Kezia Dugdale has accused the SNP of "doubling down" on Tory cuts as figures show the number of elderly Scots receiving care at home has fallen by 12%.
The Scottish Labour leader used First Minister's Questions at Holyrood to repeat calls for Nicola Sturgeon to back her party's policy to raise income tax to reverse cuts to council budgets.
Ms Dugdale highlighted the findings of the Accounts Commission, which said the annual bill for social work services was £3.1 billion in Scotland amid a fall in councils' total revenue funding of 11% in real terms since 2010/11.
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She contrasted that with the findings of The Fraser of Allander Institute last week that the Scottish Government's resource budget for this year was 5% lower in real terms than 2010/11 as a result of cuts to Scotland's block grant from Westminster.
Ms Dugdale said: "The SNP haven't just passed on Tory cuts, they have doubled those Tory cuts and the report tells us who is paying the price.
"Older people who need help to get washed aren't getting it. Elderly folk who five years ago would have had help with their meals aren't getting it.
"The number of elderly Scots getting any care at all has fallen by 12% and what's worse is that we know the SNP are planning more cuts to councils, and cuts to councils are cuts to care."
She added: "The truth is they don't have to happen.
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"I'm only asking Nicola Sturgeon to do what she has wanted to do her entire political life - make different choices from the Tories - so when she writes her budget in the coming weeks the First Minister will face a choice: she can double down with even more cuts to care or she can back Labour's plans to use the powers of this parliament. What's it to be First Minister?"
Ms Sturgeon said spending on social work had increased by 6% and spending on social care by 5% in real terms since 2008/09.
She said the Scottish Government recognised the challenges of an ageing population and had embarked on the integration of health and social care, with a promise to invest an additional £1.3 billion over the next parliament in health and social care partnerships.
The First Minister continued: "Kezia Dugdale doesn't oppose Tory austerity, she wants to shift the burden of Tory austerity onto working people the length of breadth of this country and I would say to her, she put that proposition to the people of Scotland just four months ago and she's sitting on that side of the chamber because her party came third in the Scottish Parliament election.
"I would ask her to reflect on the position she and her party are in.
"She stands up regularly and says that the future looks to be a Tory future in terms of the Westminster government and yet she's got the nerve to come here and lecture me about the implications of Tory cuts that her party are powerless to do anything about.
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"The Labour Party is a complete and utter shambles, and perhaps should be taking more responsibility for the Tories' ability to continue to impose cuts on Scotland."
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