East Ayrshire Council’s chief executive has laid out his concerns about Scotland's proposed national care service (NCS) to MSPs.

Eddie Fraser, who was the head of East Ayrshire’s health and social care partnership for six years, was among the speakers at the Scottish Parliament's local government, housing and planning committee last week.

The local authority has already set out significant criticisms of the NCS plans, arguing that the organisation could undo much of the positive work that has seen the authority, together with NHS Ayrshire and Arran, become one of the top performing partnerships in Scotland.

Mr Fraser told the committee: “We have never argued against a national care service. It is a question of what is the role of that national care service.”

He said that there was a place for a national body that would provide a ‘framework’ for care services. However, he insisted that the the best local delivery of care services came via "local people and local systems".

Mr Fraser went on to explain the level of connection between care services across the council and health service and within the council itself - connections that he is worried would be severed with the advent of the NCS.

“It is not delivered only by social work or by the health and social care partnership," he said.

"It runs through everything from well-being services right through to the health service.”

The ability to deal with some of the more vital and complex cases would be hit by the move to a centralised service, he continued.

“It is not just about social care, there is also the removal of responsibility of social work at a local level," he added.

"That includes child protection, adult protection, violence against women. There are significant risks around changing that accountability.”

Mr Fraser also said there was a lack of appreciation for the progress made in terms of social care in Scotland, citing his own decades long experience in the social work field.
He said that he had worked in the time when there were ‘home helps’ who only operated nine to five and where people with learning disabilities would invariably live in an institution.

“We are not talking up how progressive our care system is,” he continued.

“I have seen huge progress, such as work around self directed support. There may be an implementation gap between the policy and the what is happening, but the improvement is getting lost in place of structural reforms.”

He also raised concerns that the proposed changes would see a disincentive to provide preventative programmes, even such simple ones as older people’s tea dances and learning support events.

“We start to link different bits together and put more investment in wellbeing because the traditional things did not work for us," he said.

“At the core of it is the value of social care. If it is seen as a means to support the health service then it will not be valued for what it is, a way to help people stay as independent as they possibly can.

“We  need to be able to invest in things like tea dances at the preventative end to be taking the weight from further up.

“One of the dangers I see here is, where will the incentive to invest in these be?”

Mr Fraser suggested that there were already structures in place that would allow a centralised monitoring of the various health and social care partnerships, both at the authority level and from the Scottish Government.

The introduction of the NCS could also have a major impact on other council services as well, he argued.

Pointing out that much of the work of EAC’s legal team was spent on supporting social workers in their court work, he said removing this would reduce stability, as it would with other services such as human resources.

He also gave a specific example, saying: “We’ve moved down the line where on the whole our social care workers go around in electric cars.

“That is a big part of our garage services. If you take the social care workforce away, and transfer assets like the cars, it leaves us with a garage that might not be sustainable.”