National Care Service (NCS) National Forum 2025: ministerial speech

Good morning everyone. I am delighted to be with you today for my first National Care Service Forum since I have taken up my relatively new post. 

I am looking forward to hearing from you as we gather to shape the future of social care in Scotland. This is not just a policy discussion - it is a conversation about people, about dignity, and about the values that define us as a nation.

Let me start with a simple truth: social care touches every one of us. Whether it’s supporting an elderly parent, caring for a child with additional needs, or helping a neighbour through illness - these services are woven into the very fabric of our communities. 

Every day, thousands of people rely on these services. Over the course of a year, one in 23 people in Scotland access care, and for those aged 65 and over, that figure rises to more than one in five.

Everyone in this room knows that need for reform is clear. Scotland’s population is ageing. Demand for care is rising. Financial pressures are real. And the pandemic exposed vulnerabilities in our system that we cannot ignore, and we know that without bold action, these pressures will only intensify.

That is why this financial year the Health and Social Care Budget reached a record £21.7 billion. Investing in social care is not only the right thing to do but it also has a strong economic case.

It can help prevent health crises, reduce hospital admissions, and ultimately save the NHS money – all while supporting people the way they want to be supported. 

Just last week the Cabinet Secretary for Health, Neil Gray, announced a further £20million for social care to boost capacity and reduce hospital admissions this winter. 

But even as investment has reached record highs, Scotland’s adult social care sector faces avoidable financial strain. The UK Government’s changes to National Insurance contributions are set to cost the social care sector in Scotland over £84 million a year, while proposed restrictions on international recruitment threaten the sector’s sustainability.

The Independent Review into adult social care highlighted a real opportunity for change by moving from a crisis response to prevention, from financial strain to strategic investment and from fragmented services to collaboration. 

A shift in approach, attitude, and perception will lead us to a fairer, more equitable social care system for scotland.

We have spoken to thousands of people since the review, and we continue to put people at the center. 

Everyone has a right to live a full life. Our goal remains clear: to ensure high-quality, consistent, and compassionate social care for everyone in Scotland.

The establishment of a National Care Service was one of the elements the Feeley review said was required to shift attitudes and ensure consistency.  

While proposals for structural reform were ultimately not supported by Parliament and COSLA, the Government remains committed to achieving the scale of improvement that the Feeley Review said was necessary.  

The National Care Service is about what we do to improve the system for everyone in Scotland - it is a programme of work that will bring about the change that people want to see. 

It is action that is important – not a set of structures in how we’re organised. And let me repeat that - it is action that is important and not a set of structures in how we are organised.

We have reached a new agreed position with local government, with a focus on driving improvement against existing statutory responsibilities, enhanced by additional powers in the Care Reform Act.  

We’re driving improvement by actively involving people with lived experience in decision-making and ensuring their input shapes outcomes.  

This means people are involved in decisions about their care, service planning, and policy at individual, local and national levels. That’s why we’re here today, and that’s why your voices matter.

We have just heard all about the interim NCS Advisory Board from Susan Douglas-Scott and how it is bringing together key partners to drive reform, improve quality, and ensure consistency, across all areas of social care.  

The Advisory Board is an important step forward in empowering people with lived experience and will also help make decisions made about social care more open and understandable - driving transparency.  

The recruitment process opened for the full Board on Monday, and if you are interested you can apply on the gov.scot website.

We are taking a long-term, whole-systems approach to improving health and social care. 

To detail further how this will happen, we’ve published three interconnected plans and frameworks: the NHS Scotland Operational Improvement Plan, the Population Health Framework, and the Service Renewal Framework. 

Together, they set out a clear roadmap for delivering meaningful, lasting change. The Care Reform (Scotland) Act 2025 also provides the leadership and legislative framework to drive long-term improvements in social care. 

We’re putting the Act into action, bringing in positive changes shaped by what we’ve learned especially during the pandemic. 

The Care Reform Act itself has cemented Anne’s Law in legislation to ensure families are never again separated from loved ones in care homes.

It is supporting carers with a right to breaks.  As we plan the implementation of that new right, we have already increased short breaks funding to £13 million, helping up to 15,000 more carers take time off.

The Act gives more people access to independent advocacy to help you understand your rights, speak up about your care, and make sure your voice is heard.

It also reforms how services are bought and delivered, with new procurement routes to support third sector partners and ethical commissioning guidance to ensure fair treatment of workers.

We’re creating a legal framework to improve how services share information, leading to better coordination, continuity of care, and outcomes. The Act also allows faster, more cost-effective information sharing with the Social Services Council.

Strong professional leadership is key. And the Act has created a National Chief Social Work Advisor to lead the new National Social Work Agency, launching by Spring 2026, to support and advocate for the profession.

The Act also strengthens the Care Inspectorate’s powers to cancel a care service’s registration if necessary. And, building on pandemic collaboration, Healthcare Improvement Scotland will be able to support clinical aspects of inspections.

We are continuing to improve Self-Directed Support, which enables individuals to shape their care in the ways that best suit their lives, through the Self-Directed Support Improvement Plan.  

Additionally, investing further in the Support in the Right Direction Programme to make sure people across Scotland have access to Self-Directed Support information, advice and other support. 
Getting It Right for Everyone (GIRFE) is our adult practice model for ensuring that health and care organisations focus on people’s needs, and that services work well for everyone who uses them. GIRFE is currently embedded across Scotland.  

To plan for the future, we’re carrying out detailed research into unmet social care needs across Scotland—making sure the system is sustainable and responsive.

We know that up to 90,000 people in Scotland live with dementia, and this number is likely to increase over the next 20 years. 

To support people following a dementia diagnosis we are delivering a 10-year Dementia Strategy which includes a national anti-stigma campaign, enhanced access to post-diagnostic support, and more community and grassroots support. 

We have also reopened the Independent Living Fund to support disabled people with the most complex needs. 

Evaluations show that every £1 invested in the ILF generates up to £13 in social value through improved health, independence, and quality of life.

And on hospital delays we know there is much more to do. This requires catalysing the whole system to work together - both NHS and social care providers. 

We have a significant focus on reducing the number and length of delayed discharges, including for those individuals with learning disabilities and complex care needs through our Coming Home programme.  

We’re focused specifically on tackling the root causes of delays. 

This targeted approach is seeking to deliver better outcomes for patients, ensuring they receive care in the right setting, but also freeing up hospital beds for those who need them most. 

Importantly, this progress is cost-efficient - reducing unnecessary hospital stays and saving NHS resources, while providing the kind of care people want and deserve.

We need the sector to have a workforce that is valued, supported, and empowered. We are committed to ensuring fair pay, better working conditions, and long-term sustainability by attracting committed and reliable people to the workforce who want to care for others.

This year, we invested an additional £125 million to ensure adult social care workers in commissioned services earn at least £12.60 per hour, a rate higher than the National Living Wage in England and Northern Ireland. 

But fair work goes beyond pay. We’re working with COSLA, trade unions, and providers to introduce sectoral bargaining that will improve conditions. 

We’re also sharing our experience with other governments, including through collaboration on the Employment Rights Bill and Fair Pay Agreements to allow for the potential to create a Scottish Negotiating Body for the Social Care Workforce.

We have come a long way since the Feeley Review, but we are not finished. We need a whole system approach to improvement in social care and community health. 

We need local authorities, providers, carers, and communities to work together. We need innovation, collaboration, and courage. Above all, we need to keep people and their rights, their voices and their dignity, at the heart of everything we do. And achieving that I very much look forward to working with you all.