Scotland’s independent think tank
Scotland’s independent think tank

We’re running out of time to overhaul the care system

This article by Alison Payne first appeared in The Times on 14 October 2021.

People can often face significant challenges in accessing social care and too often cost is a barrier. While healthcare is largely provided through the NHS in Scotland, is taxpayer-funded and is free at the point of use, social care is not.

There are an unknown number of people who pay for their own care support, whether at home or in a care setting, as well as many people who might actually need care but are not accessing it — perhaps relying on family, friends and neighbours, or waiting for support to be put in place.

The sector’s workforce is also facing problems of recruitment and retention. Despite the vital and skilled work being carried out, terms and conditions can compare poorly with other industries.

These problems are likely to grow as Scotland’s population ages and demand for social care increases. The Scottish government established the Independent Review of Adult Social Care in Scotland, chaired by Derek Feeley, to recommend improvements to adult social care and address these issues. That report outlines the steps needed to deliver transformational change.

While there is political disagreement around the proposal to set up a national care service, there is agreement about the other provisions contained in the report, such as extending eligibility and increasing wages. But those policies would cost at least £660 million a year and politicians have yet to explain how they can meet that cost. The national insurance increase by the UK government is likely to be spent on the NHS, not social care.

Reform Scotland’s new report, The Cost of Caring: Getting Serious About Funding and Improving Social Care in Scotland, sets out how we can pay for the necessary change. We argue for a temporary 1p rise in income tax so that we can start implementing the recommendations set out in the Feeley review now.

But we also need a long-term sustainable solution. This is why we call for a cross-party commission to develop a social insurance system to fund a social care service.

Our report also calls for a widespread public awareness campaign so that voters better understand how social care is currently paid for. Radical change is needed. That comes with a cost, but we can’t afford to keep waiting.