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As the new PM is pressed on England’s failing social care system, we sometimes hear, not on BBC Scotland of course, that though still challenged, Scotland system after nearly 20 years of centre-left government by the SNP is well ahead.
What’s the evidence? What has the SNP done differently?
Let’s ask the Nuffield Trust and the IFS?
In Scotland, there is free personal care for all adults assessed as needing it. This was introduced for over-65s in 2002 and extended to working-age adults in 2019. This covers help with personal hygiene, continence, diet, mobility, and simple treatments, whether at home or in a care home. The upper threshold for residential care funding is £35,000.
In England, social care is fully means-tested and the upper capital limit is only £23,250. There is no state help above this level. There is no free personal care. A planned lifetime care cost cap was repeatedly delayed and has been effectively scrapped. https://www.nuffieldtrust.org.uk/news-item/offer-and-eligibility-who-can-access-state-funded-adult-care-and-what-are-people-entitled-to-1
Scotland spends substantially more per person on adult social care, around 36% higher than in England. This supports the free personal care policy and contributes to higher rates of state-funded recipients, especially for home care among older people. https://ifs.org.uk/publications/public-service-spending-and-performance-scotland
Analysis by the Nuffield Trust shows Scotland has higher rates of state-funded care home and home care recipients per 100,000 population than England, driven by free personal care. In England, the proportion of older adults (65+) receiving long-term publicly funded care has fallen sharply over two decades, from ~8% to ~3.5–3.6%. https://www.nuffieldtrust.org.uk/news-item/offer-and-eligibility-who-can-access-state-funded-adult-care-and-what-are-people-entitled-to-1
That Scotland still has a serious problem with delayed discharges comparable with England is often used to cast doubt on the SNP success but is simply evidence that the demand is enormous and despite greater investment in Scotland, still unmet.
To conclude, Scotland performs better on equity and access to personal care. Fewer people face means-test barriers for core personal support. Higher public investment supports broader reach and the policy is popular. It better aligns social care with a more universalist approach, closer to the NHS model. However, it faces rationing and similar capacity issues as England. England is less effective at protecting people from high care costs and has seen declining state-funded access rates for older people. Its means-tested model creates greater inequality and financial risk – people may need to sell homes. It may have more market diversity but at the cost of complexity and postcode variation.
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Yet again we hear a ‘policy’ from Burnham , affecting England only , splashed across the UK media as if it was handed down to him in tablets of stone .
No commentators , including Scottish , think to suggest that this will have no impact on Scotland , nor think to compare the response of the Scottish Government on this same social issue .
Almost every Burnham utterance since he was ”elected” as PM ( with the support of some of the electorate in one constituency ) has been English orientated . He has nothing to say about Scotland – except that he ”knows” that there is no demand for a referendum in the country he has visited once ( and refused to take questions ) since he became King of the North !
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Social Care from Burnham all good talk but is leaving it for the next Labour Gov who does he think he’s kidding,he must have been thinking about this for a long time so why does not have an election so he can set his care package up right now not wait to see if Lab wins again.
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