From transformative vision to cautious reform, the SNP’s once-bold care agenda faces a final, scaled-back vote
A Shadow of the Original Promise
When Nicola Sturgeon first unveiled plans for a National Care Service (NCS) in 2021, it was hailed as the most ambitious policy of the devolution era. Inspired by the founding of the NHS, it aimed to centralise social care under a single national body, improving standards, access, and accountability across Scotland.
Fast forward to 2025, and that vision lies in political ruins. Today, MSPs will vote on the Care Reform (Scotland) Bill—a diluted version of the original legislation, now stripped of its most transformative elements after sustained political opposition and mounting concern over centralisation.
While the “National Care Service” name has been quietly dropped, remnants of the original bill live on in what ministers now describe as “targeted but important reforms” to social care.
What the Bill Still Includes
Though the overarching national agency plan has been abandoned, several meaningful changes remain in the revised legislation. These include:
1. Legal Right to Breaks for Unpaid Carers
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Scotland has an estimated 700,000 unpaid carers, many of whom juggle full-time roles with demanding caregiving duties.
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Under the bill, local authorities will have a legal obligation to assess whether carers are getting sufficient rest.
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Where they are not, councils must provide support, such as funding for short respite breaks.
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The long-term cost of this policy is projected to reach £196–£315 million by 2035/36—still modest compared to the £13.9 billion worth of unpaid care provided annually.
2. Improved Data Sharing in Health and Social Care
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New provisions will streamline the way information is shared between health and care services, aiming to reduce duplication and prevent people from having to repeat their stories at every stage of care.
3. Reforms to Procurement Rules
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The bill introduces changes to how services are commissioned, aiming to reduce inefficiencies and prioritise quality and consistency across regions.
4. Tougher Enforcement on Failing Providers
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Watchdogs will receive strengthened enforcement powers to tackle substandard care homes or providers that fail to meet minimum standards.
Anne’s Law: The Emotional Heart of the Bill
The most symbolic and emotionally charged part of the bill is Anne’s Law, which would enshrine the right of care home residents to receive visits from loved ones—even during health emergencies.
The proposal was born out of the tragic story of Anne Duke, a 63-year-old woman with early-onset dementia who died in 2021 after being isolated from her family during the pandemic.
Her daughter, Natasha Hamilton, launched a petition that gathered nearly 100,000 signatures. Today, her campaign stands as a key reason this right is poised to become law.
“She really needed her family and I still can’t believe the separation that happened,” Hamilton said. “But I’m proud I did this—for my mum and everyone else who had to endure the torture of isolation.”
Anne’s Law would give residents the right to name a designated visitor who must be allowed into the care home, even during restrictive measures. The right has existed in practice since 2022 through national standards, but this bill will give it statutory weight.
The Collapse of the National Care Service Plan
The NCS proposal was originally intended to transfer control of social care from local councils to a new national agency, mirroring how the NHS operates.
But the plan quickly ran into deep resistance:
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COSLA, Scotland’s council body, withdrew its support, arguing the proposal stripped power from local authorities.
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Trade unions and care providers raised concerns about cost, bureaucracy, and staff uncertainty.
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Multiple health boards and third-sector organisations warned that centralisation could destabilise local services.
After spending more than £30 million preparing the groundwork, the Scottish Government finally pulled the plug on the plan in January 2025.
Social Care Minister Maree Todd admitted the government no longer had the parliamentary support to push through the original bill, but insisted the SNP remained “committed to the ambitions” of a more consistent and equitable care system.
What remains today is a non-statutory advisory board to help guide care improvements—far from the centralised agency once imagined.
Reaction and What Happens Next
The slimmed-down bill is expected to pass with broad, if unenthusiastic, cross-party support. While there is general agreement on measures like Anne’s Law and respite rights for carers, critics say the legislation falls far short of addressing Scotland’s deep-rooted care system challenges.
Still, campaigners like Natasha Hamilton believe even incremental change matters. “I didn’t expect to start a movement,” she said. “But if it means others are never shut out like we were, then something good has come from it.”
The vote in Holyrood is expected to take place later today. If passed, the reforms could come into effect as early as 2026, pending local implementation plans.
