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Last Updated: Friday, 1 February 2008, 15:31 GMT
Investing in Scotland's health
By Brian Taylor
BBC Scotland's political editor

elderly woman
More than 70,000 older people receive free personal care
Anyone remember Dr Finlay's Casebook? Splendid stories by AJ Cronin about the life of a Scottish rural GP, they were brilliantly translated to the screen many moons ago.

In one episode, the young, gauche Finlay is protesting that he hadn't known about some problem or other. The wise, acerbic Dr Snoddie leans forward and growls: "Well, ye ken noo!"

In similar fashion, the advocates of free personal care in Scotland "ken noo" - or know now. They know from a report by the spending watchdog Audit Scotland that implementation has been patchy, confusing and costly.

More to the point, they were told in advance. The scheme was implemented in Scotland by the previous Labour/Liberal Democrat administration in the face of warnings that universal care would, by definition, benefit the relatively well-off because those on limited incomes already received free, means-tested help.

SNP Ministers have a choice. They can ditch the policy - or fix it. They're for fixing it.

Those warnings were delivered by Labour members of the then Scottish Cabinet. So how did the scheme survive?

Firstly, it was strongly supported by the previous First Minister Henry McLeish who considers it a personal legacy.

Secondly, it was advocated by the Liberal Democrats within government. Thirdly, both those parties were casting an anxious eye over their shoulder at the Scottish National Party who backed free care. The governing coalition feared losing votes.

So what to do now? The SNP is in power - and already facing a tough fight to meet its manifesto commitments from a limited budget which is hemmed in by Treasury constraints for the period ahead.

SNP Ministers have a choice. They can ditch the policy - or fix it. They're for fixing it. Nicola Sturgeon, the Scottish Health Secretary, has already asked Lord Sutherland - who chaired the original free care commission for the UK - to find ways of sorting out the anomalies in the Scottish system.

Further, the supporters of free care are fighting back against the "we told you so" brigade whose views are reflected at the outset of this piece.

From a southern perspective, it can sometimes seem that devolution has meant largesse for Scotland on the scale of the South Sea Bubble

They say that universal provision - without means testing - respects the dignity of old people. It encourages people to come forward for help, free from concern that costs will be incurred. (Or, more accurately, it would do if the present confusion can be solved.)

From a southern perspective, it can sometimes seem that devolution has meant largesse for Scotland on the scale of the South Sea Bubble.

But one should bear in mind that Scotland receives a fixed budget - and that that budget is now rising more slowly than the increase in spending for England. Scotland, in short, is facing a relative - I stress, relative - squeeze.

Within that, there are choices. If Scotland opts for free care for the elderly, then that places strain on other services.

To govern is to choose. Politically, I cannot see any party advocating the removal of free care - despite today's report. Scotland has chosen - and must cope, for good or ill.



SEE ALSO
Minister backs costly care policy
01 Feb 08 |  Scotland
Pledge to increase care payments
18 Jan 08 |  Scotland
Costs warning over care provision
14 Sep 07 |  Highlands and Islands
Cashback for elderly care users
19 Jul 07 |  South of Scotland
Report uncovers care spending gap
03 Jul 07 |  Scotland
Review outlined for care policy
14 Jun 07 |  Scotland
Leaders clash over elderly care
08 Jun 06 |  Scotland

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