The Common Weal welcomes the Adult Care Review and its wide-ranging remit. We particularly welcome the fact that the Review has been asked “to include consideration of a National Care Service” (NCS) and would be keen to engage with the advisory group about this.
We are concerned, however, that having been prompted in large part by the coronavirus disaster in Scotland’s Care Homes, which has to date accounted for almost half of all deaths in Scotland from Covid-19, the remit does not include consideration of what has gone wrong.
We have two other major concerns about the Review’s remit. The first is that it is restricted to adult care and omits any reference to its relationship with the Independent Care Review for Children. Secondly, we are concerned about the Review’s timescales and the practicality of what it has been asked to do. It is clearly not possible for the Review to produce a blueprint for a National Care Service, similar to the Beveridge Report which led to the creation of the NHS, within four months.
There is a strong argument that a National Care Service should an independent service separate from the NHS. That might appear contrary to the cross-party policy drive of the last ten years to try and integrate health and social care which, so far, has had little obvious success. The chasm between primary and secondary care in the NHS remains and, with HSCPs close to financial collapse, the evidence suggests that neither the NHS nor Councils have the resources to invest the money necessary to make them work. So why not use the HSCPs to form the building blocks of the new NCS, with some health staff whose roles are as much about care as treatment transferring over, and then fund it independently? That is probably the only way to ensure that care is properly resourced. The NCS could then be designed to interface with the NHS on the one hand and, even more importantly, the informal carers who provide the majority of care in Scotland, local communities and community services on the other.