We will look at each of these items in turn and briefly explain the Scottish Government’s thinking. 

Benefit to Existing Service Users - £2.3 million

Working on the returns from 4 council areas, they estimate that only 38% of people paying charge for Personal Care would benefit with a  reduction of income for local authorities of  23%.    Many service users would only recieve a partial reduction in charges  so the percentage income loss is smaller than the percentage benefiting.    The SG has an estimate of £10 million for the income from Personal Care payments so the  reduction of income for  councils will be  of the order of £2.3 million.

  • While 38% of those paying charges will benefit, this is actually only 24% of all those who receive personal care.
  • In our March submission, SACT estimated that Frank’s Law would benefit one third of those receiving Personal Care, the Scottish Government had by last November already estimated that it would be only ONE QUARTER of people who get Personal Care who would benefit.

We can understand the reluctance of the Cabinet Secretary to release this figure.  A key flagship policy of the Scottish Government is being implemented in such a way that it makes no difference to the vast majority of people affected is not good.  

Added to that is the issue that of the £30 million being put forward to implement the policy less than 10% will go towards affected service users, then we can understand the difficulty in locating and sending the attached paper to Public Petitions Committee.

Additional Demand - £25 million

At this point SACT would like to make clear that it believes that social care in Scotland needs extra funds and that we have no problem with local authorities receiving additional resources to provide more and improved social care for those over and those under 65 in Scotland. 

This section uses 4 pages and two separate methods to justify the figure of £25 million.  There are a number of problems with the paper’s assumptions.

First the document’s authors treat the number of clients, the hours of the care and the cost of care as all being affected by only the introduction of Free Personal Care.  

There were a range of different local and national policies and initiatives introduced into social care which could have affected any of these factors.   For example, the number of hours of home care could have risen because of the policy of helping frail older people remain in their homes rather than being admitted to hospital.  

Councils are well aware that it is hard to link changes in social care to a single policy change.  For example, Highland Council, shortly after the introduction of Eligibility Criteria and running a pilot implementation scheme for Self Directed Support complained that it was hard to assess any single initiative as there was so much going on. 

“The evaluation of SDS activity in Highland was also difficult, in that this was only one of the 15 workstreams in the Highland Community Care Change Programme.”[2]

Secondly the paper tries to treat any increase in demand immediately after FPC as the same as the period after the introduction of Eligibility Criteria for operation in 2010. [3]    But Eligibly Criteria was introduced in order to prevent the continued increase in clients in the noughties by setting national standards for access to services that reduced local flexibility by social workers and care managers.   They were not two equivalent periods and it makes no sense to merge any increases in either period to get a mid-point average.

Thirdly the paper uses the measure of number of hours rather than number of clients for the increase after the introduction of Eligibility Criteria.  Since both policies were aimed either at benefiting clients or affecting the number of clients getting services (by ensuring that those in greatest need were prioritised), it would be more appropriate to use changes in the number of clients as a measure of policy effect.  

In 2010-11 there were 46,950 over 65 receiving Personal Care At Home

In 2015-16 there were 46,910 people over 65 receiving Personal Care At Home[4]

A reduction of less than 0.1 % shows that after a period of growth in numbers getting Free Personal Care, the period following the introduction of eligibility criteria saw almost no growth.   Although there can be no guarantee over equivalence, nonetheless ,this puts the figure of 4% for an increase in demand from those under 65 under some scrutiny. 

Fourth the paper suggests that there will be a 16% increase in demand for social care. But the paper does not examine from where this will come.  

There are two possibilities given that in 2017 there were 10,612 people under 65 receiving a total of 239,052 hours of Home Care support[5].    Either there are:

  • 1,697 people under 65 who are “eligible” for support do not take up a care package because they are being charged for their care and will now do so or
  • home care users are turning down 38,240 hours of home care support a week because of charges and will now seek to increase these hours as charges are being reduced or
  • a combination of both

There is nowhere else from where the extra demand can come.  Either thousands of people in substantial or critical need are being denied the support they need or thousands of people in critical or substantial need are getting less help than they need.

If either of these are right, then social care in Scotland is in major crisis.   Thousands of people and their families are being badly let down.  

