Free care for elderly on brink of collapse

http://scotlandonsunday.scotsman.com/latestnews/Free-care-for-elderly-on.3834286.jp

Published Date: 02 March 2008

By Eddie Barnes

Political Editor

THE flagship policy of free personal care for the elderly will be drastically cut because of a cash crisis in town halls across Scotland, leaked council documents have revealed.

A confidential paper handed to Scotland's 32 council leaders last month concludes that unless ministers assign "an open chequebook" to the policy, local authorities will have to systematically "limit" or "ration" the care available to over-65s.

Official auditors have estimated that councils are up to £60m a year short of being able to fund a policy which was originally intended to cost £100m a year to support.

An ageing population and increased costs amounting to hundreds of pounds a week for old people have left many councils unable to meet demand.

In a stark admission of the policy's imminent collapse, the private paper, written by officials at the Confederation of Scottish Local Authorities (Cosla), suggests that councils should start planning now to ensure blame is shared with the Scottish Government in Edinburgh so that they avoid the full brunt of a public backlash.

It also reveals that the council chiefs have already held private talks with ministers about creating a new watered-down version of the seven-year-old legislation.

The help which elderly people get with preparing their meals at home, enshrined under the law, is among the areas which may now be removed. Free personal care was passed by the Scottish Parliament in Scotland in 2001, with former First Minister Henry McLeish declaring there would be "no ifs or buts or maybes" over the plans.

After assessment, all elderly people would be given free help with tasks such as bathing, food preparation and assistance with dressing. However, numerous reports have since uncovered a postcode lottery of care, with some councils operating a waiting list, others charging for food preparation and more only ensuring help for the most in need.

The private document sets out in stark terms how councils have cut demand across the country by setting "eligibility criteria" at a level to exclude "people with moderate or low-level needs".

It then warns the council leaders: "It is evident that the policy of free personal care is coming under increasing strain."

It concludes: "Unless the Scottish Government decide to reinvent free personal care as a benefit and assign an open chequebook to it, the policy will have to be limited in some way if it is to continue.

"Even if the Scottish Government make good the identified shortfall by Audit Scotland, the fact remains that this is still structured as a demand-led policy, with a set budget, and putting more money into it will never solve the problem."

The paper also studies the political fallout of the expected cutbacks.

"The difficulty is that any attempt to change the parameters of this groundbreaking policy will look like it is being limited and rationed. In order to take this forward, therefore, the Scottish Government and local government must be and be seen to be united in their stance and jointly accountable for any fallout...

What cannot happen is that local government take the blame for not implementing the policy correctly or that local government are seen to be the ones rationing free personal care."

Cosla is now demanding "urgent clarification" from Health Secretary Nicola Sturgeon over whether free personal care is an "open-ended" policy, or whether councils are "entitled to ration care".

Their bleak assessment comes with a major review of the policy due out within the next month. It is being compiled by Lord Sutherland of Houndwood, who first recommended that the Government offer free personal care in a groundbreaking report 10 years ago.

The universal plan has come under pressure, with an ageing population piling ever greater cost pressures on local councils.

A report by the Joseph Rowntree Foundation last year found that "prior to the introduction… no attempt was made to accurately cost personal care".

Earlier this year, Audit Scotland concluded that the policy was between £46m and £63m underfunded every year.

The Cosla paper reveals that the Government is now considering fresh legislation to amend free personal care. It declares: "Ministers and local government leaders agreed in November that, if necessary, they may have to revise legislation."

The document goes on: "The Government has suggested that it wants to see minimum eligibility criteria… On food preparation, the Scottish Government has indicated a willingness, in principle, to consider legislative changes to address this issue."

A spokeswoman for the Scottish Government said that ministers would make their position clear on the matter after Lord Sutherland had reported back

Ann Ferguson, public affairs manager of Age Concern Scotland, hit out at Cosla last night, claiming they appeared too ready to ditch the policy.

She said: "It is wrong to make a judgment about where it is going before the Sutherland report comes out. This feels like a pre-emptive strike. They don't seem prepared to wait until the Sutherland review is published."

 

(The full article contains 834 words and appears in Scotland On Sunday newspaper.)