Wikipedia

National Care Service

(Redirected fromNational Care Service (Scotland) Bill)

TheNational Care Service(NCS) is a proposedpublicly fundedsystem ofsocial carein theUnited Kingdomwhich was partially introduced by theLabourgovernment ofGordon Brownin 2010 but abandoned soon after when thecoalition governmentofDavid CameronandNick Cleggcame to power inMay 2010.Similar to theNational Health Service,it would be free at the point of need and paid for throughtaxation.[1][2]The Labour Party has continued to propose the creation of an NCS while inopposition,and has done so under each consecutive leader sinceEd Miliband's leadership in 2010.

Since 2021, the proposal has been adopted by thedevolvedgovernments ofScotlandandWales.[3][4]In Scotland, it is planned for the service to be fully operational by 2028 or 2029.[5][6]In Wales, the government has begun gradually implementing the service from 2022 for what is expected to be a ten-year period.[7][8]

Background

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TheLabourgovernment ofClement Attleeintroduced apublicly funded systemofhealth carewith the establishment of theNational Health Service(NHS) in 1948.[9]The NHS covered social care until 1976,[a]when most social care services were transferred tolocal authorities.[11]Since then, most people have had to pay for social care, with publicly funded social care still available to those who pass ameans testin which examinees must prove a lack of wealth and a high need for care.[12]Publicly funded social care is also offered to some adults with "long-term complex health needs" through the NHScontinuing healthcarescheme.[13]

History

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England and Wales

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A "National Care Service" was first proposed in the later stages of Prime MinisterGordon Brown's Labour government.[14]TheDepartment of HealthunderAndy Burnhamreleased itsgreen paperShaping the Future of Care Togetherin July 2009, which proposed a new National Care Service "on par with the NHS".[15]This was followed by a public consultation in September called the "Big Care Debate", which was promoted by Brown as a "crucial national debate".[16]The consultation found a public desire for social care reform and explored different ways to introduce the NCS. The government decided to introduce the NCS gradually and in different stages, with the first stage beginning with the Personal Care at Home Act 2010.[17]This Act legally extended toEngland and Wales.[18]

The Act was passed byparliamentin April 2010,[19]with the NCS being launched a month earlier byHealth SecretaryAndy Burnham, giving allelderlyanddisabled peoplefree social care. The second stage was planned to begin from 2014 and would extend free social care to people who were inresidential carefor more than two years. A third and final stage would fully introduce the NCS, giving all adults free social care after 2015.[20][21]However, the Labour government lost theMay 2010 general electionand theConservative–Liberal Democrat coalitioncame to power. The coalition abandoned the NCS[22]and the Personal Care at Home Act 2010 was later repealed.[23]

Inopposition,the Labour Party under the leadership ofEd Miliband(2010–2015) continued calling for the introduction of an NCS that would give elderly and disabled people free social care.[24]UnderJeremy Corbyn's leadership (2015–2020), the party promised to introduce the NCS in itsmanifestosfor the2017and2019 general elections,[25][26]once again proposing free social care for all adults[27]and also freepersonal carefor the elderly.[2]It is also supported by leaderKeir Starmer(2020–present), who is planning to introduce it as a needs-based, locally delivered system should Labour enter government.[28]HisShadow Health SecretaryWes Streetinglaunched a review by theFabian Societyto see how it would operate and be funded, and aims to gradually introduce it over two or three terms of a Labour government, with a long-term aspiration of introducing the service on par with the NHS.[29]The Fabian Society's report was released in June 2023. Its proposals only apply to England and include the recommendations that short-term care and support should be free and that support should be made available for everyone regardless of theirmeans.[30][31]The NCS was included in a draft Labour manifesto for the2024 general electionfrom May 2023[32]and was acknowledged as Labour Party policy by Streeting in October 2023.[33]It was included in the Labour Party's published general election manifesto,Change.[34]