We don’t believe this and we don’t think the Scottish Government really believes this.  There was a price to pay to deliver this policy and keep COSLA on board and the price was £25 million. 

There is a simple way to check this.   If the Scottish Government’s estimate is right then thousands of people will have been knocking on the doors of Scottish Council’s over the last few months, asking for and getting social care support.   Councils will already know if there is a rapid rise in demand for social care as they will be already delivering and commissioning new services.  

But more likely actions like those of South Ayrshire Council where they merged a Frank’s Law budget element with general social care spending indicates that they have not seen an uptick in demand. 

 So to clarify this, SACT will be carrying out a Freedom of Information Request later this year to find out how many people local councils are now supporting with home care packages.   The responses will help to illuminate the results of this policy. 

Assessment costs – £1 million

£1 million from the Frank’s Law settlement has been allocated towards the cost of financial assessments and reviews.  

This is probably an underestimate as the hourly costs of £20 per hour is about one third of what the latest research says that qualified social worker costs, £59 per hour[6].  

However despite our concerns with the calculation itself, SACT is glad that for the first time the Scottish Government is making an estimate of the cost of care charging.  But it is incredibly expensive charge,  in order to deliver £2.3 million benefit there has to be an additional 40% expenditure by local authorities on administration.

Part of our argument against ALL Care Charges has always been that it is the most inefficient tax.. 

  • The cost of collecting Income Tax is less than 1%.
  • The cost of collecting Council Tax is about 2%.
  • The cost of collecting the Care Tax is 40%.

 What does Frank’s Law mean in practice

SACT continues to collect stories from people across Scotland about how the implementation of Free Personal Care means for disabled people under the age of 65.

For example:       Martin has advanced Parkinson’s which is a very serious, degenerative condition.  Following a diagnosis 24 years ago, Martin and his partner, Fiona juggled with work, family and the impact of his deteriorating condition without help, until 4-5 years ago.

 

Now in 2019, their council proposes to impose a charge of £82.75 a week based upon Fiona’s income and the money she inherited from an immediate relative’s recent death.

 

The council says that 50% of his support (a Self Directed Support budget of £11,549.72) is assessed by the Council as needed for personal care.  However they have also said that because the cost of the support for his non personal care support is greater than the charge means that there is no change to the charge because of the introduction of Free Personal Care.


The Council decides upon the percentages of personal and non-personal care required from their assessment. But how they arrive at the breakdown hasn’t been discussed with either Martin or Fiona - it's decided behind the scenes.

Just to note that their council is also is providing a carer's budget of £3,167 for carer support to Fiona without charge as stipulated through the Carer's (Scotland) Act 2016.   But is still asking her to pay over £4,000 a year for the care of her husband. 

We are collecting other ongoing cases and will report further on this matter later in the year

Conclusion

Scotland Against the Care Tax is opposed to all charges for social care to help people to live in their own homes and participate in the community as equal citizens.   Charging for such is a fundamental breach of the human rights of disabled people.  It should be noted that disabled people are the only group with ‘protected characteristics’ under the Equality Act, 2010, which has to make ongoing periodic payments for their ‘equal citizenship’. We have argued from the start that it would have been best for the Scottish Government to grasp this challenge, to scrap all care charges, instead of tackling it piecemeal. 

Once again we see large amounts of money and effort being invested in measures which lead to little benefit to disabled people across Scotland and simply result in bitterness and broken promises.   The Scottish Government CAN and SHOULD do better than this. 

 

 

[1] 10th Jan 2019, Official Report, Public Petitions Committee, Column 13

[2] The Highland Council and NHS Highland,  Housing and Social Work Committee,  14 September 2011,  Evaluation of the Self-Directed Support Test-site in Highland,   Report by Director of Social Work

[3] All Scottish local authorities were asked to adopt National Eligibility Criteria by December 31st 2009.   They were expected to be operational from January 2010.

[4] Scottish Government, Free Personal & Nursing Care 2006-07 to 2015-16 data sheet

[5] Scottish Government, Social Care Services 2017, Statistical Release 19th December 2017

[6] https://www.pssru.ac.uk/pub/uc/uc2017/community-based-social-care-staff.pdf