how that would be dealt with in legislation.
That is my question: if it is not going to be done in
legislation, how will it be done?
Guidance is the overarching argument. I know that carers
have concerns that guidance is not always followed, but there
is a will to do so. From the responses of those to whom I have
mentioned it, I think that GPs would not be averse to that. It
is more likely that we can make progress through guidance and
discussion, in particular through LHCCs, than through legislationI
am not clear how such legislation would be formulated or enforced.
That has always been my position. I was not in any doubt that
that proposal was not readily acceptable when I first saw it several
I have a question about assessments. One issue is that the bill,
which has generally been welcomed, gives carers the right to their
own independent assessment, which will have a knock-on impact
on the number of people
who require to be assessed.
I presume that people who currently have personal care supplied
at home at a cost will also require to be reassessed for free
personal care. Have you taken into account the impact on resources
and on the time that people will wait for assessments as a result
of the extra work load?
No, but there is an issue. We do not know, but the number
for carers may not be enormous. Not every carer wants an assessment.
Sometimes, carers are asked and they do not want one. No doubt
there will be extra carers who want to be assessed, and obviously
there will be extra people in the community, many of whom currently
pay for personal care. There are therefore two groups, which you
You will know that
the care development group made a decisionI think wiselynot
to go down the route of assessing people who are currently in
care homes. That saved us a further complication, and seems right
for other reasons. One of the reasons why we wanted to set aside
money for the development of services in the community was to
cover things such as assessment. The way that the money is profiledwith
a rising amount for unmet need and some switching from informal
to formal caremeans that we have earmarked money in the
first couple of years for any immediate expenditure that arises
in relation to issues such as assessment. Part of the £50 million
in years one and two could certainly be used for that purpose,
because it may be that the rush for assessment, in so far as there
is one, will be in the early stages, and thereafter it will be
more even and consistent.
Some of your answers suggest that you are not sure how
many people in the community we are talking about in terms of
free personal care. That worries me slightly, because I am not
sure how you came up with the costings, the time scales and all
the rest of it if you do not know.
There are two issues. The first relates to those who
currently receive personal care. We know how much is paid through
charging by authorities and privately, and that is the money that
we have to reimburse. As long as we know how much money is involved,
the precise number of people is secondary, because it is the money
that matters. Secondly, we have estimated unmet need and added
that on as well. Through those two things, we have covered the
full extent of the need, but it is the money that matters rather
than the numbers.
I would not have thought that the numbers were difficult
to find, given that local authorities make returns, although some
people receive private care, which the returns would not
cover. The SNP has
done some work on that which, in a spirit of co-operation, I would
be happy to shareand we did it without the wealth of civil
service resources that you have at your disposal.
Your offer is very kind. I will be interested to hear
what you say. However, I should point out that local authorities
do not separate out personal care from domestic care. Perhaps
the SNP does.
Actually the local authorities do as well.
Shona Robison has made an interesting offer.
I want to dip out of
the community care part of the bill into the health part. However,
I will then dip back into the community care aspects, so you are
not completely off the hook, minister.
We were talking about GPs a moment ago. The bill obviously
specifies that GP non-principals must register on a health board
list to practise in that health board area. When the Royal College
of General Practitioners gave evidence last week, it expressed
a concern that such a provision would prevent locums from working
across health board boundaries. Would locums be required to register
in every health board that they wanted to work in, or would registering
in one health board area be enough to allow them to practise across
Locums have to register in various health board areas
because of the nature of disciplinary procedures and the NHS tribunal.
However, the transfer process from one list to another would be
very quick and unbureaucratic; I know that people are concerned
that the process itself would be very bureaucratic and time-wasting.
That said, it is technically necessary that locums should be on
a separate list in a different local area, because otherwise they
cannot be part of the disciplinary procedure, which is based on
health board areas. Although the argument is rather technical,
it should not cause problems in practice.
In its written evidence, Unison drew attention to the
implications that staff and other measures would have on joint
working. What steps are you taking to address those concerns?
Furthermore, how will you ensure that joint working will be successful?
I am sure that, in
your answer, you will refer to paragraph 66 of the policy memorandum,
which says that "in cases of failure", you will recommend
and NHS bodies adopt certain principles, such as ... a single
Are you recommending
a single budget only
where joint working
has been seen to fail? Given that the Sutherland commission and
the committee recommended a single budget, do you think that such
a measure will be used generally or only in cases of failure?
