FIGURES released by NHS England this week show the country has one of the highest per capita incidences of dementia anywhere in the world. Dr Jeremy Isaacs, national clinical director, reported: “487,432 people are living with the condition. The number in social care with a confirmed diagnosis is at a record level.”

Although no similar study has been undertaken here, Scotland’s rate is likely to be just as high.

People are living longer. Moreover, the “baby boom” generation of the 1950s and 1960s is reaching retirement age and hundreds of thousands more will require elderly care. Thus, the largest cohort of the population is about to put greater demand on a system already regarded as “not fit for purpose”.

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Consider to the verdict of the chair of the Covid-19 Inquiry, Baroness Hallett, on the resilience and preparedness of UK agencies to cope with the pandemic.

She concluded that tens of thousands more people died than should have done because of the failure of our health agencies and governments. Victims perished in heartbreaking circumstances, she found, which further exposed the inadequacies of social care provision in Britain today.

Scotland therefore faces a stark choice. Either we watch tens of thousands more suffer the indignities of an underfunded, largely private, chronically understaffed service, or we finally bite the bullet and overhaul the system from top to bottom.

Labour promised to abandon the failed policies of the past 14 years (30 years in the case of social care) on July 4. But if Keir Starmer does not address this crisis head on, his government will reap the political consequences.

That prospect was not lost on Chancellor Rachel Reeves or Health and Social Care Secretary Wes Streeting on the BBC’s Sunday show last weekend when they both accepted that “unless we deliver sustainable solutions” to profound problems such as Britain’s failing social care provision, “populists of the extreme right and extreme left will outmanoeuvre us”.

Labour had several opportunities to address this issue under Tony Blair and Gordon Brown between 1997 and 2010 and didn’t take them. Further inaction now will be unforgivable.

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“The country is facing an unprecedented crisis in social care”, insisted the British Medical Association in a report in June 2022. “Government funding has been cut by 55% since 2010-11. A further £7.9 billion a year is needed merely to meet current demand and pay care staff the national living wage.”

The Scottish Socialist Party does not believe the current situation can hold. We carried out valuable work during the pandemic both in highlighting the extent of the problem and in demanding the creation of a national care service akin to the NHS. For instance, we commissioned a Panelbase poll, which revealed 69% of the population supported a National Care Service “free at the point of need, paid for out of general taxation, publicly owned and run, with provision fit for the 21st century”. Within that, the proportion of women over 55 – who so often are caregivers – supporting the proposal was 78%.

What would be the cost of reconstructing such a service along these lines? It would certainly not be cheap as the problem has been allowed to worsen over three decades.

Estimates vary between £5bn-£6bn for the cost of this new service in Scotland alone. If it is to be delivered properly, staffing levels and pay will need to increase substantially, as there are 500,000 vacancies in the sector today across Britain.

Taxpayers pay for most of the care provided via local authority budgets. At the same time, charges for private care in Edinburgh and North Berwick for example can reach £150,000 per annum. That means 95% of the population are excluded from such facilities. Means testing is the norm. The present model simply doesn’t work. It has the wrong emphasis. Private care homes are extremely expensive for residents and extremely lucrative for their owners.

Britain’s largest private provider, HC-One, with more than 200 facilities, is ultimately owned by a parent company registered in the Cayman Islands. Is this really the business model we want to leave future generations?

The present system is unpopular, unfair and unsustainable as anyone can see. A progressive tax increase, ring-fenced to pay for social care, would enjoy greater public support and match the NHS’s funding model.

Scotland needs to put its best foot forward on this issue just as it did when delivering free personal care and abolishing NHS prescription charges. Those reforms, together unmatched elsewhere on these isles, met the challenges posed head on and symbolised the enlightened vision we Scots had for life here in the 21st century.

We need to match that ambition today and provide the quality social care our senior citizens deserve after a lifetime of toil. The question is, are today’s MSPs up to the challenge?

Colin Fox is national co-spokesperson for the Scottish Socialist Party.