Casey Commission: Sector leaders support MPs demand for greater social care reforms
Parliament’s cross-party Health and Social Care Committee has published a new report that explores the problems of England’s social care sector and warns that too much emphasis is put on the cost of change and not enough consideration is given to the human and financial cost of inaction.
MPs state that the UK Government needs to measure the true cost of inaction on social care to be able to present a robust financial case for reforms of the system to avoid continued frustration and concerns over social care funding. They argue that that the system is “doomed to failure” and will leave everyone “continuing to suffer” under the current unsustainable system.
It comes as the Casey Commission, an independent commission on adult social care that will lay the groundwork for a new national care service in England, formally begins. The commission is headed by crossbench peer and renowned government troubleshooter Baroness (Louise) Casey.
The Committee’s report, Adult Social Care Reform: the cost of inaction was published on Monday 5th May. It cites the lack of official data held by the Government relating to social care and says it believes that the Government does not know what the potential monetary benefits of a reformed system might be and cannot assess which social care reform interventions would result in the highest returns.
MPs fear that reforms will continue to be frustrated by concerns about the expense, unless there is a robust understanding at the centre of government of the cost of doing nothing. They warn that ignoring the cost of the status quo would leave us all continuing to pay “a high price for a failing system”.
MPs want the Government to commission research to fully quantify the cost of continued inaction and call on it to publish data including an annual assessment of the level of unmet care needs for adults, as well as an annually published official estimate detailing how much delayed discharges are costing the NHS.
The Committee’s report sets out how the existing adult social care (ASC) system is not meeting the needs of the population and “the Government and taxpayers are currently paying £32 billion a year for a broken system”.
MPs highlight that this is despite the enormous contribution by unpaid carers, who provide care worth £184 billion a year, “equivalent to a second NHS”, and who are bearing the highest cost from failures to reform adult social care.
The broken system is also straining local authorities’ budgets with an increasingly high proportion of spending on adult social care, which MPs state is crowding out spending on other services, such as fixing potholes, keeping libraries open and providing youth services.
The report expresses the Committee’s concern that there is a growing disconnect between where council tax revenue is being spent and what services residents expect to see delivered from their council tax – undermining trust in local democracy.
MPs also point to the impact of the status quo on the NHS and say that social care reform is an integral part of NHS reforms and cannot be a separate process. The Committee urges Baroness Casey, in her first report, to set out the immediate steps that the Government needs to take to ensure the adult social care sector can play its vital part in the three shifts for NHS reform.
The Committee’s report highlights the social care sector’s potential to drive economic growth, contribute to regional rebalancing, and increase employment, but says that the economy is currently missing out on this potential.
The report finds that every £1 invested in the sector would generate a £1.75 return to the wider economy and that an extra £1 billion spent on social care would create 50,000 jobs across the country.
Stressing the need for reforms, MPs call on the Government to produce a growth strategy for the adult social sector care sector, and say “the Government needs to fundamentally change how it views the social care sector, seeing it as an enabler and talking about it in those terms in the public debate.”
The Chair of the Health and Social Care Committee, Layla Moran MP, said: “Alongside the strong economic potential of the sector, it is clear that the Government has to reform social care, if it is serious about making the NHS fit for the future. While social care is a vital public service in and of itself and should not be valued only for how it supports the NHS, the two systems are inextricably intertwined, and one cannot be reformed without the other.
“In order to achieve this, the Government needs solid data. Our inquiry has found that there is currently a severe lack of granular, numerical data on many aspects of the social care system. The Department of Health and Social Care needs to commission research on the costs that the NHS and the wider economy are bearing as a result of failures in adult social care.
“Unless the Government measures the true cost of inaction and can make a convincing case to the Treasury, the recommended reforms that come out of the Casey Commission will be doomed to fail.”
Leaders in the social care sector, shared their response to the key findings of the report.
Kathryn Smith OBE, Chief Executive of the Social Care Institute for Excellence (SCIE), said: “Whilst the inquiry could not estimate the full cost that we, as a country, are paying for inaction, the case for change is clear.
“This report provides further sobering confirmation of the deep and systemic challenges facing the social care sector. This evidence is clear: inaction is not an option for the people who rely on care and support, unpaid carers, our NHS and the economy.
“When properly resourced and delivered with compassion and expertise, social care is not a burden on the economy—it is a vital investment in people’s lives and communities. High-quality social care transforms lives, enabling people to live with greater independence, dignity and purpose. Social care done well reduces pressure on the NHS, strengthens community ties, and helps people thrive.
“The social care system may be ‘broken’, but it is not beyond repair. The Casey Commission gives us a real opportunity to get off the merry-go-round of reports and commissions, but nothing by way of lasting change. The Casey Commission has the opportunity to transform the social care sector into a robust, equitable, and efficient system.”
Amy Little, Head of Advocacy at disability charity Leonard Cheshire said: “This timely and essential report illustrates that as a nation we can no longer afford to neglect adult social care and the needs of disabled and older people.
“Social care is sometimes portrayed as a cost burden and a problem to be fixed. Now there’s a once-in-a-generation opportunity to reform adult social care through developments like a National Care Service informed by the Casey Commission. Social care must be seen as a core part of our nation’s infrastructure and an investment in Britain’s economic growth. Most importantly, it is an investment in the lives of disabled and older people, their families, and our communities.
“Decades of inaction on social care has left a sector burdened by huge challenges and disabled people struggling to get on with their daily lives. But this can change. Disabled people across the UK don’t have to miss out on vital care they need – help with getting up, seeing people close to them, or getting to work.?
“We echo the Committee’s call on the Government to fundamentally change how it views social care, as well as many of its recommendations. Care must be recognised as an enabler, supporting people to live independent lives, and a key cog in the wheel of economic growth. The first test of the Government’s resolve to take action and deliver change is its forthcoming Spending Review.”
Professor Martin Green OBE, Chief Executive of Care England, said: “We welcome the establishment of this Commission and Baroness Casey’s leadership. It is a significant moment to put adult social care where it belongs — at the heart of national policy. But for too long, adult social care has been overlooked, underfunded, and misunderstood. This Commission must not become another exercise in managing decline or pushing reform into the political long grass and we must remember the adult social care sector is wide and diverse beyond older person and working age services.”
The Terms of Reference rightly speak to long-term transformation, but Care England is urging the Commission to set out clear interim steps to support the sector in the here and now — particularly on workforce pressures, provider sustainability, and the funding mechanisms that underpin access to care.
“Hundreds of thousands of people rely on care services every day — many of whom, frankly, cannot wait years for change,” continued Professor Green. “Hundreds and thousands of those drawing on care today, especially older people, may not live to see the benefits of a transformed system unless the Commission brings forward immediate improvements alongside its longer-term vision. We need bold interim steps, not just plans for a decade from now.”
Dr Rhidian Hughes, Chief Executive of the Voluntary Organisations Disability Group (VODG) says: ‘We are pleased to see the Terms of Reference published for the Casey Commission and look forward to working with Baroness Casey and her team to ensure disabled people, families, carers and the third sector organisations working alongside them are at the heart of discussions.
“We welcome the commission’s dual focus on both the short and long-term needs of those accessing support and its unique position to bring together a broad spectrum of voices, experience and insight.
‘While the Commission offers an opportunity to look ahead, it cannot ignore the very significant challenges impacting people’s ability to access the support they need, how and when they choose. There is a great deal of innovation, partnership and outcomes-based activity underway, but it remains in pockets, and we need the commission to champion best practice as well as spotlight where change is needed most.”
