Scotland could create the world's first fully integrated health and social care system if the parliament's "full powers are realised", according to the architect of free personal care.
Former first minister Henry McLeish said the policy, which was introduced by his Labour administration in 2001, ultimately aimed to elevate social care to the same status as the NHS.
He said the term 'social care' could be acting as a disincentive to taking that care seriously.
The Scottish Government is considering responses to a consultation on the new National Care Service and a bill is scheduled to be introduced in the Scottish Parliament in summer 2022.
It will remove the responsibility for social care from Scotland’s 32 local authorities and combine it under a new, centralised service.
READ MORE: Scots could be among first to trial Alzheimer drug - and why regulators are right to reject it
Mr McLeish accused the prime minister Boris Johnson of being insincere in claiming National Insurance hike would fix social care because most of the revenue will go towards the health service. He said Scotland had the means to go further.
The former Labour politician has taken on a new role as Alzheimer Scotland's first ambassador and said one of his first priorities would be progressing the charity's aim of ensuring people with advanced dementia have access to free NHS healthcare.
He said: "Part of the acceptance of the ambassador role is to have a vision where Alzheimer Scotland moves forward as rapidly as it can, impacting on dementia but also to be seen as part of a very inspiring attempt to put Scotland in the lead in terms of an integrated care service.
"That to me would see us leading the UK and possibly leading the world.
"The focus in England is not the right one. If we want an integrated care service, that has to look very different to what they are aspiring to.
"The idea of an integrated care service - these are really big ambitions for Scotland and I'm delighted we are here."
"When we talk about health and social care, social care can be a disincentive to taking that care seriously. It has a different context to it. Health is specific so I want to talk about a health and care service."
Mr McLeish has previously said he would vote for Scottish independence in a second referendum if the Union fails to reform itself.
"I don't want to be drawn into that again but I think in Scotland there is huge, unfulfilled potential at the Scottish parliament," he said.
READ MORE: How GP screening could transform dementia outcomes
"I think at times we should concentrate on how we can take that forward regardless of what happens in the future.
"Politics divide. When we are tackling issues like dementia we need a united front, a united parliament and when we have that I think we can arrive at financial solutions.
"What unites Scotland is probably a desire to have the best health and social care services in the world. How that pans out in terms of constitutional structures is one thing but to me we should build on the ambition that is already here.
"I think we largely have the means in place to do that."
He said a full debate on funding was required at Holyrood and is not in favour of the planned increase in National Insurance contributions, announced by the UK government in September to raise an extra £36billion for social care and tackle NHS backlogs.
"I'm not convinced that Johnson is being sincere in his approach to social care or care," said Mr Mcleish. "It seems to me that the vast amounts of money they are injecting is really about health.
"I'm afraid that care in England will continue to be the Cinderella, getting what's left off the NHS table and not really being regarded in terms of a fully integrated care service.
"That, in my judgement is not the best way forward because it does fall disproportionately on those who are young and on lower salaries.
"I think in Scotland we have the benefit of being ahead of the rest of the UK in care anyway.
"Secondly we have the Derek Feeley report, which is a very worthwhile document and thirdly I hope the government will embrace this vigorously and look at ways of being able to finance what we intend to do.
"The goal has to be that care is free at the point of need, whether its in the community, or residential provision or in peoples' homes. And that's markedly different to what's happening in England.
"There has always been great discussion about residential care and you have to separate the hotel aspect of that and the care side. Care and nursing needs should be free.
"The government have really got to think through what the financial requirements will be. I think we are at an early stage. We might need to look at a fairer system of taxation to do that.
"Hopefully the government will now pursue with enthusiasm where this is taking us. It may take two or three years, that's not a bad thing because at the end of the day, we are not just wishing for Cinderella to come to the ball for the first time but we actually in the process should not stop making the changes that we need to."
Free personal care was introduced by his Labour administration at Holyrood in 2001, with the policy meaning the elderly received different levels of care north and south of the Border.
Mr McLeish said he faced some opposition from politicians within his own party south of the border when free personal care was touted because "they were worried people in England would want it."
"I thought (free care) was a tremendous step forward but for me it was about building a different care service that was elevated to the same level as the NHS.
"That free at the point of need was symbolic for me as where Scotland needed to be."
Commenting on his new role with Alzheimer Scotland, Mr McLeish said dementia was an area that was "close to his heart" as his late father was affected by the disease.
"I'm very interested in the fact that the charity is pursuing a human rights based approach [to care costs].
"At the end of the day this is about dignity of men and women at critical points in their lives and the impact it could make on their families.
"It's a huge social justice issue.
"We have a situation where around 100,000 people have dementia and 10% of them have advanced dementia. We need a situation where that is defined as health and not social care."
He said that their care should be the complete without families having to "wrestle the jungle of social care" provision.
READ MORE: Demands to end 'gross injustice' of dementia tax
"I cannot understand why we have reached this position", he said. ""This is essentially an issue that has to be tackled now. It will require, in my opinion, a limited amount of resources but it highlights the essence of what Scotland should be doing.
"It should be about fairness and this is manifestly unfair."
It comes amid a warning social care in Scotland is at “very real risk of collapse” this winter amid rocketing insurance premiums and a workforce exodus, MSPs have been told.
Donald Macaskill, chief executive of Scottish Care, warned that the sector is now “haemorrhaging” staff to better-paid and less stressful jobs in retail and hospitality, and the coming months will see “more and more providers going to the wall”.
Dr Macaskill, whose organisation represents independent care providers who make up around 70 per cent of care homes and home care services in Scotland, told Holyrood’s Covid-19 Recovery Committee, that insurance premiums for care homes had soared from an average of £3000-£5000 a year in 2019 to £30,000 now, on top of rising costs for heating and electricity.
Why are you making commenting on The Herald only available to subscribers?
It should have been a safe space for informed debate, somewhere for readers to discuss issues around the biggest stories of the day, but all too often the below the line comments on most websites have become bogged down by off-topic discussions and abuse.
heraldscotland.com is tackling this problem by allowing only subscribers to comment.
We are doing this to improve the experience for our loyal readers and we believe it will reduce the ability of trolls and troublemakers, who occasionally find their way onto our site, to abuse our journalists and readers. We also hope it will help the comments section fulfil its promise as a part of Scotland's conversation with itself.
We are lucky at The Herald. We are read by an informed, educated readership who can add their knowledge and insights to our stories.
That is invaluable.
We are making the subscriber-only change to support our valued readers, who tell us they don't want the site cluttered up with irrelevant comments, untruths and abuse.
In the past, the journalist’s job was to collect and distribute information to the audience. Technology means that readers can shape a discussion. We look forward to hearing from you on heraldscotland.com
Comments & Moderation
Readers’ comments: You are personally liable for the content of any comments you upload to this website, so please act responsibly. We do not pre-moderate or monitor readers’ comments appearing on our websites, but we do post-moderate in response to complaints we receive or otherwise when a potential problem comes to our attention. You can make a complaint by using the ‘report this post’ link . We may then apply our discretion under the user terms to amend or delete comments.
Post moderation is undertaken full-time 9am-6pm on weekdays, and on a part-time basis outwith those hours.
Read the rules hereLast Updated:
Report this comment Cancel