Wales

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ThedevolvedLabour-led government ofWalesexplored options for a Welsh NCS as part of its2021 cooperation agreementwithPlaid Cymru,[4]with a plan for its implementation expected by the end of 2023.[7]The Welsh branch of Labour had supported the NCS since the2021 Senedd election.[35]Since 2022, the Welsh government has gradually introduced the service over what is expected to be a ten-year period.[8][36]

Scotland

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Scottish Labourhas been calling for the implementation of a Scottish NCS since 2011,[37]with then party leaderIain Gray(2008–2011) negotiating the proposal with civil servants in 2010.[38]TheScottish Conservativessupported the proposal, as did theScottish National Party(SNP) government's then-Health SecretaryNicola Sturgeon,[39]however Sturgeon and the SNP government ultimately rejected the proposal.[40]

An independent review intoScottish adult social carewas commissioned byFirst MinisterNicola Sturgeon in 2020, as a response to the damage tocare homescaused by theCOVID-19 pandemic in Scotland.This review was dubbed "The Feeley Review" after its author and chairDerek Feeley,[41]the former chief executive ofNHS Scotland,and was published in February 2021.[42][43]The review recommended the establishment of a Scottish NCS on an equal footing with NHS Scotland, receiving centralised funding from the Scottish government.[44][45]Health SecretaryJeane Freemanaccepted the recommendation[46]and the SNP promised to introduce the NCS as a "top priority" in government in its manifesto for the2021 Scottish Parliament election,alongside the introduction of a national wage for care staff.[47][3]It is planned that the new service will be fully operational in Scotland by 2026.[5]Nationalising care homes is not part of the proposal, but it will mean ministers will get more power over social care. There is a pledge to make social care free at the point of use, although this will not include accommodation costs.[48]

TheScottish Socialist Partysupports a publicly owned and publicly funded National Care Service that would be free at the point of use (like theNHS).[49][50][51]

National Care Service (Scotland) Bill

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The National Care Service (Scotland) Bill was introduced to theScottish Parliamenton 20 June 2022.[52]If passed, the Bill will establish the NCS in Scotland and give Scottish ministers the ability to transfer social care services, which in Scotland are currently maintained bylocal authorities,to the new care service. In the case of children's services, ministers would have to hold a public consultation to be able to transfer them to the NCS. Some health services which are currently maintained by NHS Scotland and itsHealth Boardscould also be transferred should the Bill pass. NCS Care Boards would deliver care on a local level, although transferred services could also be delivered nationally. The NCS and NHS Scotland would also share information, carers would have a right to take breaks and the proposed "Anne's Law", a law which would entitle care home residents to meeting people important to them, would also be enacted in the Bill.[41]

The Bill has been met with controversy. Scottish Labour called the SNP's plans to introduce the NCS "the biggest power grab in the history ofHolyrood",[53]with deputy leaderJackie Baillieclaiming that it would endanger local authorities, adding that it was "not a National Care Service" but a "national commissioning service which can be used as afig leaffor centralising power ".[54]Other opposition parties have raised concerns about the cost of the service, which is believed to have the possibility of redirecting nearly £1.3 billion of public money from frontline services to the NCS (£495 million for the overall service and another £726 million for its Care Boards). Trade unionsGMB,[55]UnisonandUniteare also concerned about the centralisation of power away from local authorities that would be caused by the service, while theConvention of Scottish Local Authorities(COSLA) is currently taking "the time and consideration that is rightfully needed with legislation of this magnitude, to understand the breadth of the impact it will have on communities the length and breadth of Scotland".[56]

Notes

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  1. ^The NHS in Northern Ireland did not cover social care until 1973, when it merged with Northern Ireland's social care system to formHealth and Social Care,which still provides free health and social care to this day.[10]

