When free personal care was introduced in Scotland, it was broadly welcomed and there was not the predicted shift from informal to formal care.
The level of informal care remained the same but extra support freed carers to provide other care such as shopping. This increased care has enabled older people to remain at home longer.
However, free personal care is not widely understood, with many believing all care is free.
In Scotland, care home residents pay for accommodation, food and utilities, along with ‘non-personal’ domiciliary care. The public needs a clear understanding of the policy.
Local authorities must be appropriately funded and provision needs to be consistent. Guidelines are also needed on whether local authorities should direct clients to care homes rather than support them at home. A shift towards care at home has occurred since 2002.
Unmet need was seriously underestimated and this, along with the movement of costs from health to social care, contributed to increased demand.
Between 2002-05 there was a 10% increase in local authority home-care clients. Of these, the number receiving personal care increased by 62%.
The 2008 Sutherland Review recommended reinstatement of part of the attendance allowance budget, removed by the UK government in 2002.
It was estimated the value of attendance allowance payments for people receiving nursing and residential care would have been £30m – the value of the shortfall in the Scottish system.
Overall, Scotland’s system means there is clearer contract between the state and older people – an important principle.
- The Joseph Rowntree Foundation commissioned two reports following introduction of free personal care in Scotland.
Sue Collins is programme manager with the Joseph Rowntree Foundation