In a report published today, the Scottish Parliament’s finance committee says without an indication of the potential scale of all costs associated with the National Care Service Bill, which is making its way through Holyrood, it is “difficult to assess whether the proposed National Care Service is either affordable or sustainable”.
The plan to merge social care into a single national service is facing criticism due to a lack of clarity about the final price tag. However, the Scottish Government is determined to press ahead with the plan, described by the First Minister as the “most significant public service reform” since the creation of the NHS.
Groups in the care sector, including trade unions, have called for the NCS plans to be paused.
The cross-party committee is calling on the Scottish Government to provide “much needed clarity” and to bring forward fully costed plans at least two weeks before the stage one vote on the Bill, scheduled for March next year.
In mid-October, Scottish Parliament researchers estimated the cost of the National Care Service to be between £664 million and £1.261 billion over the five-year period between 2022/23 and 2026/27.
The convener of the finance committee, the SNP’s Kenneth Gibson, said: “The finance committee has significant concerns over the costings in the financial memorandum (FM) to this Bill. The FM in its present form does not provide an overall estimate of the cost of creating a National Care Service.
“A large number of decisions are yet to be made, and no estimate of costings has been provided for VAT liability, transfer of assets and staff, and the creation of a nation-wide digital health and social care record – all of which has the potential to result in significant costs.
“The committee appreciates the Scottish Government’s intention to co-design the service with those most closely affected. That work could, however, have been undertaken prior to the introduction of primary legislation.
“Major Bills should not be implemented via secondary legislation, or through business cases, which cannot be subject to the same in-depth, formal scrutiny as financial memorandums to Bills.
“The significant gaps highlighted throughout our report have frustrated the parliamentary scrutiny process. We are therefore calling for a revised financial memorandum, with detailed costings, at least two weeks before Parliament considers the Bill at stage one.”
Scottish Labour Health spokesperson Jackie Baillie said: “This scathing report adds to the chorus of voices slating the SNP’s botched plans. Even the SNP’s own MSPs are losing faith in these unworkable, unpopular and un-costed plans.
“Scottish Labour have long led the campaign for a National Care Service, but this shambles makes a mockery of this important principle. The SNP have had warning after warning – they must start listening and pause this bill, so we can take the time to get it right.”
The Bill proposes setting up a series of care boards that operate in the same way as health boards, with Scottish ministers directly responsible, meaning local authorities would no longer run social care services.
When the legislation was first announced, health secretary Humza Yousaf said it would end the “postcode lottery” in the care sector.
Mental wellbeing and social care minister Kevin Stewart said: “The National Care Service is the biggest public sector reform in Scotland since the NHS was created after the Second World War.
“Our aim in delivering a National Care Service is to end the postcode lottery in care provision in Scotland, and we look forward to continuing to working with service users to help co-design the new service.
“I welcome the scrutiny of this committee as the Parliament has an important role in strengthening the legislation that we bring forward. I look forward to giving the recommendations of the committee detailed consideration and to report back to them with the further detail they are seeking in due course.”
The briefing, circulated among MSPs, reads: “As these uncertainties are resolved, the Scottish Government should be in a position to produce more refined cost estimates.
"However, these would not receive further scrutiny as decisions would be reflected in secondary legislation, which would not have an associated financial memorandum.
"This leaves scope for estimated costs to change considerably without any detailed Parliamentary scrutiny, so it might be considered appropriate for updated costs to be presented to the Parliament’s finance and public administration committee as the Bill progresses through its Parliamentary stages and as further decisions are reached on the scope and nature of the National Care Service."