A LEADING economist has labelled plans for a national care services to halt widespread strain at the height of the pandemic “a distraction” – instead calling for focus on properly funding the sector.
Almost half of all Covid-19 deaths in Scotland have taken place in care homes – while the Scottish Government has been repeatedly asked to clarify why elderly patients were moved from hospitals to care homes without having negative test results for the virus at the outset of the crisis.
Scottish Labour have pressed for plans to be drawn up to set up a national care service in a similar publicly-funded model to the NHS.
Nicola Sturgeon last month announced that an investigation into whether such a structure could be established will take place. An independent review will be headed by former director general of health and social care and chief executive of NHS Scotland, Derek Feely.
READ MORE: Nicola Sturgeon supports Labour calls to 'remove profit motive' from Scotland's care homes
The review will be support by an advisory panel made up of Scottish and international experts and report back its findings by January 2021.
But Professor David Bell from Stirling University has insisted that “discussions about a national care service are a distraction”.
The economics expert has told MSPs investigating social care aspects of the pandemic that an increased demand for social care “will not be met without a significant addition of resources”.
Scotland’s population is expected to age over the coming decades with the National Records of Scotland warning “the number of older people in Scotland has been increasing for decades and continues to do so”.
READ MORE: Calls for inquiry into 'national scandal' of deaths in Scotland's care homes
Professor Bell added: “The question that has been addressed, but not answered, in England is how to do that fairly. Fairness has many dimensions.
“There is a gender dimension. Unpaid care is typically delivered by women and most care workers are also female. There is a generational fairness argument about whether future generations should pay for this generation’s care.”
He posed the question “at what point do you set the floor above which people are expected to contribute towards the cost of their own care” with many relatives forced to sell family homes to pay for prolonged care for their loved ones.
Professor Bell said: “Alternatively, do you pay for care from a general increase in taxation or from taxation that is aimed at a particular group of people who are likely to benefit from long-term care, or do you use some sort of insurance system? The record of those around the world is not a happy one.
“Scotland must address that strategic question. There will be an increase in demand. Whether that is met in care homes or by care at home, there will be an increase in the demand for care services for older people.”
Donald Macaskill, the CEO of Scottish Care, which represents the independent care sector, has backed the analysis by Professor Bell into the issues facing the sector.
He said: “We need to have a grown-up discussion about how we pay for social care.
“There’s more people living longer, there are more people living in single habitations, we have more relationships breakdowns than any other point in our history.
“We have got to find a way of paying for that in a society where we have less and less people of working age.
“If we are unfortunate enough to develop cancer, most of your support will be paid for by the state but if you have dementia, it’s likely you may have to sell your house.”
He added: “We are going to need more of social care in the future.
“I think it’s just naïve to presume that everybody can stay independently in their own home. To live independently in your own home is significantly more expensive than to live in a care home.
“We are not asking these questions because as a society we have been buying care on the cheap and trying to get it as cheap as possible.”
Dr Macaskill said that instead of pointing to “hindsight” around problems social care has faced during the pandemic, there should have been a focus on “political foresight”.
He also suggested that looking at a national care service for a solution to all the problems may not be a magic bullet for the issues the sector will face in the coming years.
He said: “You can argue that it’s a political mechanism after having failed to address the crisis before it happened.
“I do have concerns that the radical solutions that are required will take longer than the four-month timescale.”
He added: “My personal view is that all the focus on a national care service is a soundbite from politicians which makes people feel like they are doing something – it makes people feel that this sounds like the National Health Service.
“A one size fits all national model does not offer that local choice and diversity people want in social care.
“One of the risks of using the phrase national care service, we paint a picture of one national unit, which cannot work – we cannot have that for social care.”
Health Secretary Jeane Freeman has rubbished the assertion that considering a national care service is a waste of time.
She said: “We do not believe that considering establishing a national care service is in any sense a distraction. It is precisely because we recognise the importance of the adult social care sector that we have established the independent review to consider its future.
“The review is already working at pace, consulting and engaging to produce recommendations in a very short time frame.
“We recognise the critically important role played by social care support in ensuring the safety, dignity and human rights of people who already receive support, and that of their unpaid carers, at all times as well as during the Covid pandemic.”
Donald Cameron, Scottish Conservative health spokesman, added: “A review into a national care service is welcome at this time.
“The SNP have failed our care homes during this pandemic and changes in the system must be looked at."
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