I am trying to work out the context of the term "single
budget", because the problem is that people mean different
things by it. You probably use the phrase in a slightly different
way from us. We tend to use it as the overarching term for either
an aligned or pooled budget. We would specifically use the terms
"aligned budget" and then, after any further development
of the budget under section 12 of the bill, "pooled budget".
I think that you might mean something narrower by single budget.
I have answered that point, but I have lost the rest of your question.
But paragraph 66 of the policy memorandum says:
"It is intended
that these powers be used only in cases of failure where expected
service outcomes are not being delivered."
Furthermore, you will
have the power
"to require local
authorities and NHS bodies to adopt certain key principles, such
as a single management structure"
or a "single budget".
By single budget, do you mean an aligned budget or a pooled budget,
or do you mean that you would take a budget from a local authority
and give it to the NHS or vice versa?
That is a good question, because the power that we are
taking in section 14 refers back to section 12, which concerns
pooled budgets. We are examining the powers conferred by section
14 to find out whether they need to be more widely drawn. For
example, we might want a power that directs towards an aligned
The problem is that
we do not need to make any legislative changes for aligned budgets;
the provision to make them already exists. However, the pooled
budget requires legislation, which is why section 14 is tied into
section 12. In any case, we do not want to use those particular
powersthis sounds like the discussion I had with John McAllion
a moment agoalthough most people would be pleased that we
had them in reserve. No less than the Health and Community Care
Committee itselfright from its first reportemphasised
the importance of the whole area. As a result, there is no clearly
no point in sitting here saying that something is necessary and
desirable and then letting local agencies simply ignore it. In
summary, it is important to have the power. Although it is currently
with reference to the pooled budgets mentioned in section 12,
we are considering whether it should be more widely
Minister, you obviously have your reservations, as we
do. Much of the evidence that we have heard has expressed reservations.
What is the Scottish Executive doing to ensure that councils and
health boards have management systems in place that ensure effective
joint working? The voluntary sector has told us this morning that
they feel sidelined.
There is a circular"Joint Resourcing and Management
of Community Care Services", from 5 Septemberwhich
should be sent to the committee, if that has not already been
done. It is a useful document and is mentioned in the Unison submission
of last week. It talks about the different possible partnership
arrangements under joint resourcing and management.
In a way, that document
is the overarching document. However, clearly we have not just
sent out a document and let local authorities and health boards
just get on with things. We are concerned with the operational
development of the policy. A series of seminars and presentations
have been held and there have been visits to various local areas.
A great deal of work is going on.
Mary Scanlon asked
about staffing. An important groupthe integrated human resources
working groupis headed by Peter Bates, the chair of NHS
Tayside. The group is due to report in April 2002. I will have
a meeting with Peter Bates very soon and I am looking forward
to hearing details of the group's work. I am sorry I have not
had that meeting before today. I will draw his attention to what
has been said about the voluntary sector. Clearly, the vast majority
of the people involved are in the various health agencies and
the local authorities, but we are not forgetting the voluntary
What criteria would you use to gauge the failure of joint
working? Margaret Jamieson has mentioned the situation when GAE
is not spent on care of the elderly. Would failure be measured
in that way, or would it be measured by bedblocking or by something
else? What criteria would you use to identify failure, as mentioned
in paragraph 66 of the policy memorandum?
The precise sums of money spent are obviously related
to outcomes, but ultimately it is the outcomes that matter, rather
than the sums of money. The criteria will have to be based on
outcomes and they will have to be developed at the same time as
performance management arrangements are developed. Service outcomes
will be considered, rather than the precise sums of money spent.
So, if a local authority was spending less than its GAE
on care of the elderly, would you step in and use your powers
to recommend a single management structure as well as a single
That is a good question. You are pointing out that having
aligned or pooled budgets will not, in itself, solve the problem
of local authorities not spending all of their GAE. The amount
of money that goes into joint or pooled budgets is still a decision
for the local authority or the NHS board. You have highlighted
an interesting pointwe will still have to consider the issue
of how much money goes into the budgets in the first place.
Before asking a question, I declare an interest as a
member of Unison. That should keep everything right.
Minister, you mentioned
the integrated human resources working group that is headed by
Peter Bates. What is the membership of that group?
I do not think that anyone would have thought that you
were a member of Unison after the way you treated Jim Devine last
Having particular interests should not influence members
of the committee.
