The probability that older people will need long-term nursing care is about one in five for men, one in three for women. But no one knows in advance just who will be stricken with Alzheimer's or dementia, nor the trade-in value of their home, if they own one. Here is a shining example of an insurable risk which the private finance market is incompetent to cover. It is a job for the state. Only public authority can compel universal contributions, pool risk and, way into the future, fairly distribute resources to ensure no one in need is left exposed.
Thanks to devolution, there is now within the United Kingdom more than one state to try such a policy. The UK, moreover, has a constituent state in which social democracy is strong and, perhaps, tolerance higher for the tax or enforced contributions that free long-term care would require. It is, of course, Scotland. Response to the announcement by first minister Henry McLeish of the Edinburgh coalition's plans on long-term care has been: how audacious! They are daring to implement Sutherland - the royal commission that two years ago proposed splitting nursing from the hotel aspects of care so that elderly people cared for at home or in "homes" would no longer pay for nursing, as they do if admitted to an NHS hospital. The recommendation has now been accepted by the Scottish executive, at least in principle - details, timing and costs yet to be supplied. By implication the extra spending - £110m a year - would be found by making savings elsewhere in Scotland's budget (not as hard as it sounds, given that social policy costs there are well above need as denominated on a UK-wide basis).
Fiscal harmonisers might be shocked, but has Scotland really been bold? It is not just that Mr McLeish had to cook up a formula on Thursday to head off a parliamentary revolt, leaving himself room to dodge and weave later. Coalition is a work in progress and give a little, take a little is no bad motto for government everywhere. It is rather that Labour ministers in Scotland seem so reluctant to teach Westminster - effectively, their fellow countryman Gordon Brown - that the point of devolution is the room it makes for deviation on tax and spend. Scottish Labour leaders keep looking over their shoulders at how London will react. Instead they should be exploring the elastic bounds of the new constitutional settlement. Scottish voters have to be told they can now have generous and universal social services but their tax rates will need to be higher or more progressive than in England.
Lord Lipsey, a dissenting member of Sutherland, predicts queues of cars at the border as the English middle class rush north with granny in the back to be left on the doorstep of Dundee social services. It is unlikely. Social dumping would not happen at all if Scotland seized the freedom it now enjoys to try a made-and-paid-in-Scotland remedy for this growing problem of social provision.