A report from the Health Foundation in 2019 showed that public spending on care is much higher in Scotland and Wales than in England.
The report showed that an average of £310 per person was spent on social care services in England in 2019, 43% less than Scotland – with a spend of £445 per person – and 33% less than Wales, with a spend of £414 per person.
So, why is England lagging behind when it comes to social care spending?
Some of the difference can be attributed to a difference in population and needs, with economies of scale and the rural landscape of Wales and Scotland also being key drivers for the difference in public spending, according to the BBC.
However, the health spending in Scotland being just 8% more than in England, it’s clear that the disparity is far larger when it comes to care funding.
The report shows that, had care funding levels increased in line with demand, in 2017/18 councils would be spending over £23bn a year on public and personal care – an almost £6bn difference to the £17bn spent.
Along the same vein, it is predicted that there will be an additional gap of at least £2.7bn in 2023/24 as the need for resources rises.
What do these differences in funding mean?
Across the UK, care benefits are means-tested. However, there is a clear difference in approaches to care across England, Scotland and Wales.
For example, in Scotland, anyone aged 65 or over and who is assessed as needing care is entitled to free personal care such as washing and dressing. In contrast, anyone with assets over £25,250 is expected to pay the full cost of their care.
This means that the number of people who pay for their own care is likely to be much higher in England, especially for the older generations.
On top of this, people receiving Direct Payments are also responsible for organising their own Direct Payment’s Insurance as they are legally classed as an employer if this benefit is used to employ care workers.
The number of additional costs for people in need of care in the UK can, therefore, be concluded to be higher overall.
Social care worker pay
Interestingly, the report predicts that if social care staff were given a similar pay to the planned increases for NHS workers, the gap would fall to £4.4bn in 2023/24.
Currently, one of the biggest issues in the social care sector is recruiting and retaining staff, due to the low pay associated with caring roles, compared to pay in the NHS according to Surewise.
For example, the same report estimated there to be over 40,000 nurses working in adult social care but almost a third are predicted to have left their role in the past 12 months due to the extremely pay differences sector the social care sector and the NHS.
The Barnett Consequentials
An important factor to consider when looking at the differences in funding across Scotland, Wales, and England is the Barnett Consequentials formula.
This is a mechanism used by the UK Treasury to automatically adjust public expenditure distributed to each of the devolved nations in order to reflect changes in spending levels allocated to public services in England.
In 2009, the House of Lords concluded that “the Barnett Formula should no longer be used to determine annual increases in the block grant for the United Kingdom’s devolved administrations… A new system which allocates resources to the devolved administrations based on an explicit assessment of their relative needs should be introduced.”
Following the September 2014 Scottish referendum on independence, the Barnett formula came under extensive scrutiny amid concerns that in a last-minute government bid to sway voters against independence, Scotland had been promised continued high public spending.
Unfortunately, currently, there is no formal agreement on how to change the formula and its application through the UK.
