Scotland’s policy of providing free personal care for older people has led to a fairer system without any undue extra public spending, according to an independent assessment carried out for the Joseph Rowntree Foundation and published today. The Scottish Parliament decided in 2001 that elderly people could have free care at home and in residential and nursing homes.Researchers from the University of Stirling say people who use care services in Scotland and their families feel the arrangements are more equitable and an improvement on the past. The view is shared by social care managers in Scottish local authorities and care home providers. The study also finds that the system has not only reduced means-testing and money worries but it has not led to a reduction in informal support provided by relatives and friends as some people feared it might.
An economic analysis in today’s report shows the policy has cost more than expected. In 2002-03, for example, the actual bill was 127 million pounds compared with a planned figure of 107 million. The report says, though, that the current annual cost of 140 million pounds accounts for 0.6 per cent of the Scottish Executive’s total budget and so it has only a marginal impact on other areas of public spending.
The study concludes that differences in the public costs of personal and nursing care between Scotland and the rest of the United Kingdom are smaller than has been suggested because care home residents in Scotland are no longer paid Attendance Allowance and because payments for nursing care are typically more generous in England, Wales and Northern Ireland.
For the future, the report anticipates that a big rise in the number of people aged 85 and over might lead to a tripling of the public costs of personal care by 2053 but a further shift towards providing more care services at home and policies to promote healthier living could significantly reduce the projected bill.
The researchers, David Bell and Alison Bowes, found that free care had particularly benefited older people with degenerative conditions but that there were still misunderstandings among older people and carers about the extent of free personal care. They also identified concern among local authorities as well as older people and carers about the interaction between care charging policies and other parts of the welfare system, especially benefits.