Extending free personal care to under 65s: feasibility study

Section 1 : Background

Why are we undertaking this Feasibility Study?

Free Personal Care for people aged 65 and over in Scotland currently benefits nearly 78,000 older adults, of whom approximately 47,000 receive personal care in their homes, and 31,000 in residential care. The Scottish Government has been working with COSLA and other partners to improve the fairness and consistency of charging for social care and has committed to consider the extension of Free Personal Care to those under 65.

The Social Work (Scotland) Act 1968 (“the 1968 Act”) provides the legal basis for provision of social care in Scotland.

The 1968 Act places a duty on Local Authorities to assess the needs of residents within their area, and provide such social care services as they deem are required for the individual. The 1968 Act allows Local Authorities to charge for care provided to individuals by the Local Authority, so long as that charge is reasonable and does not exceed the cost of delivering the service.

In September 2001 the Scottish Government introduced legislation to provide Free Personal Care for those over the age of 65 who were assessed as needing it, resulting in the parliamentary approval of The Community Care and Health (Scotland) Act 2002 ^[1] .

A number of strong campaigns have led calls for the extension of Free Personal Care to under 65s who need it.

For a number of years, the Scottish Government has worked with COSLA to bring greater consistency to social care charging in Scotland. In the most recent years, the Scottish Government has invested up to £11m a year into the social care system to reduce care charges by raising the threshold at which people become eligible to contribute financially towards their social care, and by ensuring that armed forces veterans retain the full value of their war pension payments. The Scottish Government has also ensured, in partnership with COSLA, that those in the last 6 months of a terminal illness receive their care at home for free, without having to worry about charges for social care at such a stressful time. By the introduction of a standard financial assessment template across all Local Authorities, progress has been made towards greater transparency and consistency across Scotland.

The Scottish Government committed to undertake a feasibility study into the extension of Free Personal Care to people under 65 who need it, and examine the potential relationship with social security provision through this study.

Financial policy context

Overall expenditure on adult social care services per head of population has increased by 13% in real terms after taking into account inflation. Expenditure in 2003-4 was £1.9bn rising to over £3bn in 2015-16. Integration Authorities are managing more than £8 billion of resources that NHS boards and councils previously managed separately, and resources are transferring from the NHS into social care.

Almost half a billion pounds is already being transferred from the NHS into social care and integration in 2017/18. £250 million transferred from the NHS to health and social care partnerships for social care in 2016/17, which has been baselined, and a further £107m has transferred in 2017/18, in addition to the £100m Integrated Care Fund and £30m to address delayed discharge.

However, the increases in funding for social care come against the backdrop of an ageing population contributing to an increasing demand for services.