How will a Scottish national care service be paid for?


Scotland’s Health Secretary Jeane Freeman has said politicians and the public face “important decisions” about how the country pays for social care.


Ms Freeman pledged that people using care services would be at the heart of a review of social care in Scotland announced last week and which is set to report in January 2021, three months before the next Scottish Parliament election.


She said the question of what the public is prepared to pay for “absolutely goes to the heart of reforming adult social care”.


The comments came in a wide-ranging interview for the Health and Social Care ALLIANCE’s online annual conference.


Ms Freeman, who recently announced her intention to stand down as an MSP in 2021, admitted that 20 years of efforts to tackle health inequalities in Scotland were not “reaching all the people we really need to reach”.


She paid tribute to the work of community links workers, who are embedded in GP practices in deprived areas and can put patients in touch with support services to help with a wide range of non-medical problems.


In a recent report these ‘Deep End’ GPs called on the Scottish government to seize a ‘once in a generation opportunity’ and bring in more of these support workers across the country.


Although this is under “active consideration” resources are “hard-pressed” because of the pandemic, Ms Freeman said.


Looking ahead, the Health Secretary said it was important to forge better links between primary, community and social care – as well as raise the profile of services outside of hospital.


An “exemplar” public health system and a “forensic” focus on population health were identified as key priorities for the future.


“That is more than about, important though it is, no smoking campaigns or eating healthily and exercise,” Ms Freeman said.


“That’s about what do we do about diabetes and respiratory conditions and all those other things that people are struggling to live with, and need help and support to be able to do that.”


Nicola Sturgeon unveiled the review of social care in her Programme for Government last week.


She said it would “examine and set out options for the creation of a national care service.”


Speaking at the ALLIANCE conference, Ms Freeman said:


“The intention is that this is not a long-term exercise, this is a relatively quick exercise.


“It is important to hear from the receivers of adult social care, regardless of where they receive that.


“And it will build on work that had begun, particularly using the receivers of adult social care, the users’ panel, the work that was well underway before the virus appeared.”


In the early months of the outbreak, there were reports of cuts to care packages across the country, including in Glasgow and the Highlands.


Ms Freeman said she was “absolutely determined” that these should be reinstated.


Although the Scottish government announced a one-off payment for unpaid carers to help them during the pandemic, this payment only went to around one in ten people providing care because of Carers Allowance eligibility rules set by Westminster.


There is no taper in place for the Carers Allowance benefit, meaning carers lose all the support if they work over a certain amount, go into education or claim a pension.


The Scottish government is examining making the eligibility for carers support “fairer than it currently is,” Ms Freeman revealed, as more welfare powers come to Holyrood from Westminster.


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