Getty ImagesWes Streeting has defended the timescale for reforming adult social care in England, with proposals on its long-term funding unlikely to be delivered before 2028 at the earliest.
The health and social care secretary is promising “to finally grasp the nettle on social care reform”, but said on Friday the process “would take time”.
The independent commission, chaired by Baroness Louise Casey, will begin work in April but is not due to publish its final report until 2028.
Sarah Woolnough, chief executive of health think-tank The King’s Fund, told BBC Radio 4’s Today programme the timescale “feels far too long” and urged the government to look at measures that could be implemented sooner.
Other councils and care providers have said the final 2028 report is too long to wait for the long-term reform of vital services already on their knees.
The commission comes alongside immediate government plans to get care workers to do more health checks, and a funding boost for services to help elderly and disabled people remain in their homes.
It will be split into two phases, the first of which will report by mid-2026 and identify critical issues and recommend medium-term improvements.
But phase two, which will look at how to organise care services and fund them for the future, will not report until 2028 – a year before when the next election must be held.
The government’s ultimate aim is “a new National Care Service, able to meet the needs of older and disabled people into the 21st Century”, said Streeting.
He rejected the suggestion the government is pushing social care reform into the long grass, saying it is “already acting” and had “done a lot in the first six months”.
Ms Woolnough told the Today programme the government should “get on and do a whole range of things that [it] can now” and then accelerate the timetable for further reform.
“Measures to help the workforce, measures to improve quality and so on, you don’t need a commission to enable you to do a whole load of stuff,” she added.
Social care means help for older or disabled people with day-to-day tasks such as washing, dressing, medication and eating.
Only those with the most complex health needs get social care provided free by the NHS, so most care is paid for by councils.
In England, only people with high needs and savings or assets of less than £23,250 are eligible for that help, leaving a growing number of people to fund themselves.
Some face paying hundreds of thousands of pounds for their care and may be forced to sell their own home as a result.
Streeting said he had invited opposition parties to take part in the commission “to build a cross-party consensus to ensure the National Care Service survives governments of different shades, just as our NHS has for the past 76 years”.
He told BBC Breakfast there was “genuine desire” from across the political spectrum “to work together”, calling it “a big moment for social care”.
When asked if proposed funding for the sector was enough, the health secretary said public services were “on their knees” and “there’s so much more that needs to be done”, but the process “would take time”.
Baroness Casey – who has led several high-profile reviews, including into homelessness, the Rotherham child exploitation scandal and the Metropolitan Police – said she was pleased “to lead this vital work”. The commission will report to the prime minister.
She is viewed in government as being straight-talking, with good cross-party links, and as someone who gets things done.
Even so, drawing up a plan for a National Care Service that meets the needs of an ageing population and is affordable is perhaps her biggest challenge yet.
There is agreement the care system has been in crisis for years, struggling with growing demand, under-funding and staff shortages.
The problem has been getting political agreement on how overdue reform will be funded.
In 2010, Labour plans to fund social care were labelled a “death tax” in that year’s election, and Conservative plans were called a “dementia tax” in the 2017 election.
There have also been numerous commissions, reviews and inquiries over the past 25 years that have failed to bring change.
The 2011 Dilnot Commission plan for a cap on individual care costs came closest, making it into legislation, but was not implemented.
It was finally scrapped by the new Labour government last summer because it said the last Conservative administration had not set aside the money to fund the reform.
However, providing enough support for people in their own homes, care homes and supported living remains a pressing issue.
The care systems in Scotland, Wales and Northern Ireland are slightly more generous, but all are facing the pressures of growing demand and squeezed finances.
The government had promised a National Care Service in its manifesto, although provided little detail.
Streeting told the Today programme that, for him, the service is “about national standards – consistent access to higher quality care for older and disabled people everywhere in the country”.
The independent commission will work with users of care services, their families, staff, politicians and the public to recommend how best to build a care service to meet current and future needs.
Melanie Williams, president of the Association of Directors of Adult Social Services, said the “timescales are too long”.
She believes many options on how to reform adult social care are already known and worries that “continuing to tread water until a commission concludes will be at the detriment of people’s health and well-being”.
The Conservatives welcomed the government’s commission but urged ministers to reach a quicker conclusion.
Edward Argar, the shadow health secretary, told the BBC’s World At One said Streeting should “be brave, be bold, be ambitious, speed up those discussions and try to get to a conclusion and a way forward before 2028”.
Liberal Democrat leader Sir Ed Davey said he was “bewildered” by the planned length of the commission and told broadcasters his party “had expected that it could be done and dusted within a year”.
About 835,000 people received publicly funded care in 2022, according to the King’s Fund. The charity Age UK estimates there are about two million people in England who have unmet care needs – and according to workforce organisation Skills for Care, while 1.59 million people work in adult social care in England, there are currently 131,000 vacancies.
Helen Walker, the head of Carers UK, which represents millions of unpaid people who provide care to family members, said families were “under intense pressure and providing more care than ever before”.
The government also confirmed an extra £86m would be spent before the end of the financial year in April to help thousands more elderly and disabled people to remain in their homes.
The money is on top of a similar sum announced in the Budget for the next financial year.
Overall, it should allow 7,800 disabled and elderly people to make vital improvements to their homes which should increase their independence and reduce hospitalisations, says the government.
Other changes include:
- better career pathways for care workers
- better use of technology and new national standards to support elderly people to live at home for longer
- up-skilling care workers to deliver basic checks such as blood pressure monitoring
- a new digital platform to share medical information between NHS and care staff.
