IT should be a fundamental tenet of any progressive society: ensuring that the young and strong in our country care for the elderly and infirm. But in Scotland, there is a problem: the population is getting older at the same time as funding for health and social care is falling below what it is needed. The result is a system that is under serious strain and a risk that the gaps will keep on widening, with profound consequences for all of us.
These worrying trends have been obvious for years, but the latest news on the demographics of Scotland, published in The Herald this week, has only underlined the dangers.
According to the annual report from the Registrar General for Scotland, the country’s elderly population will increase by almost a third in the next 25 years and the Registrar General Tim Ellis has spelled out what this means. “The report is quite clear,” he says, “There’s going to be a heavily increasing elderly population north of the Border who risk being served by an NHS that will not be remotely equipped to provide the help they need.”
This newspaper has already been raising the issue in our Grey Matters campaign, which called for a renewed effort to ensure public services meet the needs of elderly people. We also need an honest recognition that the funding of community-based care must be improved.
But the scale of the problem, and what is needed to solve it, are becoming clearer. A new report projects there will be a 1,200 annual shortfall of care home beds within a decade. The report, from the property management firm JLL, also estimates a need for an extra 10,800 beds by 2026, or roughly 108 beds per year in Scotland – the problem being that around 1,100 beds have already been lost in the market last year.
One obvious way to relieve some of the strain is to improve social care in the community and keep people out of care homes for longer – something which the Scottish Government is committed to doing through their Health and Social Care Partnerships. However, the problem, as ever, is funding – the partnerships are an excellent idea in principle but from the beginning they have been beset by a lack of money.
Care homes themselves are also chronically under-funded as a result of councils driving rates lower and lower while demanding greater efficiencies. The Scottish Government has also insisted, quite properly, that all care staff should be paid a minimum of £8.25 an hour, but without proper funding, some in the care sector are predicting that some providers will go out of business, making the already chronic shortage of beds even worse.
The answer is some honesty about what is happening and a thorough audit of the cost of care in Scotland as well as a realistic projection of what it will cost in the future. The scale of the problem is becoming clearer all the time and it points to one inevitable conclusion: a social care system that can care for an ageing population when they need it will require more resources.
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