My officials will have to hand me a note of the people
in that group. I do not carry that kind of information in my head.
Perhaps nobody does. However, the group includes a representative
from Unison and I think that it is Jim Devine. I spoke to him
last week and he told me that he was involved.
The reason I ask is that I am concerned that the group
might be weighted to one sidehealth, local government or
the voluntary sector. I would be interested to know whether there
is an equal number of individuals from each sector to ensure that
we are considering the issues in an equal way. There are difficulties
in all the sectors. One of the areas identified in Unison's submission
related to the evidence we heard today about joint working in
Perth and Kinross and Dumfries and Galloway, which has floundered
to a certain extent because individuals employed by different
employers are undertaking the same job but receiving different
remuneration. Those are areas of concern for the trade unions.
How will that be addressed?
Those are big issues. I will write to the convener with
a note of the people on the group and where they come from. As
I said, I am looking forward to meeting Peter Bates soon.
Margaret Jamieson describes
the problems just as Unison did last week. However, the solutions
are not quite so easy to identify. Section 13 should
give comfort and maximum
protection to staff who are transferring. I know that, so far,
arrangements have mostly been made through secondment and that
Unison raised concerns about using secondment as a long-term arrangement.
Section 13 provides protection for transfer but the issue that
Margaret Jamieson describedpeople doing the same or similar
jobs with different wages and conditions and probably pensions
The Peter Bates group
is considering that because it is a more difficult and intractable
problem. Once again, I am sorry that I cannot give the committee
an interim report on that. Peter Bates has until April 2002 to
come up with some proposals on those issues.
You have asked the group to consider those areas, but
it is the attitude of staff that is important in ensuring that
the bill, should it be enacted, will deliver for the people of
Scotland. I would have thought that the staffing issue would be
one of the first things to be tackled. I am surprised that it
has been tacked on the end.
The Royal College of
Nursing raised that issue as well. That is not an area that I
usually pursue. However, the RCN said that there was not enough
emphasis on robust consultation processes and that there should
be a requirement on the national health service and local authorities
to consult their staff, the public and any others with a legitimate
interest. It seems to be an area on which you have fallen down.
I do not know about that. The Peter Bates group has been
up and running for a while. We acknowledge that it is a complex
area. I do not know all the people on the group, but I know that
Jim Devine is on it and I assume that most of the major players
are representedthe Royal College of Nursing is represented
on the group. It would seem to be the correct forum to deal with
No doubt we will return to that at a later date.
I am sure that you will.
Did the care development group consider the provision
and funding of aids and adaptations and what the level of service
We made a recommendation on that. This is one of the
matters about which it was not very easy to get detailed information.
We produced figures showing how much was being spent by local
authorities and Scottish Homes, but we recommended that the national
"should take forward
further work to consider the effectiveness of current provision
of equipment and adaptations and to progress improvements in these
We flagged up that
issue in the section of our report on housing, which at a previous
meeting of this committee one of our members described as a little
short. This is another area in which the initial money that is
being made available for the development of services in the community
could be deployed beneficially.
Are there any further points that you would like to make,
minister, or do you think that you have covered everything that
you wanted to discuss this morning?
Yes, I think that we have covered most things.
The questioning has been fairly comprehensive. I thank
the minister for giving evidence to us this morning. No doubt
we will see much more of him in the weeks to come, as we continue
to take evidence on the Community Care and Health (Scotland) Bill.
I want to put on record
that the committee invited representatives of Scottish Care to
attend this meeting to give evidence to us, so that we could hear
the views of those working in the private care home sector. Unfortunately,
Scottish Care did not feel able to do that at present. We hope
that we will receive a written submission from Scottish Care before
our stage 1 report is put together.
The Deputy Minister for Health and Community Care is here to discuss
the statutory instruments that are before us. We are to deal with
a series of instruments on the issues of amnesic, paralytic and
diarrhetic shellfish poisoning. Minister, would you like to open
with a general statement, or should we just work our way through
I can make a little speech, if members would like me
I know that Mary Scanlon has a question for you.
This is a delaying tactic.
