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Last Tuesday, 1 February, three months after receiving them, Scottish Government published 1,098 responses to its consultation on the National Care Service. Of course, the sheer number of responses will have impacted how long was needed to prepare them for publication, including the permission and redaction process.

This is no small matter. The quality of life for so many of us, and our loved ones, will be directly affected by the Scottish Government’s decision on the ultimate shape of Scotland’s National Care Service.

Carnegie UK’s work to develop Gross Domestic Wellbeing, ‘a holistic alternative to GDP as a measure of social progress’ uses four domains to assess collective wellbeing – democratic, social, economic and environmental.

Democratic wellbeing relies on us trusting that our voice will be heard in decisions that affect us.

An estimated quarter of a million of us receive adult social care, a number anticipated to significantly increase as our population ages, and not including Scotland’s army of unpaid carers. The Independent Review of Adult Social Care, tasked with exploring the creation of a National Care Service, met with over 1,000 people. So, it’s unsurprising that so many individuals and organisations felt they had something important to contribute to the government’s thinking, something it needed to hear; and dedicated time and resources to participate in the consultation.

But for this engagement in the democratic process to translate into trust in democracy, Scottish Government must demonstrate that these views were heard. The first test will be when government publishes its analysis of the responses; when we see how the voices were interpreted, and the way the careful work of analysis was approached.

The Promise Scotland’s response, like others, concluded that there was no evidence as to whether the government’s proposition to include children and families in the National Care Service would or would not #KeepThePromise. This response was only one of over a thousand government received, but it was reached via The Promise Scotland’s commitment to its obsolescence - so no vested interest - and an unwavering focus on the change required to #KeepThePromise. Its position came from the work of the Independent Care Review that listened to thousands of children and young people. Over three years and through listening to over 5,500 individuals it built a shared vision for Scotland. The response also took account of the work done over the past two years towards making that a reality.

Some organisations undertook surveys to inform how they answered the National Care Service consultation questions. Subject-matter experts, like the NHS Board Chairs and Chief Executives who have shared interests, devised collective responses. Representative bodies took responsibility for relaying multiple opinions in their response. Many without the resources to participate fully in the consultation will have relied on others to convey their important messages.

Although a thousand responses may not seem significant compared with how many of us receive social care, organisations, groups and individuals showed up and did what they could with the resources they had in the belief that they would be heard – whilst also fulfilling their sense of democratic wellbeing.

What the government needs now is rigorous analysis - not arithmetic.

Analysis that respects the diverse range of ways that citizens engage in democratic processes, that ensures all these voices are properly heard, including the multiple voices in single responses; that appraises the expert views, and takes account of any vested interests – which by their very nature consultations, and reviews, attract.

In a process designed to allow for engagement so varied and diverse, all things are not equal. In a decision that is so important, one plus one does not necessarily or simply equal two.

The ultimate tests of the impact of the consultation will be whether the voices informed the final decision - and whether that decision is the right one for the people of Scotland.

Since August last year when the Scottish Government’s consultation started, the uncertainty about the final shape of the National Care Service has been unsettling. It created an unwelcome hiatus in terms of work to #KeepThePromise. With several, including The Promise Scotland, expressing worries that, never mind the consultation, any subsequent public sector reform will be a huge distraction and suck up precious time that would be so much better spent on change - and thwart the ongoing work that is gaining traction and giving cause for hope.

To allow for the legislative timetable to be kept, it is expected that the Scottish Government will make public its decision in March.

This leaves the rest of us with a few weeks to catch up: to examine the responses; to consider the analysis when it comes; and to reflect on our own views and whether the government has addressed any concerns we may have voiced.

To make sure its programme of work respects the range of positions and perspectives, The Promise Scotland has commissioned an independent analysis of all responses that mention children and families. The volume of consultation responses and when they were published means this is unlikely to be finalised before the government announces its position - so The Promise Scotland is unlikely to be clear about what has informed the government’s evidence base.

But importantly for government, the scale of engagement provides an opportunity to demonstrate that it cherishes democratic wellbeing and can be trusted to be open and transparent in its decision-making.

Ministers may believe that clarity on the National Care Service and a plan for significant public sector reform will help them win over voters and ensure the retention of a majority.

They might be right.

But the Independent Care Review secured cross-party support, which was restated in February 2020 when it published its seven reports and has been maintained ever since by The Promise Scotland. Meaning there is no political impediment, nationally or locally to #KeepThePromise.

And, on Saturday 5th February, the activities to mark the second anniversary of the Care Review showed progress is being made. Hundreds of individuals and organisations reaffirmed their commitment to change, with many listing what changes they’d made, and what else they are planning to do differently.

For democratic wellbeing to thrive, there needs to be no false analysis that sabotages the heartfelt promises to do better by children and families. Because at its worse, hasty decisions, loss of progress and momentum towards meaningful sustained change could lead to, say in a decade’s time, Scotland having another care review – and the generation promised better, but let down, asked to re-live their trauma alongside a new generation, failed in all the same old ways. All to tell Scotland what it already knows now.

What the Scottish Government does next will not only be test of the extent to which we all have a voice in decisions that affect us and whether that voice is heard, it will also determine our democratic well – or ill – being.


About the author

Fiona Duncan - Independent Strategic Advisor
Photo credit: Sarah Maclean

Fiona Duncan

Independent Strategic Advisor

Fiona Duncan is the Independent Strategic Advisor on the promise, and advises Scottish Ministers in this capacity.