It is one of Scotland's comforting myths that older people are better cared for north of the Border thanks to the policy of free elderly care.
This policy has undoubtedly helped tens of thousands of Scottish people to remain independent and in their own homes. However, as the Care Commission points out, nine in 10 of us will still end up spending some time in a care home or nursing home in our twilight years. And there the picture is not so rosy.
Free personal care doesn't cover care home accommodation costs, and these can be onerous, meaning that many elderly people still have to sell their homes. And even for the majority who qualify for means-tested council provision, the picture is disturbing to say the least. Too often, older people are left to languish in insanitary squalor with little or no stimulation.
We report today that in Edinburgh alone, some 400 care home beds, 15% of total provision, are currently out of commission because of fears about the quality of care. Several of the city's homes, including three run by the private health insurance company Bupa, are not being allowed to take new referrals for this reason. The Care Inspectorate, the independent care watchdog, has threatened Pentland Hill nursing home in Corstorphine with closure if care standards do not improve in the new year. Police are currently investigating four deaths at the Bupa home.
The problems are familiar enough: poor nutrition, dehydration, lack of supervision, inadequate and unsympathetic staff. Scrutiny by the inspectorate has helped Scotland avoid some of the worst abuse scandals that have emerged in English nursing homes such as Winterbourne View in Bristol or Hillcroft in Lancashire. But this should not be grounds for complacency.
One of the knock-on effects of the care homes crisis is the return of what used unkindly to be called "bed-blocking" - older citizens having their discharge from hospital delayed because of the lack of care home places in the community. It costs an average £225 to keep a patient in a hospital bed overnight, and with Scotland's population ageing rapidly, this could cause serious problems for NHS Scotland finances down the line. But it is above all the indignity and insecurity suffered by the older person, not the cost, that is unacceptable.
The Herald called in August for a full-scale beds review in Scottish hospitals, but it is clear that a review is also needed of care home places. And of the quality of care provided in such homes. The existence of free personal care should not be used as a diversion from the continuing problems faced by local authorities in meeting the cost of care. According to one opinion poll, a majority of Scots would accept higher council taxes if they could be sure it would go to improve services such as these.
This is in everyone's interest, regardless of age. The one certainty in life, like taxes, is that we all grow old eventually.
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