Proposed legislation that aims to provide better support to Scotland’s carers has been backed by the Health and Sport Committee. However, MSPs are calling for the Scottish Government to address a number of concerns.
In its stage one report on the Carers (Scotland) Bill, the Committee outlines its concern that the costs the Government has set out to pay for implementation of the legislation may be underestimated and that this may have a detrimental effect on other care services. MSPs are calling on the Government to commit to providing additional funding should the costs of implementing this bill be significantly higher.
On the detail of the proposals the Committee is concerned that the broadening of the definition of a ‘carer’ could reduce local authorities ability to prioritise cases which may then result in resources being diverted away from those cared for people most in need.
The Committee also believes that there should be a greater emphasis in the Bill on the role of the NHS, integration joint boards where appropriate and that GP practices in particular could play a greater role in identifying carers.
MSPs also share the concerns of carer’s organisations that a lack of consultation with carers when the person for whom they are caring is admitted to hospital or most importantly when they are discharged, could lead to unnecessary readmissions to hospital. The Committee has recommended that the Government respond to the call for a duty to be placed on health boards to involve carers in hospital admissions and discharge procedures.
Convener of the Committee Duncan McNeil MSP said:
“It is clear from our work into this legislation that carers make an invaluable contribution within our society and that this role often goes unrecognised.
“Our Committee believes that this legislation will significantly contribute to supporting carers. However, we have a number of concerns which we are asking the Scottish Government to urgently address.
“We are also calling for assurances from the Scottish Government that this bill actually has the resources behind it to deliver the step change that it promises on paper.”
Deputy Convener of the Committee Bob Doris MSP said:
“During our scrutiny of this legislation we spoke too and heard directly from many carers across Scotland to get their view on how this bill would influence their lives and the life of the person they care for.
“The Committee was clear that this legislation would provide a better deal for carers and would enable support services to be more targeted and focused on the carer themselves.
“However, there are clearly areas of detail that the Scottish Government needs to work on as this legislation progresses through Parliament. Our Committee was clear that areas such as the role of the NHS and GPs and consultation with carers on hospital admissions are two areas that need action.”
The report made a number of recommendations including the following:
On the definition of a carer:
- The Committee supports the broadening of the definition of ‘carer’ and the provision of a universal entitlement to an Adult Carer Support Plan and Young Carer Statement which will enable more carers to seek support. However, we are concerned by witness evidence that this could reduce local authorities ability to prioritise cases which may then result in resources being diverted away from those cared for people most in need.
On eligibility criteria:
- The Committee recognises the concerns on both sides, with regards to setting out eligibility criteria either locally or nationally. We note the Scottish Government’s intention to provide national direction through guidance to which local authorities must have regard.
- Whilst the Committee notes the evidence from carers that the bill should require eligibility criteria to be set out by the Scottish Government on a national basis from the outset, it also recognises the views expressed by local authorities that there is a need to allow them to prioritise in line with local needs.
- The Committee requests that the Scottish Government give further consideration to whether the balance of eligibility criteria between Government and local authorities is appropriate.
On short breaks:
- The Committee believes that short breaks are vital in enabling carers to continue in their caring roles in good health and to maintain a life alongside caring. However, the Committee is concerned that the Bill does not provide enough clarity on what constitutes a short break.
- The Committee recommends that the Scottish Government provide further clarity on what may be offered to carers under the term short break.
On information and advice services:
- The Committee recommends that the focus of the Bill should be to support and enhance existing carer information and advice services and only require the establishment of new services where necessary.
- The Committee recognises the concerns raised by witnesses in relation to the allocation of resources within the third sector and of the estimated costs for the necessary provision of information and advice workers.
Identifying carers and the role of the NHS
- The Committee recommends that there should be a greater emphasis in the Bill on the role of the NHS (along with integrated authorities where appropriate) in the preparation of local carer strategies and that the duty to consult health boards should make explicit reference to establishing an integrated strategy for identifying and supporting adult and young carers
- The Committee requests that the Scottish Government responds to the views expressed by a number of witnesses that the identification of carers could be greatly improved by requiring GP practices to maintain carer registers.
Hospital admission and discharge procedures
- The Committee shares the concerns of carers and carer organisations that a lack of consultation with carers when the person for whom they caring is admitted or, more importantly discharged from hospital could result in crisis situations developing and lead to unnecessary readmissions into hospital.
- The Committee recommends that the Scottish Government responds to the calls from carers and carer organisations to include provisions in the Bill that place a duty on health boards to involve carers in hospital admissions and discharge procedures.
- The Committee recommends that the guidance issued to local authorities on the preparation of local carer strategies places a greater emphasis on the role of schools in identifying and supporting young carers.
- The Committee recommends that the Scottish Government set out the level of detail of a young person’s caring role that would be shared with their Named Person, under what circumstances, and what involvement the young carer would have in those decisions.
Costs and resources
- The Committee shares the concern of many stakeholders that the costs set out in the Financial Memorandum may be underestimated which may have a detrimental effect on other carer services and mean that the aims of the Bill will not be met.
The Committee believes it would be helpful for the Scottish Government to publish the findings of the finance led group. It should then set out revised estimates for the costs associated with implementing the Bill, or commit to providing additional funding in the future should it become apparent that the costs set out in the Financial Memorandum are significantly underestimated.