This article was first published at healthandcare.scot

The Scottish government looks set to miss its target of ending charging by councils for non-residential care services by the next Holyrood election despite acknowledging that the current system has a "significant impact" on the lives of disabled and vulnerable people.

Instead councils – and the health and social care partnerships they operate – are hardening their approach to generating revenue from these services.

healthandcare.scot has been examining non-residential care charging across Scotland, and trying to establish just how much money Scotland's councils make – and lose – under the present system.

Ahead of the Holyrood elections in 2021, the SNP made a commitment in its manifesto to ‘scrap all non-residential social care charges for those who need support’.

There are now fewer than 14 months before the next Scottish election.

The latest Scottish government budget does not include any funds to deliver the commitment. Instead the issue has been handed to a working group of government officials and local authority organisation COSLA in a final bid to find a way forward.

In answer to a recent question in the Scottish parliament, Minister for Social Care Maree Todd said the Scottish government and its partners remain "absolutely committed to reviewing" the system as part of broader reform of social care:

"I've heard directly from disabled groups and vulnerable individuals across Scotland about the significant impact that these charges have on their lives, and I have directed my officials to continue working with COSLA and local partners to explore any possible options to achieve that objective, considering the current economic climate."

Sara Redmond, Chief Officer at the Health and Social Care Alliance Scotland, the ALLIANCE, told us:

“The ALLIANCE has consistently called for all non-residential social care charges to be scrapped as a priority action needed to reform social care.

“We welcomed the Scottish government’s commitment to end charges in this parliamentary term, which was restated in the most recent Programme for Government. However, we are disappointed that progress towards doing so has been slow, and no funds for ending non-residential social care charges have been allocated in the Scottish government’s Budget.

“For many disabled people, people living with long term conditions and unpaid carers, social care services are essential for their participation in society and equal enjoyment of their rights.

“Charges for non-residential care puts participation and rights at risk, increases the financial pressures on people accessing care, and causes them to forego essential services or manage without support.”

New charges

Across Scotland, councils have long had the option of charging for non-personal care services, such as help with shopping, support to attend social activities, time spent at a day centre, meals delivered to people's homes, short term respite care and providing blue badge parking permits.

Charging is means tested and people in some circumstances are exempt.

Councils cannot charge for personal care, needs assessments, advice services or any service provided to an unpaid carer.

The Verity House agreement signed between ministers and COSLA included a commitment to exploring an approach to ending charges for non-residential social care support within the lifetime of the current parliament.

Maree Todd's questioner in Parliament, Scottish Labour's Social Justice and Equalities spokesperson Paul O'Kane, called the current situation a broken promise with consequences, warning that more councils are having to introduce care charges for the first time for people who have physical and learning disabilities.

In the teeth of opposition from local individuals, families and their carers, one local authority that had previously provided all these services without charge, this month opted to levy a £20 an hour fee.

Explaining the move, East Renfrewshire Council stated:

‘For many years, we have worked hard to avoid the need to introduce charges for non-residential care, and up until now we are the only health and social care partnership in Greater Glasgow and Clyde that does not charge for these services. Regrettably, our financial position, the demand for services and the increasing complexity of need, means we need to consider introducing means-tested charges for these services. 

‘Our hope is we can work with individuals, families, carers and our wide range of partners to minimise the impact of any change to our charging policy.’

This week Aberdeenshire Council toughened its stance, undertaking to recoup a far greater proportion of costs for social care services than it has in the past.

In its financial recovery plan, the health and social care partnership says it will from April move to a model of ‘full cost recovery’ of services including non-personal, day care, and community alarm telecare provision, in a bid to raise an additional £3.3m a year.  

The costs involved

East Renfrewshire Health and Social Care Partnership says that its modelling suggests around £1.5 million per year could be raised from introducing charging, a figure that it says is comparable to similar areas.

healthandcare.scot’s attempts to establish the amounts of money involved using freedom of information allowed us to draw only a limited picture after Scotland's largest local authority, Glasgow City, said it could not provide the information.

Only East Renfrewshire responded saying it did not charge for these services in the year 2022/23.

Even without data from Glasgow, Aberdeen, Midlothian, Na h-Eileanan Siar, North Ayrshire, South Ayrshire and South Lanarkshire, total income from charges in that financial year for the 24 councils that did provided information exceeded £30min 2022/23.

Tracking the charges over a five-year period up to and including 2022/23 showed no overall pattern. Some councils increased income over the five years while others raised less in 2022/23 than in the two years before the pandemic.

Chasing arrears

One challenge for councils is what to do about the people who cannot or will not pay.

In some parts of Scotland, this group makes up a significant proportion of those being charged.

healthandcare.scot asked the councils about the level of arrears from people not paying their charges – and what the council did about nonpayment.

Several councils chose not to answer questions on non-payment. Others said that, because nonpayments are carried over to the following year, they were only able to say how much was currently owed rather than provide an annual figure.

Renfrewshire and North Lanarkshire councils gave a figure for arrears in 2022/23 higher than that year’s income.

Chasing nonpayment by people accessing social care services is a step too far for many local authorities.

Five councils told us outright that they have a policy of not pursuing legal action against non-payers.

Inverclyde Council wrote:

"The council currently only issues invoices, reminders and second reminders. None of the debts were progressed to a sheriff officer or collecting agencies."

Several other councils, while not stating that they have a non-pursuit policy as such, did not provide information on any system they use to recover unpaid charges.

Only three councils of those that responded – East Ayrshire, Highland, and Perth & Kinross – provided numbers for people pursued for non-payment.

What next?

Few would suggest that the current system of non-residential care charging is ideal, not least as most councils are reluctant to enforce collection from a group of service users who are, by definition, in need of help.

The inclusion of a manifesto commitment to abolish non-residential care charging was a political decision by the SNP and ultimately it will be a political choice by the Scottish government whether the funds are made available to councils to allow them to waive all future charging.

Without a full picture of the total income to Scottish local authorities from these charges, it is not possible to estimate how much such a move would cost.

However, the incomplete data provided to us suggests that the amount would be less than the £150m price tag that the Scottish Fiscal Commission has placed on another Scottish government ambition, to abolish the two child benefit cap.

In the meantime, Sara Redmond says simply:

“The ALLIANCE would urge the Scottish government to make the funds available and work with COSLA to end non-residential social care charges without delay.”