Did the Introduction of Free Personal Care in Scotland Result in a Reduction of Informal Care?

There are more than 5 million carers in the UK. These provide a vital low cost resource to support frail older people. Without their continued participation in caring activities, governments would face a steep increase in formal care costs. Therefore the issue of substitution between formal and informal care is a vital policy issue. This paper explores a recent “natural experiment” in care provision. In 2002, the Scottish Parliament agreed to provide personal care free of charge to all those in need of such care. This policy was not followed elsewhere in the UK. Social conditions and data resources are largely uniform throughout the UK; this permits a reasonably rigorous evaluation of the initial impact of the policy of free personal care on informal caring behaviour. Using a difference-in-difference methodology with the British Household Panel Survey, the authors show that informal caring in Scotland did not decrease relative to the rest of the UK after the substantial expansion in formal provision in Scotland. While the finding is in line with other international evidence, the paper argues that it may partly be explained by changes in the type of care that informal carers provide following the policy change.