Manifesto funding pledges from the SNP are ‘likely to fall short’ when it comes to the recommendations of the Feeley social care review that were accepted by ministers ahead of the election, an independent thinktank has said.

But they are the only one of Scotland’s main political parties to provide overall social care spending commitments in their manifesto for the next Parliament.

The review of adult social care carried out by Derek Feeley and his team recommended a National Care Service be established in Scotland in the wake of the pandemic.  

Nicola Sturgeon has promised to deliver the findings of the review and said spending on social care would rise by 25% over the next parliamentary term – an increase of at least £800m by 2026.

But analysis of the parties’ manifestos by the Fraser of Allander Institute has questioned whether this is sufficient, warning the party’s pledge may not match what Derek Feeley recommended once the effects of inflation and demographic change are factored in.

David Eiser of the Fraser of Allander Institute told healthandcare.scot: “Assuming that [the £800m] is a cash increase and the Feeley review’s £660m is in real terms – which is how I read it – the commitment seems likely to fall short, even before the effects of demographic change are incorporated.”

A spokesperson for the SNP however told healthandcare.scot they were “confident” their commitments would cover the recommendations of the review of adult social care.

How do the parties’ spending plans compare?

Opinion polls suggest the SNP will remain in government after the elections, and the party has pledged that a National Care Service will be up and running by the end of the Parliament in 2026.

While the Holyrood parties generally back the Feeley review’s findings, they differ on whether a National Care Service should be set up, with the Conservatives and Liberal Democrats saying the centralisation of services would lose local accountability and could repeat mistakes made during the formation of Police Scotland.

The Greens are pushing for greater public ownership of care services – the majority of which are provided by private and third sector providers – while Scottish Labour says ‘huge structural change’ is neither desirable nor necessary. Labour, the Lib Dems and the SNP are promising to remove charges for social care to varying degrees.

The parties generally back higher wages for care staff – with Labour and the Greens advocating a £15 per hour wage – though they have not provided figures on how much this will cost. The Feeley review suggested that every pound above the Living Wage would cost an extra £100m a year.

Aside from the SNP, the parties are light on detail for social care spending. The Scottish Conservatives, who say they would end “historic underfunding” of social care, do not include a figure in their costings document. A similar publication from Scottish Labour allocates £667m for social care in the 2021/22 financial year but provides no information on subsequent spending.

What did the Feeley review say?

Derek Feeley made a series of recommendations to improve social care, including higher wages for care workers, establishing a national oversight body answerable to ministers and making social care – with the exception of care home accommodation fees – free at the point of use.

The review said a “substantial and long-term” funding boost of £660m a year would be needed to achieve this, suggesting this figure would have to be on a real terms basis, or adjusted for inflation.

It also said that a further real terms increase of at least 3.5% a year would be needed ‘on top of the initial investment’ just to maintain service levels, because the number of older people in Scotland is steadily growing.

The Fraser of Allander Institute’s analysis said the £800m commitment in the SNP manifesto would amount to a 2.6% real terms increase per year.

An extra £800m on current levels of spending would work out as around a £500m in real terms by 2026, according to the Institute – some £160m short of Derek Feeley’s estimate.

Asked whether Fraser of Allander was right, the SNP said: “The Fraser of Allander blog is correct in recognising that only the SNP have actually committed to increasing social care funding in this parliament.

“Our commitment is to increase social care funding by at least 25% by the end of this parliament - which would be an increase of over £840 million on the projected social care spending for 2021/22.

“We are also committed to increasing frontline NHS spending by 20% over this parliament, which you may be aware would include the expected resource transfer that takes place every year from NHS boards to social care and integration services.

“As we have set out in our manifesto, if re-elected, we will begin the formal legislative process of establishing the new service within the first year of the new Parliament and aim to have the new National Care Service fully functioning by the end of the parliament.

“The profile of increased funding for social care will be linked to the implementation of the Feeley review recommendation through, and associated with, the new legislation. Despite the complexity that will be evident in such a substantial undertaking of creating a National Care Service it is our aim to take it forward as quickly as is practicable.

“We are confident that our planned investment in health and care in this parliament will deliver the Feeley recommendations, create a National Care Service, scrap non-residential care services, and deliver record high investment in social care.”

 

Read more: Councils call on parties to acknowledge what they do; Manifesto health checks: Scottish Labour; the Scottish Conservatives; the Scottish Lib Dems; the SNP; the Scottish Greens

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