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What are the prospects for Scottish care funding?
Funding for care services in Scotland has been continuously reduced due to year-on-year cuts in local authority funding, causing great difficulties for people who use these services. The simple cause of this is central national government’s programme of reduced spending in an effort to eliminate our national economic deficit as quickly as possible. However, new policy and practice initiatives hold out some hope for alleviating the worst effects of funding reduction.
Policy and practice initiatives
In self-directed support, funders are legally obliged to give care service users more autonomy, choice and control of their care service. This has the potential for more innovative, personalised and effective services. Similar high expectations are held of the national programme to integrate health and social care services, and three change funds (Reshaping Care for Older People, Reducing re-offending Fund, and the Early Years and Early Intervention fund) have been introduced as part of the reform of public services, as wells as the integration of health and social care.
The overall aim is to shift towards a preventive approach, to manage care problems 'upstream' and therefore to reduce demand on long-term services. There are some shining examples of preventive, partnership working developing within the sector, putting people at the centre of services providing advice and information: for example, community cafes to promote participation, good mental health and self-management; and promoting activity for better physical health - these are all examples of alternative approaches, and interestingly have a common theme of service users as a resource, participating and co-developing the service which they receive.
More Council fiscal autonomy?
A further potential change that may impact funding, are the possible changes in local authority finances. Reform Scotland quote OECD figures which show that we have substantially less tax raised locally than in other comparable countries. They have recommended that local authorities here should be able to raise much more of their finances through local tax initiatives, which could in turn, reduce dependence on grants by central government to sustain the level of care service provision.
Three provisos apply, I think. a) the electorate may not welcome what may be an overall increased tax burden, B) the local taxes would have to cover more services than health and social care and c) the proposals are at present only recommendations to the Commission on local Tax Reform.
So we can be optimistic, but not yet certain that the changes in policy, practice and funding of new services will begin to redress the cuts which have been so damaging over the past years.
Tony Clarke – QCS Expert Scottish Care Contributor