References

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  1. ^Whittome, Nadia(15 June 2022)."We desperately need an alternative to the orthodox economic consensus".LabourList.Retrieved15 June2022.
  2. ^abBuchan, Lizzy (22 September 2019)."Labour promises free personal care for older people in bid to end 'national scandal'".The Independent.Retrieved15 June2022.
  3. ^ab"Nicola Sturgeon pledges National Care Service is a 'top priority' if SNP wins election".Daily Record. 20 April 2021.Retrieved28 July2021.
  4. ^abPamben, Deven (23 November 2021)."Wales to examine creation of a National Care Service".LaingBuisson News.Retrieved15 June2022.
  5. ^abPringle, Esmé (27 January 2022)."Watchdogs: Care can't wait five years for action".Healthandcare.scot.Retrieved15 June2022.
  6. ^"Scotland's National Care Service delayed by three years".BBC News.14 December 2023.Retrieved5 January2023.
  7. ^abThis article incorporates text published under the BritishOpen Government Licence:"First step to National Care Service as expert panel announced".Welsh Government.21 February 2022.Retrieved15 June2022.
  8. ^ab"Written Statement: National Care Service – Initial Implementation Plan Publication (14 December 2023)".GOV.WALES.14 December 2023.Retrieved5 January2024.
  9. ^Mandhai, Shafik; Chughtai, Alia (7 June 2017)."NHS England at a glance".Al Jazeera.Retrieved16 June2022.
  10. ^Nicholson, Elspeth; Shuttleworth, Kelly (18 August 2020)."Devolution and the NHS".Institute for Government.Retrieved16 June2022.
  11. ^"Separation of health and social care".parliament.uk.12 April 2005.Retrieved16 June2022.
  12. ^Bottery, Simon (7 September 2021)."What will the government's proposals mean for the social care system?".The King's Fund.Retrieved16 June2022.
  13. ^"NHS continuing healthcare".NHS.uk.3 August 2018.Retrieved16 June2022.
  14. ^"What would a National Care Service look like?".New Statesman.3 January 2024.Retrieved5 January2024.
  15. ^Burke, Stephen (2 October 2009)."National care service – what's the big idea?".The Guardian.Retrieved15 June2022.
  16. ^"Big Care Debate: How to get involved".The Guardian.8 September 2009.Retrieved15 June2022.
  17. ^Building the National Care Service(PDF).Department of Health.London:HM Stationery Office.30 March 2010. pp. 4, 7–8.ISBN9780101785426.
  18. ^"Personal Care at Home Act 2010 Content: Provision 3".legislation.gov.uk.Retrieved15 June2022.
  19. ^"Personal Care at Home Act 2010".UK Parliament.17 August 2010.Retrieved15 June2022.
  20. ^"National Care Service launched".GOV.UK.30 March 2010. Archived fromthe originalon 9 June 2010.Retrieved15 June2022.
  21. ^Social Care Funding: Time to End a National Scandal(PDF).House of Lords Select Committee on Economic Affairs. Dandy Booksellers Limited. 4 July 2019. p. 11.ISBN9781787764316.
  22. ^Jarrett, Tim (23 September 2017).Social care: Government reviews and policy proposals for paying for care since 1997 (England).House of Commons Library.p. 11.
  23. ^"Personal Care at Home Act 2010 (repealed)".legislation.gov.uk.Retrieved15 June2022.
  24. ^Samuel, Mithran (27 September 2010)."Labour leader Ed Miliband backs national care service".Community Care.Retrieved15 June2022.
  25. ^"Social care: What's happened to the 'dementia tax'?".The Week UK.22 June 2017.Retrieved15 June2022.
  26. ^Clarke, Sarah (21 November 2019)."Labour confirms plans for free personal care in 'radical' manifesto".Home Care Insight.Retrieved15 June2022.
  27. ^"Labour pledges to spend £6bn to make social care free".i.22 September 2019.Retrieved15 June2022.
  28. ^Starmer, Keir(19 June 2022).""Councils will be at the top table" – Keir Starmer's LGA Labour conference speech ".LabourList.Retrieved21 June2022.
