Lindsay Scott | Age Scotland | What are the issues around Scotland’s constitutional future and older people?
Perhaps the most groundbreaking piece of legislation passed by the Scottish Parliament has been Free Personal and Nursing Care for the Elderly. It was an area of policy where the then Labour – Lib Dem Executive took a different approach from the UK Labour Government and helped established a significant precedent, where devolution would produce different policy solutions within the 4 nations of the UK, even where the same party had power at both Holyrood and Westminster.
This policy has been hugely successful in shifting the balance of care and now more people are receiving the care they need in their own homes. The number of people in receipt of free personal care in the home increased from 32,870 in 2003/4 to 44,200 in 2008-9. This increase in demand more than surpasses the rate of growth amongst the older population and is helping delay admission into residential accommodation, one of the policy’s key aims. Not only is this what older people want but it is by far the most cost-effective option.
Care homes cost around £600 per week while the average weekly cost of a personal care package delivered at home is around £119. When you scale that up to a rapidly growing population it is clear that investing in Free Personal and Nursing Care is a key pillar of preventative spending. Also it is a very popular amongst older people as signalled in Lord Sutherland’s 2008 report.
But despite it being an effective policy it is not a cheap one; with over £350m being spend annually to fund it. Yet because the UK Labour Government was pursuing a different approach to personal care and was continuing to charge for services according to a recipient’s capacity to pay, there was tension between the Scottish and UK administrations about funding for the policy. The then Scottish Executive had expected to rely on the continued payment of the UK attendance allowance (AA) as a partial contribution towards the personal care costs of care home residents, however as is well known the Department for Work and Pensions (DWP) disagreed.
Clients being provided with personal care in care homes in Scotland no longer receive AA, as DWP rules preclude its payment when a local authority is contributing towards the client’s care costs. This means that DWP retains the payments that would previously have been made to these clients. In contrast, those receiving free personal care at home, who previously paid for this care, continue to receive AA.
The lack of flexibility in the UK benefits system affects the costs associated with free personal care in Scotland, adding an additional £22m to the price of the delivering Personal Care. There is a consensus amongst politicians in the Scottish Parliament that if policy changes north of the border remove eligibility for UK benefits, then there should be a mechanism for re-allocating this money to Scotland, a position that the charity fully endorses. However successive UK Government’s have rejected this and taken a politicised approach to funding decisions.
Age Scotland is not calling for more powers for the Scottish Parliament per se, but the current settlement does not give the Scottish Government the freedom to pursue policies that sit within its legislative gift without it being financially punished. If powers with regard to the benefit system were devolved, we would remove some of these vagaries and be able to concentrate our efforts on improving care for older people rather than debating constitutional theory.
Whether the solution comes in the form of more powers for the Scottish Parliament or an improved intergovernmental interface, surely in the twenty-first century it should be possible for politicians of both institutions to work together to improve later life for all of Scotland’s older people. We live in hope.