From hopes to launch a "big" public consultation on social care funding and a faster Commission timeline - here's everything we learned from Baroness Louise Casey's health select committee appearance.
Baroness Louise Casey’s recent appearance at the Health and Social Care Committee’s one-off look at her Independent Commission on Social Care showed she is keen to accelerate her review timelines, indicating that reform could move faster than expected if, as reported, the expected next PM, Andy Burnham, lives up to his claims to want to prioritise fixing social care.
She said she hopes to launch a “big and deliberative” public consultation this month to help the commission reach conclusions on the “appetite for renegotiation of the public contract” and who should pay for care.
She added her work, which is expected to lay the foundations of a National Care Service - can and should move faster to rescue a fragmented system under sustained pressure, poorly understood by the public, and heavily reliant on private provision, but will have to happen largely within existing funding, emphasising efficiency, simplification and structural change rather than new investment.
Here’s everything care home leaders need to know from the session:
National Care Service reform could speed up
Baroness Casey confirmed that the Commission is working to accelerate timelines where possible, with initial recommendations expected this year rather than waiting until the 2028 deadline.
“If we can bring the overall piece of work in earlier, we should,” she said.
She also indicated that early outputs would include proposals, adding:
“We intend to publish a report this year outlining what changes we think could be made.”
Baroness Casey said she had been speaking to Mr Burnham
Consultation on the new ‘social contract’ on care funding is imminent
Baroness Casey said that she hoped that “ we will commence” a “process” to meet the “ need for a broader national dialogue on who pays for care and public “appetite” for a “renegotiation of the social contract,” this month “in quite a big and deliberative fashion, which will help us to guide the next phase of what the reform looks like.”
And she stressed the importance of understanding public expectations:
“What do we expect from families… what is the appetite of the public to pay differently?”
She added that the consultation will be key to helping find “solutions that can gain cross-party consensus”.
Reform expected within existing resources
However, Baroness Casey challenged the assumption that reform requires new money, instead pointing to inefficiencies within the system.
“We ought to be… looking at what could be done within existing resources,” she said.
“My frustrations are probably already apparent to you, but they are where we can do better within the existing resources. I think there are things that can be done within the existing resources,” she added.
System fragmentation remains entrenched
The gap between health and social care, and between the national and local systems, is deeply entrenched. Asked directly whether organisations are working together effectively, Casey responded bluntly:
“God, no.”
She added that the system has gone too far in separating care from healthcare:
“The idea that we divide more what is care and what is healthcare is a road that we have gone down too far already. We need to pull it back,” she said.
“Being a public servant, I am on record over the years as saying that coterminosity of geographical locations would make life a lot easier for those of us running public services, and it would make collaboration easier,” she added.
Public understanding of social care remains poor
Baroness Casey said a key problem with adult social care is a lack of transparency around entitlement and funding for social care, and committed to defining a national health and social care service and people’s entitlements in her phase one recommendations this year.
“There is not a very clear way that we tell the public what it is, when it will happen and how it will happen,” she said.
“We keep imposing on the public—we are still doing it now—a need to understand our system. We need to understand them and what is happening in their lives,” she added.
She also highlighted the disconnect between reality and public awareness
“We keep imposing on the public—we are still doing it now—a need to understand our system. We need to understand them and what is happening in their lives,” she added.
“Some days I think to myself that we would be better off saying to the public, certainly in England, 'You will not get any financial support until you are down to £23,500” at which point it will kick in. We do not even tell them that because we are a bit guilty about it. There is no very clear way that we tell the public what it is, when it will happen and how it will happen.”
Asked if she would define it, she said, “Yes, we will do it this year.”
Delivery relies on families and the private sector
Baroness Casey said the role of the private sector, families and carers in social care delivery is poorly understood.
“Most of the time, we think that that is [provided by] local government. Actually, it is not just local government. It is individuals, families and carers. It is a massive amount of the private sector,” she said
And she added that “the whole landscape of what people call social care is often provided by the lowest-paid and the most uncertain level of delivery that I have ever come across in my career in terms of delivering a public service in a rather complicated way.
System complexity is driving inefficiency
Baroness Casey said the current care journey was described as overly complex and difficult to navigate.
She said that “people are literally applying for funding to employ navigators” to help them find their way through the system, as it is “so blinking complicated.”
