The Feeley review of adult social care has been criticised as ‘rebranding’ exercise with only a small number of ‘modest tweaks to the system’.

Common Weal says the proposals do not equate to a real National Care Service and if similar proposals were applied to the health service “it would be the end of the National Health Service as we know it”.

The review fails to go far enough across a range of areas, according to Common Weal, including restricting the role of private care providers, setting out staff pay levels and retaining ‘top-down’ decision-making.

The thinktank goes on to say that some changes, such as splitting the delivery of adult social care from child care, and other services like housing that are essential to effective support, could actually reduce the quality of care.

Derek Feeley’s review said that delivery of adult social care should be taken from councils and given to Integration Joint Boards that would answer to a National Care Service body.

Crucially, the review did not back taking care services – most of which are run by private and third sector providers – into public ownership.

This was deemed to represent ‘an unaffordable public outlay’ and to be ‘hugely time-consuming’.

A valuation requested by the Care Inspectorate during the first wave of the pandemic suggested the value of private care homes in Scotland was around £2bn.

Common Weal says it was a mistake that the review did not properly consider public ownership.

‘The question of whether a comprehensive free, publicly-funded service analogous to the NHS is desirable and affordable is not discussed,’ it says.

Instead, the review said that more national standards on pay, the quality of care and transparency should be introduced.

The plans were quickly accepted by the SNP, with other parties backing many of the key recommendations. In a manifesto published last week, Nicola Sturgeon promises a National Care Service will be ‘full functioning’ by 2026, while the Conservatives – who do not believe a National Care Service is the right approach – say social care in Scotland should be viewed as “equal to the NHS”.

But, in its analysis of the Feeley review, Common Weal claims the plans fail to address ‘fundamental questions’, including shying away from key issues such as differential pay rates for care workers in the public and private sectors.

And it says that integration could lead to care being subsumed into health priorities and power being shifted from local councils to government ministers and ‘unelected’ Integration Joint Boards.

Nick Kempe, a former head of older people’s services at Glasgow Council who now sits on Common Weal’s Care Reform Group, said the review had “ignored the lessons of the last year”.

He said: “…Even its recommendations, designed to perpetuate the current system and failed policy initiatives, seem too much for the Scottish government. 

“Since the report was published it has left care workers hanging on the Living Wage, while offering a 4% pay increase to NHS staff, and instead of embedding a human rights approach continues to place multiple obstructions in the way of friends and relatives who wish to spend time with relatives in care homes.

“Instead of top-down decision-making, we need a national debate about how to create and resource a National Care Service worthy of the name.”

Robin McAlpine of Common Weal added: “All political parties must make clear in this election whether they are offering a real new dawn for the very many people who need care at some point in their lives or whether they are content with tweaks and rebranding.

“If these proposals were applied to healthcare, it would be the end of the National Health Service as we know it, so how can doing the same thing for care be called a National Care Service? Scotland needs an awful lot more ambition than this.”

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