Published Date:
By SCOTT MACNAB
FREE personal care for the elderly is fast becoming unaffordable and charges may have to be introduced, local government leaders have warned.
But Lord Sutherland, the architect of the landmark policy, said charging should be considered across the whole of the NHS before any decision was taken.
The Scottish Government has pledged to retain free personal and nursing care for the over-65s, but health secretary Nicola Sturgeon has already been forced to plug a £40 million funding gap.
Douglas Yates, health and wellbeing spokesman for the Convention of Scottish Local Authorities (Cosla), warned yesterday that change was inevitable and that elderly people could be means tested for personal care.
"The current system is not sustainable into the future," he said. "It's the demographics - the numbers that will be coming into the system and the cost to the taxpayer.
"The reality is that, with the age of baby-boomers who are coming up to pensionable age at this particular point in time, we'll need to be looking at a different system and perhaps charging."
TheUK
Elderly care has been largely free inScotland
• Too few people making provision to pay for care in old age
• David Manion: Ending free care would be false economy
Councils, which implement the policy, say they are chronically underfunded, and the situation has been magnified as spending cuts start to bite.
Cosla chief executive Rory Mair recently warned that free services were "killing"Scotland
Mr Yates said: "If there was a decision made to apply means testing to a particular situation, it would perhaps mean that many of those who receive free personal care might not do so into the future. They may have to pay for it. The message is going back through Cosla to the Scottish Government that there's a problem, a big problem, looming in the future. It needs to be given real, earnest consideration.
"I think there's definitely an acceptance that we have these problems looming. I don't think anyone is not well aware of it
The Scottish Government has pledged to retain free personal and nursing care for the over-65s, but health secretary Nicola Sturgeon has already been forced to plug a £40 million funding gap.
Douglas Yates, health and wellbeing spokesman for the Convention of Scottish Local Authorities (Cosla), warned yesterday that change was inevitable and that elderly people could be means tested for personal care.
"The current system is not sustainable into the future," he said. "It's the demographics - the numbers that will be coming into the system and the cost to the taxpayer.
"The reality is that, with the age of baby-boomers who are coming up to pensionable age at this particular point in time, we'll need to be looking at a different system and perhaps charging."
The
Elderly care has been largely free in
• Too few people making provision to pay for care in old age
• David Manion: Ending free care would be false economy
Councils, which implement the policy, say they are chronically underfunded, and the situation has been magnified as spending cuts start to bite.
Cosla chief executive Rory Mair recently warned that free services were "killing"
Mr Yates said: "If there was a decision made to apply means testing to a particular situation, it would perhaps mean that many of those who receive free personal care might not do so into the future. They may have to pay for it. The message is going back through Cosla to the Scottish Government that there's a problem, a big problem, looming in the future. It needs to be given real, earnest consideration.
"I think there's definitely an acceptance that we have these problems looming. I don't think anyone is not well aware of it
It's just how we tackle it and how it's dealt with, because decisions need to be taken that will not be popular."
At the moment, anyone assessed as being eligible for personal and nursing care at home is entitled to receive it regardless of income.
Those paying residential care costs - so-called self-funders - get a weekly contribution of £159 to their personal care, which rises to £231 if nursing care is also required.
Lord Sutherland yesterday stepped up calls for greater integration of NHS and social care budgets, a proposal at the heart of the recent Christie Commission report on reform of public services.
"Until that's done, you will be wasting money - using money ineffectively," Lord Sutherland said. "That's the way ahead, and it means there will be savings in health care, because a hospital bed costs you £2,000-plus a week - even a nursing-home bed costs half of that.
"It's less in a residential home and less if it's care at home in most cases."
He said that as well as saving money, more integration would also lead to better care. "What it means in my mind, and this will doubtless be unpopular, is that if there is some charging for care of the elderly, it should apply equally in the health services and you should treat it all as one pot of money and make your rational decisions across the whole piece," he said.
"I think at the moment the Scottish Government and Parliament have committed to too much public expenditure to be sustained across the whole board. If there are to be cuts, then health and social care should be regarded as a single item."
The Scottish Government's budget will fall by £1.3 billion this year and cuts will continue over the next few years.
