YOUR campaign to introduce free end-of-life care for people with advanced dementia ("To say we can’t afford free care for those with advanced dementia is unjustifiable", The Herald, December 1) is welcome, but raises a wider question. Why just extend free personal care to those with dementia, why not extend it to everyone who needs care for whatever reason?

Following the Sutherland Report, the Scottish Parliament to its credit acknowledged that it was wrong that the shift from care in hospital to care in the community had resulted in people being charged for care that had previously been free under the NHS. The introduction of free personal and nursing care in 2002 was intended to address this issue, but it only covered older people who needed help with specific physical care tasks. It didn't address the position of the under-65s or those who had once been cared for by the NHS because of their mental health needs. That gap was partially addressed in 2018 when the Scottish Parliament extended free personal care to the under-65s. The obvious final step would be to extend free personal care to cover all mental health needs, including dementia. If that were done there would be no need to reclassify advanced stage dementia as health care as Alzheimers Scotland is advocating.

A better alternative, following Covid, would be to look beyond Sutherland and consider making all care in Scotland, like health, free at the point of use. Why, for example, distinguish between the care needs of those with early stage dementia and those with advanced stage dementia? Is one more deserving than another? If a person needs care, and has no-one to provide that care for them, that should be sufficient and not depend on the ability to pay.

The large shift in the number of people with advanced dementia dying at home rather than in hospital, as revealed by your article, could have been a positive thing for most of those affected, if only appropriate care services had been available. The care gap won't end, however, until we create a National Care Service that is valued as much as the NHS, properly resourced and where charges are not used as a form of rationing.

Nick Kempe, Glasgow G41.