Scots free care costs rise by 150%

29 Aug 12
Holyrood’s guarantee of free personal care for all elderly people is under renewed pressure from soaring costs
By Keith Aitken in Edinburgh | 29 August 2012

Holyrood’s guarantee of free personal care for all elderly people is under renewed pressure from soaring costs.

Figures from the Scottish Government show that the flagship policy now costs 150% more than when it was launched nine years ago. In 2010/11, it cost £342m, up from £317m the previous year and £133m in 2003/04, the first year of the policy’s operation.

Some in the care sector are now questioning whether universal free care is affordable. But the policy, brought in by the previous Labour-Liberal Democrat coalition under Henry McLeish and retained by Alex Salmond’s Scottish National Party administrations, continues to command broad political support. It is in part a victim of its own success, with uptake having risen rapidly. 

Numbers receiving home-based care have risen by more than 40%, from 32,870 in 2003 to 46,720 last year, while free personal care in care homes is now costing £108m, against £86m in 2003.

Supporters say that these figures conceal savings, because they reduce the number of elderly people needing to be looked after in hospital. But opponents say that demographic trends point to steeper demand ahead, with the charity Age Scotland projecting that Scotland’s overall care bill for older people could rise by £1bn in four years. 

The Association of Directors of Social Work has called for a review of care costs to be carried out in Scotland, similar to the Dilnot Commission in England which argued in favour of patient contributions to care costs up to a £35,000 ceiling.

But Cabinet Health Secretary Nicola Sturgeon said the Scottish Government remained fully committed to funding free personal care, and pointed to expected savings from the coming integration of health and social care provision. 

Labour’s Jackie Baillie said her party too remained committed to free personal care, but expressed concern that quality could be damaged by financial constraints: ‘We have previously suggested creating a National Care Service to join up budgets and set a minimum standard of care but are open to working with the Scottish Government to look at ways to ensure personal care is sustainable in the long term.’

Only the Scottish Tories voiced doubts about affordability. Health spokesman Jackson Carlaw said the policy ran alongside ‘vote-winning’ provisions such as  universal free prescriptions and free bus travel for all over-60s.

‘If the SNP wants to continue funding free personal care, then it has to be far less casual in extending other entitlements and refusing to find ways to make them more sustainable,’ he said.
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