Nothing less than a radical redesign of social care will bring the changes we need
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4 min read
Social care enables people of all ages with disability to live fulfilling lives and can be transformative. And yet some 3.5 million people in this country aren’t getting the care and support they need – which means they can’t participate in education, work, family life, leisure and community.
The demand for care and support goes up each year. More children with complex needs are surviving into adulthood. More people are living longer with disability. And the baby boomers are ageing.
This is why, as politicians and as a society, we need to put this issue at the top of the agenda.
Baroness Casey has been appointed by the Prime Minister to lead an independent commission to make recommendations for how adult social care in England needs to change. She has started her work this month and will report in two phases; the first in 2026 and the second in 2028.
Before getting elected, I was chair of the Archbishops’ Commission on Reimagining Care. We set out a radical set of proposals for the future of adult social care in England, developed by listening to those with direct experience. Here I set out a few of our ideas.
Firstly, shift public attitudes and understanding of care and support. Care is often seen as help with the practicalities of daily living – eating, washing and getting dressed – but at its best it is much more than that, attending to our social, emotional and spiritual needs. It is also seen as something that other ‘vulnerable’ people need, when the reality is that at some time in our lives we are likely to either give or receive care; it is a universal need.
And there remains a common misconception that care is free on the NHS, so it is only when people themselves or their loved ones need care that the reality bites: publicly-funded adult social care is one of the meanest means-tested supports. The value of your home is at risk. Seeing the value of care and support and seeing it as something that affects us all, is the precursor to building public support for a more generous and collectively funded entitlement. Too many attempts to reform social care have floundered on the failure to take the public along.
Second, we must rebalance responsibilities between the state, citizen, community and families. As local authority budgets have been further squeezed by cuts over the past decade, only those with the highest levels of need, often in crisis, get any support. Otherwise, you have to pay for yourself or go without. When care isn’t there, family and unpaid carers must fill the gap. There are millions of unpaid carers who are largely invisible and frequently exhausted.
As part of building the foundations of a National Care Service, there must be greater recognition and investment in the voluntary, community and faith sector that provides community-based support. There needs to be a new deal with carers, with stronger rights to breaks, and the practical, financial and emotional support they need. A stronger role for the state and a framework of rights and entitlements, so everyone knows what they can expect and what their responsibilities are.
Third, radical redesign of the system. There are lots of examples of great care in this country and examples of how other countries provide care and support. We don’t need to wait for new laws or more funding to transform the system.
An effective social care system could serve as a springboard for achieving many of the government’s wider goals
The key for the future will be putting people in control, through greater access to direct payments and personal budgets, harnessing assistive technology and testing out AI and robotics, rewarding the workforce through a Fair Pay Agreement, redesigning roles to create more fulfilling career opportunities, and providing diverse housing options that are accessible, adaptable and affordable.
The cost of inaction is too great. An effective social care system could serve as a springboard for achieving many of the government’s wider goals. It would ease the financial pressures on local authority budgets, provide better pay and career options to care workers in currently one of the lowest-paid jobs in the economy, reduce staff turnover, and minimise the burden on our welfare system.
It would also significantly alleviate the strain on NHS services and unlock the sector’s potential to drive growth and regional rebalancing. This improvement has the potential to increase tax revenues from unpaid carers and individuals receiving care, who currently face limitations on their ability to work.
The Casey Commission is a once-in-a-generation opportunity to fundamentally reshape how millions of us will experience care and support for decades to come. Let’s seize this moment, work together across political parties, and put the voices of those who draw on care and support, and their carers, at the heart of these reforms.
Anna Dixon is the Labour MP for Shipley and chair of the APPG for Carers
