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Now is the time to focus on tackling Scotland’s health and social care crisis, not restructuring services for a National Care Service

Colin Poolman 20 Dec 2022

Last month I gave evidence to the Scottish Parliament’s Health, Social Care and Sport Committee on the National Care Service (Scotland) Bill. 

Social Care
With so much public focus currently on NHS pay and our mandate for strike action across Scotland’s NHS boards, this was a welcome opportunity to discuss the challenges facing our members working in social care settings, while also reminding MSPs that the serious issues facing our health and social care services are all interlinked. 

I told MSPs on the Committee that RCN Scotland agrees with the view expressed by many stakeholders, that now is not the right time to proceed with plans to create a National Care Service (NCS). We believe the Scottish Government must focus on dealing with the crisis that is engulfing Scotland’s health and social care services right now, rather than embarking on an expensive and disruptive structural shake-up.   

We agree that the way our social care system works is unsustainable and are very clear that the care home and community sectors have been undervalued for far too long. We agree with the aims behind the NCS Bill to improve the quality and consistency of care across Scotland. But the last thing that individuals working under pressure to deliver services need right now is disruptive structural overhaul.  

They need services to be better funded. They need increased investment in the workforce so that the social care and community health sectors have the right numbers of staff, with the right skills, in the right place. They need the workforce to be better valued, with better pay, terms and conditions and access to professional development and clear career pathways. Central to all of this is the need to recognise the increasing necessity to deliver complex clinical care within community and care home settings. 

The success of social care reform is entirely dependent on having the right workforce and this must reflect increasing clinical need in Scotland’s communities and recognise that nurses are in a unique position to deliver the required level of clinical care.    

There are still so many unanswered questions about the Scottish Government's plans for a NCS. We don’t know how the NCS will operate in practice, what services it will be responsible for delivering or how it will coordinate effectively with the NHS. Ministers plan to work out the detail through a process of ‘co-design’ once the legislation has passed. We have a lot of concerns about this approach and believe Ministers need to be really clear about the detail of what they’re trying to achieve before passing the legislation to create the structures of a NCS.   

The current critical situation across Scotland’s hospitals will not be solved until the shortages within the social care and community health sectors are addressed. This needs to be an urgent priority and we are concerned that a focus on this huge structural overhaul is diverting attention and resources away from where they need to be.  


Read more about our work on a National Care Service here 

You can watch the evidence session here  
Colin Poolman

Colin Poolman

RCN Scotland Director

Page last updated - 20/05/2023