THE cost of providing free personal care to the elderly has soared to almost half a billion pounds a year, leading to claims that one of Holyrood's most cherished pieces of legislation may have to be re-examined.
The independent think tank Fiscal Affairs Scotland said the cost of the policy, introduced at Holyrood in 2002 with cross-party support and still seen as one of the most important laws to be voted through by MSPs since the Scottish Parliament was reconvened, has risen by 60 per cent in real terms between 2004-05 and 2013-14, to £494 million.
Demand for care at home services is likely to increase further in coming years, with a rising number of over 65s, potentially living longer with more complex conditions, and a policy of integrating health and social care services potentially leading to more pensioners seeking to take advantage of free community services.
The Fiscal Affairs Scotland report states: "The cost of providing FPC (free personal care) support to help people stay in their own homes for longer is averaging around £7,600 per person per year (in 2013-14 prices). The on-going affordability of the FPC policy will be further tested if this per client cost rises.
"As and when more people aged 65+ seek support at home, this may also include a growing number with more complex needs. Consequently, the current cost per individual may need to become more flexible again to accommodate such a new demand."
A decade ago, the think tank said the policy was costing around £5,400 for every person receiving free care at home.
Currently, the elderly are offered free services such as help with meals, personal hygiene and mobility if it is needed regardless of income. Almost three quarters of cash spent on the policy is for services provided to pensioners in their homes, with the remainder going on those who live in care homes. Around five per cent of the 950,000 pensioners in Scotland receive free personal care.
Scottish Conservative health spokesman Jackson Carlaw said: "We supported the introduction of free personal care for the elderly, and will continue to do so as long as it remains affordable. But the fact is the cost is soaring, and that requires some attention.
"There is no use in having free personal care if the money to fund it ceases to exist. We need a wider look at how the NHS deals with the ageing population to find a balance which ensures people are cared for with dignity, in a way which is sustainable for the public purse."
Advocates of the policy believe that it is cost-effective as helping someone to stay in their own home is cheaper than the alternatives, while preventing illness and injuries ease pressure on hospitals where treatment is far more expensive.
Health Secretary Shona Robison said: "Free personal care currently benefits around 78,000 older people in Scotland. We have increased the payments in line with inflation each year since 2008 by providing local government with additional funding to ensure the sustainability of this important policy.
"We are committed to increasing the health budget, which is now at a record level of over £12 billion a year. Alongside the NHS, we are committed to ensuring that people have access to the right care, in the right place at the right time.
"In partnership with local government, we are integrating health and social care services to support better provision of care within communities and in people's homes. We are supporting the implementation of integration around the country with investment of over £500 million over three years."
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