Health and social care merger at heart of Scots election

Radical plans to merge health and adult social care are at the heart of the Scottish election campaign, with all of the major parties putting forward proposals to bring the two services together.

In manifestos launched yesterday, both the Conservatives and Labour pledged to merge the health and adult social care budgets.

Labour’s plan for a National Care Service would see formal local partnerships of councils and health boards take responsibility for health and adult care in line with new national standards, to ensure equitable levels of care throughout the country.

It said the proposal would end the postcode lottery for care while helping tackle delayed discharges through the merger of NHS and adult care budgets.

The Tories would strip responsibility for adult care from councils, passing this to the NHS, saying it would “remove the incentive to use hospital beds when social care would be a more appropriate alternative”.

Although it has not published its manifesto yet, the Scottish National Party in government initiated work to integrate health and adult care through “lead commissioning” arrangements between councils and NHS boards.

Under these, one partner would take responsibility for health and adult care in each area for specific client groups.

The Liberal Democrats, who published their manifesto earlier in the week, have also backed stronger links, saying they would require effective joint working between health boards and councils, including through shared premises and staff.

The Lib Dems said they “oppose the centralisation of care into a single, national care service, with little accountability and enormous costs and bureaucracy”. However, a report commissioned by Labour from an expert panel also rejected the creation of a centralised bureaucracy to run any National Care Service, implying this would not be the party’s approach.

The Lib Dems and Labour explicitly backed the retention of free personal care for older people in their manifestos, despite concerns over its long-term affordability. The SNP has vigorously backed the policy in government while the Tories have also long supported it.

The contest on 5 May is a straight fight between Labour and the SNP, who are running neck-and-neck in the polls. However, neither is likely to win an overall majority, under Scotland’s system of proportional representation, meaning there is likely to be either a minority government or a coalition.

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