A report by Holyrood's Independent Budget Review group, set up last year to deal with the impact of cutbacks, said the free personal care policy was "hard to justify" and called for the eligibility criteria to be looked at again. It also suggested a range of changes, including providing free only the first five hours of care at home per week and charging after that - that could bring annual savings of £119m. Removing free personal care in care homes could provide savings of £93m a year.
A Scottish Government spokesman said it was committed to "protecting vulnerable citizens".
He went on: "We will maintain the existing eligibility for free personal care. We established the Christie Commission on public sector reform in order to maximise spending on front-line services, given the financial challenges we face, and the Cabinet sub committee on public sector reform met last week to take forward our plans.
"The 2011-12 budget introduced a £70m change fund to help local authorities and health boards work together to deliver adult social care. We are determined to go further in delivering an ambitious reform programme, which puts citizens and communities at the centre.
"The Scottish Government has faced up to the consequences of the biggest reduction in public spending imposed by Westminster on any Scottish Government, and has worked with Cosla leadership to agree a council funding package which maintains key public service commitments, including free personal care."
The central recommendation of economist Andrew Dilnot's report for theUK
He believes this would save thousands of pensioners having to sell their homes to pay for residential care, and would enable insurers to offer cover for the potential cost of personal care.
Health Secretary Andrew Lansley said keeping the status quo inEngland
The report will also propose a single set of rules to determine what help elderly people need, so ending a "postcode lottery", under which councils operate their own criteria, resulting in people with similar conditions receiving varying support depending on where they live
At the moment, anyone assessed as being eligible for personal and nursing care at home is entitled to receive it regardless of income.
Those paying residential care costs - so-called self-funders - get a weekly contribution of £159 to their personal care, which rises to £231 if nursing care is also required.
Lord Sutherland yesterday stepped up calls for greater integration of NHS and social care budgets, a proposal at the heart of the recent Christie Commission report on reform of public services.
"Until that's done, you will be wasting money - using money ineffectively," Lord Sutherland said. "That's the way ahead, and it means there will be savings in health care, because a hospital bed costs you £2,000-plus a week - even a nursing-home bed costs half of that.
"It's less in a residential home and less if it's care at home in most cases."
He said that as well as saving money, more integration would also lead to better care. "What it means in my mind, and this will doubtless be unpopular, is that if there is some charging for care of the elderly, it should apply equally in the health services and you should treat it all as one pot of money and make your rational decisions across the whole piece," he said.
"I think at the moment the Scottish Government and Parliament have committed to too much public expenditure to be sustained across the whole board. If there are to be cuts, then health and social care should be regarded as a single item."
The Scottish Government's budget will fall by £1.3 billion this year and cuts will continue over the next few years.
A report by Holyrood's Independent Budget Review group, set up last year to deal with the impact of cutbacks, said the free personal care policy was "hard to justify" and called for the eligibility criteria to be looked at again. It also suggested a range of changes, including providing free only the first five hours of care at home per week and charging after that - that could bring annual savings of £119m. Removing free personal care in care homes could provide savings of £93m a year.
A Scottish Government spokesman said it was committed to "protecting vulnerable citizens".
He went on: "We will maintain the existing eligibility for free personal care. We established the Christie Commission on public sector reform in order to maximise spending on front-line services, given the financial challenges we face, and the Cabinet sub committee on public sector reform met last week to take forward our plans.
"The 2011-12 budget introduced a £70m change fund to help local authorities and health boards work together to deliver adult social care. We are determined to go further in delivering an ambitious reform programme, which puts citizens and communities at the centre.
"The Scottish Government has faced up to the consequences of the biggest reduction in public spending imposed by Westminster on any Scottish Government, and has worked with Cosla leadership to agree a council funding package which maintains key public service commitments, including free personal care."
The central recommendation of economist Andrew Dilnot's report for the
He believes this would save thousands of pensioners having to sell their homes to pay for residential care, and would enable insurers to offer cover for the potential cost of personal care.
Health Secretary Andrew Lansley said keeping the status quo in
The report will also propose a single set of rules to determine what help elderly people need, so ending a "postcode lottery", under which councils operate their own criteria, resulting in people with similar conditions receiving varying support depending on where they live
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