Effects of the Free Personal Care Policy on Care Decisions: what can we learn from Scottish Househol

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Effects of the Free Personal Care Policy on Care
Decisions what can we learn from Scottish
Household Survey data?

• Paul McNamee

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Policy Background

• Policy implementation of Free Personal Care (FPC)
  in Scotland from July 2002
• Replacement of means-testing with universal
  entitlement to care
• Concern surrounding reduction in supply of
  informal care
• Funding of long-term care in England and Wales
  under review

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Theoretical Background

• If personal care is a commodity displaying usual
  characteristics, fall in price should lead to an
  increase in demand and reduction in demand for
  substitutes (e.g. informal care)
• Influence of behavioural constraints
• Supplier can affect demand
• Informal care may be a complementary good

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Aims

• To examine trends in the use of informal and
  formal care provision at home before and after
  introduction of FPC
• To assess the influence of socio-demographic
  factors and economic status on care decisions

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Methods

• Scottish Household Survey 2001-4
• Continuous cross-sectional survey of a sample of
  general population in private households
• Selection of households where both highest income
  householder and an additional adult were aged 65
  years or over
• N 15,040 households

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Results
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Results
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Results
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Results
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Results
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Summary

• Introduction of FPC did not lead to any
  significant changes in demand for informal or
  formal care
• Economic status is important in arriving at care
  decisions
• Strong association between income and informal
  care, with FPC weakening the relationship
• FPC associated with reduction in inequality in
  home care hours
• Further work required to help understand
  differential take-up of FPC amongst different
  income groups

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Issues raised by use of SHS

• Limited ability of SHS to allow us to understand
  why there is differential take-up
• SHS not designed to address policy questions in
  long-term care
• Question wording problematic in some parts
• But overall can contribute to policy debate, and
  lead to generation of new hypotheses