  29. ^Mason, Rowena (3 July 2022)."Labour to aim to launch national care service inspired by creation of NHS".The Guardian.Retrieved4 July2022.
  30. ^Watson, Iain (8 June 2023)."Social care: Labour urged to commit to care worker pay increases".BBC News.Retrieved13 June2023.
  31. ^Crerar, Pippa (8 June 2023)."Labour aims to reform England's adult social care sector if it wins election".The Guardian.ISSN0261-3077.Retrieved13 June2023.
  32. ^Neame, Tom Belger, Morgan Jones, Katie (11 May 2023)."Revealed: Full draft policy platform that could form 2024 Labour manifesto".LabourList.Retrieved13 June2023.{{cite web}}:CS1 maint: multiple names: authors list (link)
  33. ^Weakley, Kirsty (9 October 2023)."National care service to be built with local government, Labour says".Local Government Chronicle (LGC).Retrieved28 October2023.
  34. ^"Labour manifesto: What they plan to do in government".BBC News.5 July 2024.Retrieved8 July2024.
  35. ^Owen, Twm (14 September 2021)."Welsh Government putting £48m towards social care".The National.Retrieved16 June2022.
  36. ^"Welsh national care service".Healthcare Financial Management Association.14 December 2023.Retrieved5 January2024.
  37. ^"National Care Service is the only way forward for adult care".East Lothian Labour.Retrieved17 June2022.
  38. ^"Iain Gray in civil service talks about return to power".The Scotsman.1 November 2010.Retrieved17 June2022.
  39. ^Torrance, David (10 August 2011)."Scotland speeds plans to pool health and social care".The Guardian.Retrieved17 June2022.
  40. ^Scottish Labour: Scotland's NHS Recovery Plan(PDF).Scottish Labour.2021. p. 11.
  41. ^ab"National Care Service (Scotland) Bill: Overview".Scottish Parliament.20 June 2022.Retrieved21 June2022.
  42. ^Wilson, Caroline (3 February 2021)."Review backs National Care Service to 'raise standards' in care homes".The Herald.Retrieved17 June2022.
  43. ^This article incorporates text published under the BritishOpen Government Licence:"Independent Review of Adult Social Care".Scottish Government.Retrieved17 June2022.
  44. ^Fraser, Douglas (3 May 2021)."How much do we care about those who need care?".BBC News.Retrieved17 June2022.
  45. ^"Nicola Sturgeon to consult on National Care Service in first 100 hundred days".Home Care Insight. 2 June 2021.Retrieved28 July2021.
  46. ^"Backing for Feeley Review recommendations".Scottish Government.16 February 2021.Retrieved17 June2022.
  47. ^Albert, Angeline (15 April 2021)."Nicola Sturgeon promises National Care Service and national wage for care workers".Carehome.co.uk.Retrieved17 June2022.
  48. ^"Letter from Scotland: A more generous social care system".Health Service Journal. 9 June 2021.Retrieved28 July2021.
  49. ^"Scandal of underpaid care home workers predates coronavirus".The National.15 December 2020.Retrieved20 January2021.
  50. ^"Elderly care for profit is a scandal that should be ended".The National.23 July 2020.Retrieved20 January2021.
  51. ^Fox, Colin (25 May 2020)."Colin Fox: Why Scotland needs to have a National Care Service".The National.Retrieved20 January2021.
  52. ^"National Care Service (Scotland) Bill".Scottish Parliament.20 June 2022.Retrieved21 June2022.
  53. ^Summers, Lisa (21 June 2022)."National Care Service for Scotland will 'end postcode lottery'".BBC News.Retrieved21 June2022.
  54. ^Grant, Alistair (21 June 2022)."National Care Service plans branded 'biggest power grab in history of Holyrood'".The Scotsman.Retrieved21 June2022.
  55. ^Green, Chris (21 June 2022)."Scotland's plan for National Care Service sparks backlash from unions".i.Retrieved21 June2022.
  56. ^Bol, David (21 June 2022)."Warning SNP ministers risk diverting £1.3bn to set up National Care Service".The Herald.Retrieved21 June2022.
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