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Fraser of Allander Institute, University of Strathclyde
General questions about the Bill
The Policy Memorandum accompanying the Bill describes its purpose as being “to improve the quality and consistency of social work and social care services in Scotland”. Will the Bill, as introduced, be successful in achieving this purpose? If not, why not?
Please provide your response in the box provided.
No. Reforms that will have a direct impact on frontline services and will deliver the vision set out in the Policy Memorandum including ‘timely, consistent and high-quality services’ have not been developed to the point where they can be part of the Bill at this time.
Future secondary legislation
Please provide your response in the box provided
Whilst welcome, we note that the scrutiny function of the Parliament outwith primary legislation will be more limited.
Do you have any general comments on financial implications of the Bill and the proposed creation of a National Care Service for the long-term funding of social care, social work and community healthcare?
Please provide your response in the box provided.
The National Care Service Bill does not provide a blueprint for the full reform programme envisaged by the Scottish Government. The financial information that has been worked on by officials and included in the Financial Memorandum only covers what is in the legislation. Whilst there are some gaps (e.g. the integrated health and social care record) and minor queries we have noted in our analysis, on the whole and given the exceptional levels of inflationary uncertainty at the moment, analysis provided by the Scottish Government is reasoned and logical.
There is little information available on the costs of reforms that are outwith the NCS Bill currently laid in parliament. Reforms that will have a direct impact on frontline services and will deliver the much hoped for ‘timely, consistent and high-quality services’ have not yet been developed and are not part of the Bill. Sequencing of reform, and the timing of when the Bill is laid in parliament, is ultimately a decision for Ministers.
There is little information available on the costs of reforms that are outwith the NCS Bill currently laid in parliament. Reforms that will have a direct impact on frontline services and will deliver the much hoped for ‘timely, consistent and high-quality services’ have not yet been developed and are not part of the Bill. Sequencing of reform, and the timing of when the Bill is laid in parliament, is ultimately a decision for Ministers.
Questions about the Financial Memorandum
Did you take part in any consultation exercise preceding the Bill and, if so, did you comment on the financial assumptions made?
Please provide your response in the box provided.
No
Do you consider that the estimated costs and savings set out in the FM are reasonable and accurate?
Please provide your response in the box provided.
The financial information that has been worked on by officials and included in the Financial Memorandum only covers what is in the legislation. Whilst there are some gaps (e.g. the integrated health and social care record) and minor queries we have noted in our analysis (sent seperately), on the whole, analysis provided by the Scottish Government is reasoned and logical.
There are currently no costs associated with the integrated health and care record in the FM.
With regards to Rights to Breaks from Caring, actual amounts spent on respite and breaks are not, we understand, available as local authorities are unable to produce figures which disaggregate this type of spending. The Scottish Government do not ring-fence spend for carers and there is no specific amount within the local government settlement which can be attributed as a contribution to carer respite and breaks. Whilst it is acknowledged that local authorities spend some money on carer respite and breaks, the level of uncertainty around the actual amount is substantial. The Scottish Government have estimated a figure based on. It is not clear how SG could obtain a more accurate figure however.
There are currently no costs associated with the integrated health and care record in the FM.
With regards to Rights to Breaks from Caring, actual amounts spent on respite and breaks are not, we understand, available as local authorities are unable to produce figures which disaggregate this type of spending. The Scottish Government do not ring-fence spend for carers and there is no specific amount within the local government settlement which can be attributed as a contribution to carer respite and breaks. Whilst it is acknowledged that local authorities spend some money on carer respite and breaks, the level of uncertainty around the actual amount is substantial. The Scottish Government have estimated a figure based on. It is not clear how SG could obtain a more accurate figure however.
Does the FM accurately reflect the margins of uncertainty associated with the Bill’s estimated costs and with the timescales over which they would be expected to arise?
Please provide your response in the box provided.
On the most part, levels of inflation haven't been factored into the figures which will affect nominal spending. In terms of real costs, however, the ranges look reasonable.
With regards to Rights to Breaks from Caring, there are ranges that look at different levels of overall take-up, but not over the profile of take-up.
The Bill does transfer social care spending to SG, and although this does not lead to additional costs, it does move the budget line and the responsibility for managing uncertainties there.
The Financial Memorandum assumes a 3% real terms increase on all years and services to account for any non-inflationary pressures. This means a real terms increase by 2026-27 of close to £1 billion across social care. No rationale is given for the 3% rise, and it is a little lower than the increase in costs that the LSE/PSSRU estimated for England over a similar time period in a 2020 paper. More work on this area to determine the particular factors that will affect demand (under current provision) would be wise. This part of the FM does contain estimates of inflation. The FM states that these figures are taken from the ONS, but we understand they are actually from the Bank of England. It is unclear why the SFC forecast has not been used by the Scottish Government. The SFC figures imply that the Scottish Government may have overestimated inflation in 2023-24 and 2025-26, but underestimated it in 2022-23 and 2026-27. However, the outlook for inflation at the moment is so uncertain that forecasting nominal expenditure is extremely difficult. Using a range of possible estimates may be the best option for financial planning and this is another improvement that could be made.
As noted already, thre is is little information available on the costs of reforms that are outwith the NCS Bill currently laid in parliament. Reforms that will have a direct impact on frontline services and will deliver the much hoped for ‘timely, consistent and high-quality services’ have not yet been developed and are not part of the Bill. Sequencing of reform, and the timing of when the Bill is laid in parliament, is ultimately a decision for Ministers, not for those producing costings for the FM.
With regards to Rights to Breaks from Caring, there are ranges that look at different levels of overall take-up, but not over the profile of take-up.
The Bill does transfer social care spending to SG, and although this does not lead to additional costs, it does move the budget line and the responsibility for managing uncertainties there.
The Financial Memorandum assumes a 3% real terms increase on all years and services to account for any non-inflationary pressures. This means a real terms increase by 2026-27 of close to £1 billion across social care. No rationale is given for the 3% rise, and it is a little lower than the increase in costs that the LSE/PSSRU estimated for England over a similar time period in a 2020 paper. More work on this area to determine the particular factors that will affect demand (under current provision) would be wise. This part of the FM does contain estimates of inflation. The FM states that these figures are taken from the ONS, but we understand they are actually from the Bank of England. It is unclear why the SFC forecast has not been used by the Scottish Government. The SFC figures imply that the Scottish Government may have overestimated inflation in 2023-24 and 2025-26, but underestimated it in 2022-23 and 2026-27. However, the outlook for inflation at the moment is so uncertain that forecasting nominal expenditure is extremely difficult. Using a range of possible estimates may be the best option for financial planning and this is another improvement that could be made.
As noted already, thre is is little information available on the costs of reforms that are outwith the NCS Bill currently laid in parliament. Reforms that will have a direct impact on frontline services and will deliver the much hoped for ‘timely, consistent and high-quality services’ have not yet been developed and are not part of the Bill. Sequencing of reform, and the timing of when the Bill is laid in parliament, is ultimately a decision for Ministers, not for those producing costings for the FM.