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Free personal care in Scotland
Free personal care was introduced by the Scottish Government in 2002. Local authorities will directly pay the care element of fees for those people whose care needs they assess and approve. The assessment covers direct assistance needed with daily living and counselling support. Some services may be chargeable, such as laundry or housework services. Nursing services come under the policy also, in care homes. Eligibility for attendance allowance remains, but those people receiving free personal care in a care home lose their eligibility for attendance allowance after 28 days.
Saving money from the public purse?
The policy, originally introduced with cross-party support, is now subject to strong criticism, as well as fierce support from several quarters. It is supported by advocates of the policy, who claim that it helps to maintain people in their own homes, and is thus cheaper than a care home service for people who need support. They claim it is saving money from the public purse.
A crisis point in escalating costs?
Critics point out that the future funding of the policy has not been made clear, and that a crisis point in escalating costs will soon be reached if new funding is not found. The Fiscal Affairs Scotland charity, an independent think tank, points out that the annual per person cost of free personal care has risen by £2,000 over the past 10 years, to £7,600. Their recent report predicts an ongoing increase in costs due to an increasingly elderly population, with more serious care and support needs, and a higher demand for support in the community. Approximately a quarter of the total expenditure of the scheme goes to support people in care homes, while three quarters goes on care at home. The proportion spent in community support is predicted to keep rising as people live longer and care needs increase as a result.
Committed to increasing the health budget
The Scottish Government strongly supports free personal care. The Health Secretary, Shona Robson, stated recently that the government is committed to increasing the health budget, and is also committed to integrating health and social care . Over the next three years, £500m is committed to this integration.
So, in times of austerity this popular policy is a testing point for the Government: can it sustain the increasing costs of supporting the care of (currently) 78,000 people, or will the increasing cuts in services across the UK as a whole impact on this service? Time alone will tell.
Tony Clarke – QCS Expert Scottish Care Contributor