The report calculates that the £3.1bn currently spent annually on social work will need to rise by up to £667m between now at 2020 just to meet current demand projections. It acknowledges innovative ways some councils have found to maintain social work services, on which spending has risen by 3% since 2011-12 while overall municipal spending has been cut by 11%.
But that approach is no longer sustainable, the report says, and new thinking is required at this “watershed” moment. This was particularly important given the ongoing reorganisation of social care delivery through joint local authority/NHS boards, the financial impact of paying the Living Wage to all employees, and the challenges of demography.
It calls for a fundamental and inclusive review of provision, taking into account demographic projections, funding outlook, best practice and the principles of user-led services. There should also be better accountability, a stronger analysis of outcomes, better risk assurance and increased measurement of user satisfaction with the services provided.
"Increasing pressures on social work and rising expectations of what it should deliver can only intensify,” commission chair Douglas Sinclair said. “Now is the time for some frank discussions and hard choices. It is vital that people who use and provide services – and the wider public – are actively involved in that debate on future provision."
The report says that the social care merger has made governance more complex, but reminds councils that they retain statutory responsibility for these services. “Elected members have important leadership and scrutiny roles in councils,” it states. “It is essential that elected members assure themselves that service quality is maintained and that risks are managed effectively.”
It urges both councils and ministers to engage the public in debate about the long-term shape of social work and social care.
Currently around 300,000 Scots of all ages receive some form of care. The public, voluntary and private sectors employ more than 200,000 social work and care staff. Even so, most care is provided by 759,000 unpaid carers, whose work is valued at £10.8bn a year.
The report received a cautious welcome from the Convention of Scottish Local Authorities, representing most Scottish councils. Peter Johnston, who speaks on health and wellbeing, welcomed recognition of the innovations applied by councils and committed member authorities to work with ministers to bring about further reform.
He endorsed the report’s view that a tipping point had been reached at which existing financial approaches were no longer viable, and accepted that councillors continued to bear both statutory responsibility and a key role in leading debate.
But he added: “We need all partners – including the Scottish Government – to support and engage in an honest and frank dialogue with the public about what we can and can’t afford going forward, and how we can fundamentally redesign services so that they are both more effective and more affordable.”
