Scotland is rightly proud of the fact it has, so far, been able to continue to provide personal care free of charge to elderly people who need it.
But those who need help with washing or dressing often also depend on a personal alarm to summon help if they fall, need someone to fetch their groceries, or rely on a regular visit to a day centre for social interaction.
It is up to councils to decide whether to charge for these services and, if so, how much. Forced to make deep budget cuts, it is inevitable that, faced with tough budget choices, many have introduced payment for services that were previously free and charges have also been increased.
The result, however, is such wide variation that the standard of living of many of the most vulnerable people in Scotland, the frail elderly and adults who need care, now depends on their address.
It is clearly unfair when day care for the elderly remains free in some places but costs £34.60 per day in the neighbouring authority, when the cost of an alarm ranges from zero to £5.50 per week or when some people have their shopping done for free while others pay almost £8.
This is a disturbing situation when those who depend on these services are among the most vulnerable in society and have little disposable income, making the increases particularly onerous. The greatest disparities are in the cost of day care, which is a vital service for people who would otherwise have long days of isolation. In Perth and Kinross, for example, day care which was free five years ago is now charged at up to £89.25 per week. Other areas which have striven to protect day care have capped charges, as low as £10 a week in East Dunbartonshire, while the hourly rate is just under that elsewhere.
The glaring discrepancies among this patchwork provision must puncture any complacency that the policy of free personal care ensures the wellbeing of vulnerable elderly people.
The situation is further complicated by some costs being means-tested but the range of charges (including for community alarms and care for younger adults) makes it difficult to describe provision as anything other than a postcode lottery. It is the essence of accountability for local authorities to make decisions according to local need and with agreement to freeze council tax, increasing service charges is inevitable. But when it comes to basic services such as day care and meals, such a wide variation can only mean some vulnerable people are suffering.
Councils across the country are committed to protecting frontline services but the bills have to be paid. It may be time for a national ceiling for total charges. At the very least there should be some levelling of provision across the country, possibly through the Convention of Scottish Local Authorities. Clarity is certainly required about what individuals are paying for. And if there is to be any hope of reducing costs through shared services, the anomalies identified in The Herald's report today must be recognised as obstacles and overcome.
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