Wes Streeting, The Guardian.
Our National Care Service will meet the urgent needs of our generation – just as the NHS did when it was created in 1948.
Three sentences in Labour’s 1945 manifesto contained a simple but historic promise: “The best health services should be available free for all. Money must no longer be the passport to the best treatment. In the new National Health Service there should be health centres where the people may get the best that modern science can offer, more and better hospitals, and proper conditions for our doctors and nurses.”
In the three years following Labour’s election victory, Nye Bevan fought opposition from the Conservatives, the British Medical Association and from some within his own cabinet to found the NHS. For 76 years, it has provided healthcare free at the point of need, surviving Labour and Conservative governments alike.
The idea was inspired by the Beveridge report, which identified five giants of idleness, ignorance, disease, squalor and want. Were the report being written today, William Beveridge would surely add a sixth: care needs. The social care system in this country is failing. Despite an ageing population, access to publicly funded adult social care has fallen, and the number of older people receiving state-funded care in England has dropped by 10% since 2014–15.
This is piling enormous pressure on the NHS. In November, more than 12,400 hospital patients a day were well enough to leave but had to stay overnight. One in three of these delays were due to care not being available in the community. There is no solution to the crisis in the NHS that doesn’t include a solution for social care.
By 2050, there will be 4 million more people aged 65+ in England than today. If we do nothing, real social care costs are expected to nearly double by 2038, compared with 2018 numbers. Many more people will be left without the care they need, the burdens will fall on the health service and our NHS will be overwhelmed. We can’t keep paying a heavier and heavier price for failure. Our NHS can’t afford to keep bearing a heavier burden. We can’t afford not to act.
Labour took a lot of flak in the general election campaign for not spelling out in more detail our plans for a National Care Service. I was honest about the reason why – general election campaigns are where plans for social care go to die. In 2009, when Andy Burnham established cross-party talks on social care, David Cameron pulled out and leaked details of the talks to attack Labour in the election campaign. In 2017, it was Labour that torpedoed Theresa May’s proposals. Then Rishi Sunak defunded Boris Johnson’s cap on care costs.
Over the past 15 years, there have been plenty of good ideas for how to address this crisis, but a lack of good politics. This government is committed to doing politics differently. Today, I am announcing an independent commission on building a National Care Service. The commission will publish its interim report next year and conclude towards the end of the parliament. Previous reviews on different aspects of social care, including Andrew Dilnot’s work on care costs, will be fed into the commission. It’s fair to say that it won’t be starting from scratch.
I’m delighted that Louise Casey has agreed to chair the commission. She has served under Labour, Conservative and coalition governments. She is a trusted, independent figure, who will involve all political parties and the public in the process of building a national consensus around what our country wants from social care, and how a National Care Service can best meet our needs.
She and I have already been working together on immediate action we can take today to improve social care. Alongside the commission, the government is also announcing an in-year uplift to disabled facilities grant funding for 2024-25. This will provide about 7,800 extra home adaptations to help disabled people live safely and independently in their own homes.
We are publishing new national standards to help the people who use care, together with their families and care providers, to buy the latest, most effective assistive technology. We are better integrating NHS and social care, with the NHS and local government sharing funding and working together to keep people out of hospital, which is better for patients and less expensive for taxpayers. We are providing guidance and support to help care workers to carry out routine monitoring while they’re looking after people, including blood pressure checks. We’re also joining up care and medical records, so that NHS and care staff have the full picture they need to provide the best possible care to patients.
For care workers, this will mean taking on new skills and more senior roles, as part of our steps to professionalise the workforce. As Keir Starmer said at the Labour party conference, his sister ought to command the same respect for her role as a care worker as he does for his role as prime minister.
Alongside this action plan, we have legislated for fair pay agreements to help fill the 131,000 vacancies in social care. We’ve also provided a £2,300 rise in carer’s allowance for family carers, and have allocated extra funding to social care in the budget. We’ve done a lot in six months but there’s a hell of a lot more to do, and the best is yet to come.
It will take time, but Casey’s work will finally grasp this nettle and set our country on the path to building a National Care Service that meets the urgent needs of our generation, guarantees quality care to all who need it, and lasts long into the future.
