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Will the old flee to Scotland?

Tom Brown

Published 08 January 2001

Scotland versus England is an age-old problem, but what may really divide us in the near future is the old-age problem.

The new First Minister, Henry McLeish, has hoisted his personal flag of independence by promising full implementation in Scotland of the Sutherland report on long-term care of the elderly, while the Blair government has baulked at meeting the costs. Elderly Scots would have both their medical and their personal care paid for by the Scottish government, while only medical bills would be paid by taxpayers in the rest of the UK.

Different policies on either side of the border would lead to bizarre possibilities. What would stop people who have lived in England, Wales or Northern Ireland from becoming Scots in their old age to take advantage of the free care? Might there be a Zimmer-frame exodus, an explosion of eventide homes in Gretna, Coldstream and Scottish border towns, handy for visits from southern relatives? Or would residential qualifications be imposed? More likely, would a Westminster government not be shamed into following, for once, the Scottish lead?

At present, every elderly person classified as a medical patient receives free personal care. Those who are in residential care or have visiting nurses in their own homes because they need help with washing, dressing and feeding are means-tested. They receive free care only if their assets are worth less than £10,000, and those with assets worth more than £16,000, including their homes, pay the full amount. When the royal commission led by Professor Sir Stewart Sutherland of Edinburgh University called for the abolition of this distinction, the Health Secretary, Alan Milburn, objected that it would consume most of the extra NHS resources being made available for the elderly. His Scottish counterpart, Susan Deacon, agreed: "To make this change at this time, when so many needs exist for tens of thousands of older people, would not be right."

The UK bill would be £1.3bn for up to 250,000 people. In Scotland alone, the cost is estimated at £110m a year, and it could be as much as £600m in 50 years' time.

However, Deacon is now having to do a U-turn as part of McLeish's agenda to draw a clear line between the Scottish Executive and London. When he succeeded the late Donald Dewar, McLeish parried Scottish Nationalist jibes that he would be a Blair puppet with the promise to look again at the Sutherland report.

But it is also a strong personal commitment. McLeish has adopted as his slogan the creation of a "confident, competitive and caring" nation. In his New Year message, he said: "There is no point having a devolved Scottish Parliament if we cannot do things differently here."

Already, the SNP is pressing for immediate implementation, but McLeish has cagily left the date vague. The Scottish Executive is bound by a three-year spending plan, so, if the money for Sutherland is found before then, some other part of the budget would suffer. Conveniently, the promise can be honoured in 2003 - the last year of the present administration and just in time for the next Scottish election.

The political problems for the UK and Labour are more perplexing. Already, there is a growing divide between Scotland and England. Following the divergence on student fees, Section 28 has been scrapped in Scotland and an anti-hunting bill is galloping through the Holyrood parliament while Westminster is stalling. The Scottish Executive is also drawing up a family law bill which would give Scotland "the most liberal marriage laws in the UK", including no-fault quickie divorces, while the Lord Chancellor, Lord Irvine, has gone cold on similar proposals for England and Wales. (Can we expect couples in future to flee to Gretna to get divorced rather than tie the knot?)

Scotland has always had its own jealously defended education and legal systems, but separate policies on the care of the elderly would open up a constitutional and political minefield. For one age group at least, they would create the two-tier United Kingdom against which William Hague and the anti-devolutionists keep warning. That is why social security provision is one of the powers reserved to Westminster. Different rates of benefit for pensioners, poor families, the jobless and the disabled in different parts of the UK were unthinkable.

McLeish's decision to go his own way on the care of the elderly would raise questions about the formula under which Westminster allocates the budget for the Scottish Parliament. English MPs already complain that it gives Scots too big a slice of the UK cake, and that argument would be reinforced if Scotland could afford to be more generous to its old people. Moreover, the lobbying muscle of pensioners outside Scotland would certainly come into play.

McLeish may be taking care of the old folks at home, but outside Scotland he could unleash the formidable forces of grey power against his own Labour colleagues.

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