How to fix the social care crisis

Labour needs a “big bang” for the state

Today on Arguably, Dan Mead of ThinkLabour explains how to succeed where so many have failed and reform social care. This piece is paid but you can read it now by becoming a full subscriber or signing up for a seven-day free trial.

(Image: Berni0004/Shutterstock)

Labour’s battle of ideas has begun and adult social care reform is back at the top of the political agenda. Reports suggest that the issue could feature in the first 100 days of an Andy Burnham government.

Social care has long been hazardous territory for politicians of all parties. The last Labour government’s attempt to establish a National Care Service in 2010 was thwarted after the Conservatives denounced the plan as a “death tax”. Then in 2017, Theresa’s May proposal unravelled after the absence of a cap on costs saw it branded the “dementia tax”.

Ever since, our social care system has groaned under the weight of a rapidly ageing population. A report from the Kings Fund in 2025 detailed a litany of problems:

• Those receiving care find it hard to access, of variable quality, and face a one-in-seven chance of catastrophic costs greater than £100,000.

• Those providing care through the formal system are overworked and underpaid, and many relatives provide vast amounts of unpaid care to fill holes in the system.

• And this has wider impacts on society: under-provision of care and poor integration with the NHS means hospitals fill up as they are unable to discharge patients to the appropriate place for their needs.

The current Labour government’s approach has been to put social care in the too-difficult box, with an independent commission chaired by Louise Casey not due to conclude until 2028.

Yet this is an area where, to borrow a line from Keir Starmer, “incremental change won’t cut it”. To make the politics of social care reform work, transformation is the only way forward.

Where Margaret Thatcher’s government had a “big bang” for the City of London, Labour needs a “big bang” for the state. Counterintuitively, only by combining social care and another political taboo – local government reform – can Labour win the politics.