Cost of Free Personal Care - Too High
IS the price of providing free personal care for Scotland's ever-ageing population just too high to pay?
The latest figures yesterday revealed that council spending on the nation's flagship policy has rocketed, up 21% on personal care services for people in their own homes (from £185m in 2005-06 to £224m in 2006-07).
The government's chief statistician suggested that the jump could be down to a range of reasons, from growing demand for more complex and costly care at home to the impact of the recent equal pay deal, forcing councils to pay bigger wages to female carers and home helps.
There were also one-off costs for some councils such as Edinburgh, which reimbursed elderly residents for meal preparation charges following conflicting advice over whether or not they too should be provided free.
In Edinburgh, where the cost of free personal care (FPC) for pensioners at home rose from around £16m to nearly £19m (2005/6 to 2006/7), those refunds added more than £1m to the bill.
Glasgow City Council forked out the most by far for FPC at home at £39m compared to £20m during the same period. As Scotland's largest local authority, the figure reflects the greater numbers of residents.
But given that the council is also one of the few local authorities that still charge for preparing food, it looks likely that costs will get higher still.
For while at least four councils continue to bill pensioners for cooking a meal, the policy's architect, Lord Sutherland, and the current SNP government have said that such services should be free.
While that particular funding battle goes on, Age Concern Scotland yesterday suggested that there had not been a huge rise in actual spending at all.
The charity said it believed that the real cause of the apparent sudden price rise was better accounting procedures following a critical Audit Scotland report into how councils recorded the cost of free personal care.
"There has not been a huge demographic change or a fall in elderly people's health over that time. What there has been is more clarity.
"I genuinely think this 21% rise has more to do with that. It might not be an increase in expenditure but in the column marked free personal care," a spokesman said yesterday.
Even if that is true, no-one seems to be suggesting that costs will fall in future years.
Which still leaves the question of whether or not we can really afford to fund a legacy of Scotland's devolved government.
It is now seven years since the then First Minister Henry McLeish's pledge, as he announced the radical policy, that it would be "fully funded and implemented".
Last year economists at Stirling University working on behalf of the Joseph Rowntree Foundation noted pointedly that before the policy was introduced "no attempt was made to accurately cost personal care".
That failure led to underfunding and a postcode lottery of services, exacerbated by lasting confusion over whether or not councils should pay for preparing food for people under the policy.
Professor David Bell, one of the authors of last year's Stirling University report, believes that we can finance the policy and that costs will slow down next year.
He said: "The reason people say it is unaffordable has to do with demographics and the fact that the population is ageing. This rise is not an increase in volume, it's an increase in cost per hour."
That increased cost, he says, is due to an increase in so-called larger care packages, such as providing 24-hour care for people with dementia living in their own homes.