'National Care Service' is an SNP power grab that won't address the crisis in health and social care – Alex Cole-Hamilton

This week saw the first frost of winter. It’s a time that ambulance workers, doctors, nurses and social care workers dread.
The NHS is struggling with a huge gap in its budget (Picture: Christopher Furlong/Getty Images)The NHS is struggling with a huge gap in its budget (Picture: Christopher Furlong/Getty Images)
The NHS is struggling with a huge gap in its budget (Picture: Christopher Furlong/Getty Images)

The cold weather brings with it a tidal wave of demand for services that are already buckling under the strain. On an almost daily basis, we see warning lights blinking on across almost every department.

Ambulance delays, hold-ups in A&E, cancelled operations, people stuck in hospital for want of a social care package. It’s not being overly dramatic to say that the problem has never been quite so acute.

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Professor Paul Gray, the NHS chief executive for six years under Nicola Sturgeon, has said this crisis would have happened with or without Covid. It is the result of years of botched workforce planning, increasing demand and what health board bosses have described as a "billion pound hole" in the health services' budget.

In the face of rising pressures and the soaring cost of living, NHS staff can only be pushed so far. There is even the prospect of strikes because ministers will not listen to the very fair pay demands of healthcare staff. The dead hand of ministerial disinterest is at large once again.

Scotland is cursed with a government that is more interested in eye-catching gimmicks than real solutions. For evidence of this, look no further than the ministerial power-grab that is underway in the formation of the misleadingly named “National Care Service”.

The National Health Service was forged out of necessity amidst the rubble and poverty of war. It is free at the point of delivery and provides a service universally to everyone regardless of background. None of this is true of the National Care Service.

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It is simply a plan that will centralise the oversight, function and strategic direction of social care in Scotland. It assumes that ministers and government officials in Edinburgh know more about the intricacies of delivering care in rural Caithness, or in Arbroath, than teams on the ground in those places do.

As this legislation goes through parliament, the evidence presented by almost every stakeholder from trade unions to health bosses has been staggering – their reactions range from bewilderment to outright opposition. Setting up this vast and unnecessary bureaucracy comes with a price tag of anything between £800m and £1.5bn. That’s roughly equal to the gap we need to close in the funding of our NHS.

Likewise, when the SNP centralised Scotland's regional police forces, Scottish Liberal Democrats warned that when you bring regional organisations together to form a national body, they lose their VAT exemption. The same principle is likely to mean a whopping great tax bill coming over the horizon as well.

Liberal Democrats believe fiercely that care should be designed and delivered as close as possible to the people who receive it. We know that local social care partnerships understand the needs of local people far better than ministers in Edinburgh.

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There is a need to reform the way we do care in Scotland, but that’s about making it a profession of choice by improving pay and conditions. It’s why and I and my party will fight to stop this ministerial vanity project every step of the way.

Alex Cole-Hamilton is Scottish Liberal Democrat MSP for Edinburgh Western