National Care Service costs significantly understated, says spending watchdog

The Scottish government's "price tag" for a new National Care Service is likely to be significantly understated, Audit Scotland has said.

The spending watchdog has highlighted a number of concerns about the service which would make ministers accountable for adult social care in Scotland.

The government initially said it could cost up to £0.5bn to deliver.

By mid-October, Scottish Parliament researchers estimated the bill over five years to be £664m to £1.261bn.

In a written submission to parliament, Audit Scotland has highlighted issues with pensions, VAT changes, capital investment and health board transition costs, which could see the final total increase further.

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It says "a number of costs associated with the measures... have yet to be assessed" and that "the potential for additional cost is significant".

The proposed National Care Service is currently the subject of a bill making its way through parliament.

It would see the setting-up of a series of care boards that operate in the same way as health boards, with Scottish ministers directly responsible.

It means local authorities would no longer run social care services, while aiming to support people in their own homes or among family, friends and community wherever possible.

'Power grab'

The Scottish government has touted the move as potentially the most significant since the creation of the NHS.

However, opposition parties and union leaders have described it as a government "power grab" and an "all-out assault on local democracy".

Some SNP MSPs have also been publicly critical, with Kenneth Gibson saying the policy "seemed like a sledgehammer to crack a nut" if it does not provide the funding to address issues in the healthcare sector.

His party colleague Michelle Thomson also said she had "no confidence whatsoever" that the service's financial memorandum represents any level of accuracy or value for money.

Holyrood's finance and public administration committee has begun hearing evidence from health and social care bosses, as well as Audit Scotland's audit director Mark Taylor.

The new service was proposed after a review into adult social care

Mr Taylor told MSPs lessons should be learned from the creation of other new services like Social Security Scotland.

He said: "Government needs to be able to be much clearer, at a much earlier stage, about its financial plans."

Responding to a question from the SNP's Michelle Thomson, he said the purpose of the National Care Service was to improve standards and consistency.

"What's not clear, and understandably so, is the price tag that will ultimately be associated with that," he said.

"If that is to be levelling up - to use that politically loaded phrase - if it's about areas where the quality and consistency of the service falls below a certain standard, does that have a price tag attached to it?"

Mr Taylor added: "What's the price tag, what's the cost associated with that service redesign?

"I understand at this stage of the process that it's very difficult to get a sense of that, but that's the hidden cost here."

Health Secretary Humza Yousaf previously said the creation of a National Care Service for Scotland would end the "postcode lottery" in the sector.

The service was proposed after an independent review into the future of adult social care triggered by the Covid-19 pandemic.