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The Scottish National Care service was first announced by former First Minister Nicola Sturgeon in 2021 as a major reform of the devolution era. However, the plans have been scaled back and delayed amid disagreements over cost and implementation. Council leaders have recently walked away from negotiations, with opposition parties now pushing for the plans to be abandoned altogether. The government is facing financial and political restrictions, which suggests that the proposed care service may never become a reality.
The original proposal for a National Care Service aimed to establish a network of care boards across Scotland, similar to the NHS, to ensure consistently high-quality care provision and end the “postcode lottery.” While these objectives were laudable, the details of the plan have always been contentious, with concerns over cost and governance being raised. To address these issues, the revised version entails councils and NHS boards retaining accountability for staff and services in a shared model.
Critics contend that the proposed legislation’s specifics, currently being reviewed at “stage two” of the parliamentary process, confound the creation of a new structural entity with strengthening adult social care foundations. NHS Lothian, for example, argues that current resources should be allocated to improving frontline social care delivery. NHS Tayside also doubts if the latest changes will improve service provision significantly. Furthermore, council leaders’ recent vote to walk away from negotiations indicates broad resistance towards the proposed structure, while trade unions Unison and GMB have criticized the plan for failing to deliver the expected change.
Few doubt the importance of improving standards in care and establishing a care service in principle. However, various groups, including councils, health boards, unions, and third-sector organizations, argue for more details on cost and governance to make this plan workable. Social Work Scotland warns that the years of negotiations have “sapped stakeholder trust and energy” and resulted in an “expensive and disruptive restructure.” Amidst the budget crunch and political crises, it is uncertain whether the National Care Service will ever become a reality. The existence of various interest groups advocating for more details, along with the council leaders’ recent vote against the plan, indicates that much work remains to build the necessary bridges for the plan to succeed
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