HENRY McLeish has urged Nicola Sturgeon not to be tempted to put her plans to establish a National Care Service on hold following hefty criticism and growing concerns over cost.

The former first minister, who was the architect of free personal care for the elderly, often regarded as one of the most popular policies since devolution, said the government must press on with the reforms.

He warned that if the plan was halted problems in the health and social care sector – already facing intense pressures – would mount as the number of people needing social care grows as people live longer.

Mr McLeish, who is an ambassador for Alzheimer Scotland, said he understood the difficult background in which the reforms were being made.

He cited the UK’s financial problems and the scrapping of the increase in national insurance by the Conservative government as among the challenges.

“The National Care Service is probably the most important reform that has happened in Scotland since the 1998 Scotland Act. It is taking place against an unbelievably difficult financial background, against a background of a crisis in care, a crisis in health and a government at Westminster ... [which has] scrapped the national insurance increase which means there could be cuts in care down south and that could hit us,” he said.

“So this may not be the easiest time but we have got to get this right. The prize is that Scotland could be leading Europe in the development of care.

“What we don’t need is this to collapse into internal bickering in Scotland among the various institutions and political parties. And that is my fear.”

The National Care Service was a recommendation of the Independent Review of Adult Social Care (Feeley review) which reported in February last year.

A bill to establish the service was introduced in June this year with its stated purpose to improve the quality and consistency of social services in Scotland. 

The reform is also intended to improve conditions for staff in the sector amid concerns that many are leaving for better pay and less challenging roles in other areas of work.

A lack of care staff and a shortage of beds in residential homes is contributing to problems in the health service with about 1,800 hospital beds being taken up by people who don’t need acute care but do need support either in their own home or in residential care.

The bill is a framework bill that lays the foundations for a National Care service, allowing for the substantive detail to be co-designed, chiefly with people who access support, those who deliver it and unpaid carers, later.

The legislation – which is currently making its way through Holyrood – will see the government set up “care boards” directly accountable to Scottish ministers who will take on functions and staff that are currently managed and run by local authorities and health boards.

Ms Sturgeon has described it as the most significant reform to public services since the creation of the NHS.

But criticism of the bill has been mounting, with MSPs, councils, unions and carer’s charities urging the government to pause or think again.

The public spending watchdog Audit Scotland raised serious concerns last month about the financial memorandum accompanying the legislation. It warned that ministers had underestimated “the margin of uncertainty” in their cost estimates, which have ranged from £650 million to £1.3 billion. 

Mr McLeish said there are about 700,000 unpaid carers in Scotland, 200,000 workers in social care, and at present 70,000 people at home and 40,000 in long-term residential care with 130,000 people in some form of care in the community.

“This is an enormous subject and unless we get a unifying approach we are going to get mired in party political differences and differences between local government, central government and the trade unions,” he said.

Mr McLeish went on to say the Scottish Government needed to adopt a more collaborative approach and make sure care providers, councils and trade unions were on board with the reforms.

“Local government has a remarkable record in public health provision over the last century but this government has at times been running down local government and it is facing its own crisis,” he said.

“So while I don’t think we should stall the process [of setting up the NCS], what I am asking for is for the government to rethink how we take it forward. I think they should take a multi-party approach, include all opposition parties and I would like to see the Health Secretary and his shadows set up a co-ordinating committee. 

“I would also like to see local government treated not as a group that is being difficult, but for their problems to be understood. It would be a National Care Service but it has to be locally delivered.”

He added: “The demographics are working against us and unless we can develop a coherent health and social care policy in Scotland we are just going to be building up problems for the future.”