If Scotland can, why not England?

Alzheimer's Society CEO Jeremy Hughes has called on the government to make personal social care free in England, as in Scotland. He was responding to figures showing a 35% leap in hospital admissions for people with dementia in the past 5 years. Hughes attributed the rise to England's ‘scarce, inadequate and costly’ social care system (Campbell, 2020).

For many with dementia, entering hospital means a prolonged stay because of a lack of social care to support their return home. Hospitals cannot provide the individualised care someone with dementia needs. In an unfamiliar, stressful environment, these individuals are vulnerable to confusion, delirium, as well as other health risks of hospitalisation, including hospital-acquired infection, loss of muscle mass, falls and pressure ulcers (Andrews et al, 2017).

Scotland has provided free basic personal care to people over 65 years since 2002, and recently extended cover to all working-age adults. Scotland's system is not comprehensive; people with expensive care needs must fund additional services themselves, such as accommodation. Setting up a basic free social care system in England similar to Scotland's is estimated to cost £4.4 billion a year; more comprehensive coverage might cost £6–11 billion a year (Alderwick et al, 2019).