We have now had a National Health Service for 70 years, but the care sector remains fragmented, largely privatised, of very variable quality, and with clear evidence of poor value for money. Scotland should state a commitment to creating a National Care Service wholly in public ownership and should set a timetable for achieving it. The first step should be to create a national childcare service, completed by the end of the 2016 to 2021 parliamentary term.
If we do a simple international comparison we see just how inefficient the fragmented, for-profit childcare system we pay for is. Sweden spends 1.1 per cent of GDP on childcare (less than Scotland) and delivers universally excellent state-run nurseries from the end of parental leave to the start of school, with the average child:staff ratio being 5.3 children to every worker. This is the broad model that Scotland should follow. A mechanism for creating a national childcare service and making substantial investment in childcare facilities has been outlined above. There are many models for creating that infrastructure which can be explored. For example, given the likely long-term decline in retail provision on high streets, vacant retail units might be used to create bright, attractive childcare centres right in the heart of our towns.