A gap between legislative intent and delivery has been experienced historically in social care. The National Care Service (NCS) is the latest attempt to change this.
Any analysis involving social care in Scotland involves a lot of uncertainty. However, given the scale of reforms, transparency is key to building trust and consensus around financial estimates that can stand up to scrutiny and deliver what is promised
Attempts at social care reform are not new in Scotland. However, over the past decade attempts at reform have been set against a backdrop of financial pressures and uncertainty for local government. Whilst financial resources are not the only factor that will affect the success of social care reform, without sufficient resources it will be much harder.
A lot is at stake. Mainly for the people who need to draw on social care, but also for the risks around managing the Scottish Budget. There are many big questions that are yet to be addressed before concerns over the looming potential for yet another gap between vision and reality can be dispelled.
For example, we have very little understanding on unmet need in Scotland. New provision to meet at least some of this need will be required to meet the vision of all people being able to access timely, consistent, and high-quality health and social care support across Scotland. If we cannot quantify how many people will draw on new support it will not be possible to cost and plan.
This type of analysis will hopefully come to the fore over the next year as more of the reform agenda starts to take shape.
There are many potential benefits from getting reform right. Prevention is a worthy, and arguably necessary, aim given the current fiscal outlook and future demographic change. However, there is no doubt that there will be significant upfront costs associated with the NCS vision beyond the amount currently earmarked, especially given the structural reforms that are envisaged. How this money is found, or raised, are additional questions that the Scottish Government will soon need to grapple with.