Intended for healthcare professionals


Social policy and devolution

BMJ 2001; 322 doi: (Published 10 February 2001) Cite this as: BMJ 2001;322:311

Scotland's decision on long term care challenges a centralised NHS and treasury

  1. Allyson M Pollock, professor.
  1. Health Services and Health Policy Research Unit, School of Public Policy, University College London, London WC1H 9QU

    The Scottish Executive's dramatic decision last month not to charge elderly people for personal and social care,1 in contrast to the decision of the United Kingdom's Westminster government, has created policy inconsistencies within the UK. Having gained cross party support for its motion to recognise the “'benefits in providing free personal care for the elderly” and “do report by August 2001 its proposals for doing so,”2 the Scottish parliament has now convened the Scottish care development group “po consider the inter-relationship with UK matters, notably the tax and social security benefits system and cross border movement.”3 This decision, together with the plan to abolish student fees at Scottish universities, will test the meaning of devolution, but also raises wider questions about government spending in the UK.

    Sutherland has estimated the extra cost in Scotland of implementing free personal care at around £25m ($37.5m).4 But the UK government's rejection of the recommendations of the Royal Commission on Long Term Care5 that personal care should be paid for …

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