Podcast transcript – Free personal and nursing care, February 2008

Hi, we’re here today talking to Nick Hex, portfolio manager at Audit Scotland, about Audit Scotland’s latest report, A review of free personal and nursing care.

So Nick, what is this report about?
The report examines the financial implications of the free personal and nursing care policy in Scotland including the effects on older people, councils and the Scottish Government.
And what have you found?
We have found that free personal and nursing care needs to be better planned, better managed and better funded for it to continue to benefit older people in Scotland in the future.
In particular, we found that the Scottish Executive and councils did well to implement free personal and nursing care in the timetable set for this but further work is needed. Monitoring the financial impact of the policy has been limited with no longer-term cost projections being developed. There are indications of a growing shortfall in funding and there are differences in the use of waiting lists and eligibility for free personal care, which are leading to variations across Scotland, for example, whether food preparation is free or not.
You mention variations in the service there. Are you saying that people living in different areas get different levels of service?
This is a universal policy, like child benefit, so all older people should have access to free personal and nursing care. However, we know that there are variations in what is categorised as personal care, particularly food preparation, which means some older people in Scotland pay for this and others don’t. So to an extent where people live does make a difference.
You also mentioned a shortfall in funding. Is this something that is going to get worse in the future, with Scotland expected to have a growing older population?
The funding gap so far has not been a result of any significant increase in the numbers of older people. However as the older population is expected to grow considerably, as indicated in our report, the need for care is likely to increase which will have an impact on overall costs.
What do you want to see happen now as a result of your report?

We have made a number of recommendations in the report aimed at the Scottish Government and councils, some of which need to be addressed as a matter of urgency. In particular, there are two recommendations that should be addressed urgently:
•	improving the monitoring and financial planning of free personal and nursing care, and updating long-term cost projections
•	ensuring that what is covered by free personal care is transparent and is consistently applied across Scotland.
There are also some very specific recommendations about clarifying whether councils should charge for food preparation or not.
Ok Nick, thank you very much for your time.