Financial experts overseeing the Scottish Government’s policy to merge health and social care have warned there is not enough money to deliver the multi-billion-pound reform.
A document produced by the finance officers in charge of the merger claims reductions to health and council budgets combined with pressure to make savings and the cost of paying the living wage means there is a cash shortage.
Integrating health and social care is a major public sector reform, which has been introduced in an attempt to ease pressure on the NHS by caring for more elderly people in the community.
Analysis of the policy has been carried out for a report submitted to the Scottish Parliament’s health committee by the Chartered Institute of Public Finance and Accountancy (CIPFA) and the CIPFA Integration Joint Board Chief Finance Officer Section – a group comprising Scottish integration authority chief finance officers.
The report notes that £8.3 billion has been allocated to integration authorities for their 2017-18 budgets. The cash comes from Scottish Government budget resources which is distributed to NHS boards and local authorities.
The report said: “There is emerging evidence which indicates that the current level of resources is less than that required to meet current cost and demand pressures.” It then warns that the shift in the balance of care from hospital to community will take longer to achieve as a result.
A number of integration authorities have estimated how much more money they require, from a 2.65 per cent increase required for Midlothian in 2018-19 to 14 per cent over two years in North Ayrshire. However, the experts acknowledge that “realistically” the policy will have to be delivered using existing resources, and warned this will speed up the cut in cash available to hospitals.
The group recommends that in order to financially support the integration agenda, there needs to be a long-term financial strategy established by the Scottish Government. In planning for this, the government should also examine whether integrated authorities should receive a direct allocation of funding to maintain progress.
The chair of the CIPFA IJB Chief Finance Officers Section, Sharon Wearing, said: “With emerging evidence of current budget deficits of integrated authorities between 3 per cent and 14 per cent, there is a careful balance to be struck between the level of resources necessary to manage current demand while planning for system redesign. It is of crucial importance that there is integration, however it needs to be properly planned for to ensure the sustainability of services.”
Scottish Labour’s deputy leader Alex Rowley said: “This is a very serious warning that SNP ministers must take seriously. The SNP needs to stop passing on Tory austerity and support Labour’s proposals to invest in our communities.”
A Scottish Government spokeswoman said: “Health investment has increased in each and every year of this government and is at a record high. Integration is one of the most ambitious programmes of work this government has ever undertaken and one which we believe will deliver health and social care services that work more efficiently.”