For more than thirty years the UK government has recognised that adult social care is both in difficulty and becoming increasingly important to large numbers of people. A combination of improvements in neo-natal care, which means more babies able to survive with a disability, and the inexorable demographic effect of people living longer, has meant increases in the numbers of working age adults needing care and those needing either domiciliary or residential care in their later years. 

These changes are immutable. Yet successive governments have shied away from taking decisive action to address them. Commissions have come and gone. One of them, the Dilnot Report under the Cameron coalition government, found its recommendations turned into the 2014 Care Act. But even then, one of the key findings, about how to protect savings and wealth for those needing care, was never implemented after the Treasury found it too expensive. 

So today we face the latest elegant excuse for delay, the Casey Commission. This is designed to take most of the current Parliament to produce its final recommendations. There are hopes that an interim report next year will suggest some short-term improvements which can be implanted within the current spending framework, but no one is expecting radical action in the near future. It was perhaps significant that the phrase “social care” did not occur once in the Chancellor’s recent Budget Speech. 

Why not? Asking the question is not a particular criticism of the current government, as administrations of all hues have the chance to address it seriously. There are four main reasons. 

First, the skills and hard work of those in the sector keeps the system going whatever the pressures. For many years no government has had to face a full-on media storm with headlines about a crisis in care. (One purpose of the Social Care Foundation is to urge the government to act before we reach this kind of crisis.) Instead there is a gradual decline in the quality of care in some areas, which will be exacerbated as finding new care workers becomes more difficult with increasing restrictions on immigration. This decline is enough to cause problems but not enough to provoke the sort of crisis that would demand immediate action. 

Secondly, however you cut the cake people are going to have to pay more to stabilise the care system. Whether it comes through taxation or individual payments we are all going to have to find extra money. Politicians are reluctant to confront an already unhappy electorate with this. This is one reason why I wince at talk of a National Care Service. The name alone suggests a service free at the point of use, which is never going to happen for the majority of care receivers, and we should not promote this illusion. 

The third reason is that those who receive care, and their nearest and dearest, and not about to go out on the streets and demand attention. I agree this is a terrible reason for their voice not to be higher in the political clamour, but it is sadly the case. 

The fourth is the absence of a single voice speaking on behalf of the care sector. There are many good people and strong organisations within the sector but without the clarity of a recognised representative making the case for the whole sector, along the lines of the CBI or the FSB (Federation of Small Businesses), there is an important gap.

Some of the necessary changes do need government action, but others, perhaps particularly the last one, do not. These are important for issues for the care sector to consider in 2026. 

By Damian Green, Chair, Social Care Foundation 

Damian Green will speak at the Care & Dementia Expo, to be held at the NEC on March 25-26.