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What is the SNP’s National Care Service, and is it already in crisis?

Old woman with hand on walking stick, with a care worker's hand holding her arm.
The SNP wants to launch a National Care Service by 2026. Image: Shutterstock

A north-east care home boss signalled alarm bells over the SNP’s proposed National Care Service and warned it may harm frontline care.

Nicola Sturgeon’s vision for overhauling services by 2026 has been criticised for lacking detail and is dogged by questions over funding.

Has her plan hit a major stumbling block?

What is the National Care Service?

A new National Care Service will merge all social and personal care services into one body run by the Scottish Government if it’s approved.

The new national body would then be split into regional boards across Scotland.

This organisation would then be answerable to health ministers in Holyrood instead of local councils.

But critics aren’t sure the model is viable.

Why is there opposition?

Care bosses, council chiefs and trade unions have warned there’s no guarantee a National Care Service will help a sector that’s already struggling.

Robert Kilgour, who runs care homes in Aberdeen, Peterhead and Moray, fears the government is “ploughing ahead” despite concerns.

He said: “I’m not convinced it’s going to improve things on the frontline. Just introducing a national care service won’t necessarily improve care.

Renaissance Care boss Robert Kilgour. Image: Nick Mailer

“We haven’t had the Covid inquiry to see what lessons could be learned, yet they’re ploughing ahead in a blinkered fashion.”

He added: “I fear it’s a political marketing exercise. It’s a further land grab for central control.”

Much of the scepticism over the new model circles back to a recurring theme: nobody knows how it will work or what will change.

NHS Grampian wants details

In a major consultation, north and north-east health bodies said they had been given no evidence a National Care Service would lead to improvements.

NHS Grampian warned there was “insufficient detail” and said there was a “significant risk of disruption” to existing setups.

Western Isles council bosses said there was “limited analysis” as to why social care arrangements required a drastic overhaul.

They warned a new National Care Service could end up being a “damaging structural change” which takes years to get up and running.

Mr Kilgour claimed the Scottish Government had not done enough to explain why the new care service is necessary.

He told us: “They’re not prepared to engage with key stakeholders in a meaningful way.

“In principle I’m supportive. But you’ve got so many different groups against the way the government is ploughing on.”

Is it affordable?

Launching a health body modelled after the NHS is a big ask at any time – but doing so in the current economic climate is an even tougher task.

SNP ministers have faced questions over whether they can justify huge funding commitments to the project when cuts are being made elsewhere.

Deputy First Minister John Swinney
John Swinney has made major spending cuts. Image: PA

Deputy First Minister John Swinney was forced to defend plans to spend more than £1 billion on the new care service while slashing mental health funding.

Public spending body Audit Scotland warned costs could continue to rise.

Will the SNP stick by their proposals if further cuts have to follow?

How will it serve rural Scotland?

Many of Scotland’s more rural communities have different needs to those in the central belt when it comes to social care.

There are concerns a centralised body may not work for Scots in the north and north-east.

Western Isles Council said they had worries over a possible “loss to local democracy and accountability”.

Tess White criticised the care service plans. Image: DC Thomson

North East Tory MSP Tess White said: “Services outside the central belt inevitably suffer when ministers grab power from local providers.

“We’ve seen the impact of this centralising agenda on rural healthcare, and we cannot let social care go the same way.”

Tough project for Kevin Stewart

Launching a national care service has long been one of Ms Sturgeon’s flagship policies and her party has shown no signs of reversing course.

In a Holyrood committee, social care minister Kevin Stewart – who is an Aberdeen MSP – dismissed fears over a lack of detail.

Kevin Stewart defended the proposals. Image: DC Thomson

He said: “There are stakeholders who are not content with all aspects of this – but what I would point out to the chamber is that this is about people.”

However, further pressure will continue to mount on the SNP in the months to come as details become clearer and it progresses through Holyrood.