Contrary to the headlines over years of petty and ill-informed sniping from opposition parties and the MSM, within Scotland, the personal care service here is seen as a model for adoption in Tory-abused England by the Institute for Public Policy Research.
‘While the NHS has been protected since the financial crisis, social care has faced significant funding cuts. This is having severe consequences in the sector. There has been a staggering 5 per cent drop in the number of people receiving publicly funded social care per year – totalling around 600,000 people since 2010 – despite an ageing population (Darzi 2018). The cuts are also beginning to impact on quality, particularly as a result of workforce pressures – with high turnover and huge staffing gaps. Meanwhile, provision in the sector is becoming increasingly unstable as a growing number of providers struggle to survive.’
Published on 23 May 2019, this IPPR report talks of a crisis in social care in England. There are several points at which the model developed in Scotland is mentioned as something that can be learned from. Though the report points to areas where the Scottish system can be improved, there are three comments we can take unreserved pride in:
- Whilst the government in England rejected the recommendations made by the Royal Commission on Long Term Care for the Elderly, largely based on cost, Scotland decided to implement them. This allows us to understand how this system might work in practise.
- Ahead of its introduction in Scotland many argued that free personal care would simply crowd-out informal care from family and friends. However, the evidence does not support this: there has been no reduction in informal care hours delivered in Scotland (Bell and Bowes 2011). Instead there is evidence that carers switched the tasks they perform from basic caring functions (eg washing or dressing) to emotional and social support (with greater flexibility about when this care was delivered). This is a particularly striking finding given that the evidence suggests that social and emotional support is the area of care in England that has suffered the most under austerity (Darzi 2018). This suggests that the introduction of free personal care could address this deficiency and significantly improve the quality of care in England.
- However, these cost increases could be offset further by the potential efficiency savings delivered by greater integration between health and social care. Some of these can be achieved as an inherent part of the system re-design. For example, the introduction of free personal care should make NHS continuing healthcare redundant which IPPR calculated could deliver an annual saving of up to £2 billion per annum rising to £3.3 billion by 2031 (see info box).4 There could be savings on attendance allowance (if it only becomes accessible to people in their own home as in Scotland).