Labour Urged to Tackle Social Care as Fabian Society Pushes National Care Service

If a new Labour leader wants to demonstrate a commitment to confronting Britain’s political challenges, few issues offer a better starting point than the strained social care system, according to a new collection of essays from the Fabian Society.

The essays, to be published this week, urge the government — regardless of who leads it — to move forward with creating a “national care service” more closely aligned with the National Health Service and ensure it is properly funded.

Nine years ago Monday, former Prime Minister Theresa May launched the Conservatives’ general election manifesto in a cavernous former mill in Halifax, with a plan to fund care costs at its center, aside from what critics called philosophical blather.

The Conservatives promised that no one would have to sell their home during their lifetime to pay for care, with costs deferred until after death; the first £100,000 of a patient’s assets would be protected, but beyond that they would be liable.

Before the day ended, Labour labeled the plan a “dementia tax,” arguing it could result in part of a patient’s home value being used to fund care after death.

The policy — and May’s clunky retreat — was widely credited as a factor in the Conservatives’ worse-than-expected 2017 election performance, ultimately costing May her premiership.

Seven years earlier, a plan by then-Labour Health Secretary Andy Burnham to levy a charge on estates to pay for universal social care was called a “death tax” by the Tories, and the policy died when Gordon Brown was swept from power in the 2010 general election.

It is easy to see why politicians have since avoided the issue: the trade-offs are difficult, and voters do not want to hear they must pay for a system they may never need.

Boris Johnson did announce a “health and social care levy” on national insurance to cap families’ care costs at a maximum of £86,000, but Liz Truss, with her aversion to tax increases, scrapped it. When Labour came to power two years later, Chancellor Rachel Reeves increased the social care budget but indefinitely shelved the idea of a cap on fees as too expensive.

Labour has not been idle: radical plans for a statutory negotiating body for care workers’ pay are progressing, with more details expected next month about participants.

But the broader question of how the nation collectively addresses the challenges of caring for an ageing society has been ducked.

That leaves families still selling their homes to fund care and worrying about how long the proceeds will last as they witness a relative’s heartbreaking decline, while the cash-strapped care sector struggles to meet growing demand.

The sorry history of politicians failing to grasp the issue partly reflects the fiscal constraints they increasingly face.

But it also marks a kind of learned helplessness — an unwillingness to make an argument, a trait identified as Keir Starmer’s worst failing in Jess Phillips’ resignation letter last week, according to the article.

Almost two years on from the 2024 general election, even the Fabians, wedded to gradualism, are warning the government not to waste more time.

Ben Cooper, co-author of the Fabian collection, warns Labour against waiting for the cross-party consensus it claims to seek as part of a social care review by Louise Casey.

“While cross-party consensus is important, building the foundations of the national care service cannot wait,” Cooper said. “The second half of this parliament must be about delivering affordable, high quality and personalised care with better conditions for the workforce. Otherwise, voters will remain frustrated with the slow pace of change – and unwilling to trust the government with another opportunity to fix social care.”

Labour MP Anna Dixon agreed in her contribution: “The goal of the Casey Commission was to build a strong cross-party consensus around a long-term vision for care. But, ever since the review began, concerns have grown over the pace and urgency of change.”

Burnham, if he replaces Starmer, or Angela Rayner, would be acutely aware of the need to fund any uplift in care spending. The fear stalking bond markets that a Burnham or Rayner premiership would mean a wild splurge without tax increases is wide of the mark.

Burnham has recently discussed replacing inheritance tax with a progressive “care levy” to fund a national care service.

That would align with an idea floated by former Transport Secretary Louise Haigh in the journal Renewal last week: social care funding should be centralized instead of falling heavily on local authorities, which are then punished by voters for cutting other community services.

Mathew Lawrence of the thinktank Common Wealth, associated with the Burnham-adjacent group Mainstream, has called for more public sector involvement in the sector, arguing that in today’s economy “care is degraded by financial extraction at the point of delivery.”

Casey’s final verdict is not due until 2028. Yet, as Cooper at the Fabian Society said, giving a clear direction of travel now would “show what Labour stands for.”

It will be unforgivable by the time of the next general election, as May robotically put it back in 2017, if “nothing has changed.”