Today's debate concerns
emergency orders banning the catching of king and queen scallops
in waters around Scotland. Orders SSI 2001/374 and SSI 2001/388
prohibit the harvesting of king scallops because of amnesic shellfish
poisoning. Order SSI 2001/387 prohibits the harvesting of king
scallops because of paralytic shellfish poisoning. Order SSI 2001/391
prohibits the harvesting of queen scallops because of diarrhetic
shellfish poisoning. In all cases the orders have been introduced
due to the respective toxin's being present in concentrations
above the action level set by the European Union. This is a consumer
safety measure, as scallops containing high levels of toxins can
cause illness in humans ranging from nausea, vomiting and headaches
through to extremes of short-term memory loss and death, which
can occur when a large amount of toxin is ingested
I assume that I will
have to move each motion separately.
We will deal with each instrument individually.
All these problems are caused by toxins and toxic algae.
There seem to be more outbreaks of shellfish poisoning at this
time of year, when the weather is cooler. Ought not outbreaks
to diminish at this time? What is the Executive doing to discover
the cause of outbreaks? Has any progress been made in finding
out why outbreaks are on the increase?
When I come to a meeting of this committee with an official,
as I have done on the previous six occasions on which subordinate
legislation has been discussed, I am not asked any questions by
members. When I come on my own, I am asked a detailed question
of a scientific nature. [MEMBERS: "Aw."]
Shellfish poisoning is a long-standing problem and I am not aware
of any significant deterioration in the situation. Clearly, I
will have to write a second
letter to the convener
about the research that has been done on this issue, to add to
the letter that I promised to write on a matter raised under the
previous item. I will write that letter, answering Mary Scanlon's
questions, within the next week.
Are you happy with that, Mary?
Yes. That is fine. Thank you.
In the spirit of co-operation, we are happy to accept
The first four statutory
instruments are subject to the affirmative procedure.
Protection (Emergency Prohibitions) (Amnesic Shellfish Poisoning)
(West Coast) (No 8) (Scotland) Order 2001
The Subordinate Legislation Committee had nothing to report on
That the Food Protection
(Emergency Prohibitions) (Amnesic Shellfish Poisoning) (West Coast)
(No 8) (Scotland) Order 2001 (SSI 2001/374) be approved.[Malcolm
Motion agreed to.
Protection (Emergency Prohibitions) (Paralytic Shellfish Poisoning)
(East Coast) (No 2) (Scotland) Order 2001 (SSI 2001/387)
The Subordinate Legislation Committee had nothing to report on
That the Food Protection
(Emergency Prohibitions) (Paralytic Shellfish Poisoning) (East
Coast) (No 2) (Scotland) Order 2001 (SSI 2001/387) be approved.[Malcolm
Motion agreed to.
Protection (Emergency Prohibitions) (Amnesic Shellfish Poisoning)
(West Coast) (No 9) (Scotland) Order 2001
The Subordinate Legislation Committee had nothing to report on
That the Food Protection
(Emergency Prohibitions) (Amnesic Shellfish Poisoning) (West Coast)
(No 9) (Scotland) Order 2001 (SSI 2001/388) be approved.[Malcolm
Motion agreed to.
Protection (Emergency Prohibitions) (Diarrhetic Shellfish Poisoning)
(Orkney) (Scotland) Order 2001 (SSI 2001/391)
The Subordinate Legislation Committee had nothing to report on
That the Food Protection
(Emergency Prohibitions) (Diarrhetic Shellfish Poisoning) (Orkney)
(Scotland) Order 2001 (SSI 2001/391) be approved.[Malcolm
Motion agreed to.
We now move to consideration of statutory instruments subject
to the negative procedure.
I can go now.
You are free to go, minister. Thank you very much for
Stuffs and the Feeding Stuffs (Enforcement) Amendment (Scotland)
Regulations 2001 (SSI 2001/334)
The regulations were originally circulated to members on 5 October.
No members' comments have been received. The Subordinate Legislation
Committee has made comments to the Executive and is satisfied
with the Executive's response on drafting matters. No motion to
annul the regulations has been lodged; therefore, the recommendation
is that the committee does not wish to make any recommendation
in relation to the instrument. Are we agreed?
Health Service (General Dental Services) (Scotland) Amendment
(No 2) Regulations 2001 (SSI 2001/368)
The regulations were originally circulated to members on 9 October.
No members' comments have been received. The Subordinate Legislation
Committee has made comments to the Executive and is satisfied
with the Executive's response. No motion to annul the regulations
has been lodged; therefore, the recommendation is that the committee
does not wish to make any recommendation in relation to the instrument.
Are we agreed?
That brings us to the end of our public business for
in private until 12:05.