No, Labour is not ‘grasping the nettle’ – it’s kicking social care reform into the long grass

Roy Griffiths once described social care as ‘everybody’s distant cousin but nobody’s baby’. Disappointingly, 37 years on, that sentiment holds true, writes Andrew Grice

Wes Streeting, known in Labour Land for his karaoke, channelled his inner Frank Sinatra to declare “the best is yet to come” for adult social care. He could have added another line from Sinatra’s song: “You came along and everything started to hum.”

The health secretary has passed the parcel of making it hum to Louise Casey, the crossbench peer and Whitehall troubleshooter. She will chair an independent commission to propose the national care service in England Labour promised at last year’s election.

Although Casey is an excellent choice, that doesn’t disguise the most important line in Streeting’s announcement on Friday: she will not deliver her final report until 2028. It means this urgent issue might not be resolved until after the next election.

Recent history tells us that prime ministers with big majorities, like Margaret Thatcher and Tony Blair, tend to seek a new mandate after four rather than five years. Even if Keir Starmer holds on until 2029, there is no guarantee Casey’s proposals will have been implemented by then – or that the Treasury will find the money.

Before last year’s election, Starmer repeatedly promised to end to “sticking plaster solutions” and vowed to tackle the difficult long-term challenges previous governments had ducked. But as PM, he has now applied another plaster to the ailing care sector and again kicked reform into the long grass. This depressing timetable is worse than expected. Casey will issue an interim report next year but will not make recommendations on the crunch issue of how the care system should be funded until 2028.

Although Streeting promises to “finally grasp the nettle,” he is dropping it. There is no need to start with a blank page: the social care crisis has been well documented by three government commissions, three independent commissions, five white papers and 14 parliamentary inquiries in the last 30 years.

A national care service was first proposed by Andy Burnham as health secretary in 2009. Now it looks like Streeting is asking Casey to work out what Labour meant by it. In fact, Streeting has a draft plan up his sleeve: as shadow health secretary, he jointly commissioned a blueprint by the Labour-affiliated Fabian Society. What the estimated 2 million people with unmet care needs require is strong leadership and political will. With a massive majority, Labour has no excuses.

True, Streeting will deserve plaudits if he can build a political and public consensus on reforms which, like the NHS, would not be undone by a future government. But while the Conservatives and Liberal Democrats will join cross-party talks next month, taking the politics out of it as an election looms will not be easy. Labour and the Tories have a different view on how much of the extra billions the sector so obviously needs should be met by the state and individuals respectively. Labour is less inclined than the Tories to ensure people don’t have to sell their homes to pay for their care.

Streeting is promising new national standards to help people who use the system, their families and care providers to buy the latest and best “assistive technology.” That makes the national care service sound suspiciously like one in which most people pay for their own kit.

The review’s timescale should be speeded up. In the meantime, a creaking system will limp on, piling more pressure on the NHS – which has 13,000 hospital beds filled by people who do not need to be there, while there are 131,000 vacancies in the care sector.

Many providers relying on local authority and NHS fee rates are on the brink; they cannot wait until 2028 – or even 2026. The chair of one told me: “We won’t make it through. So our overriding interest is short term.”

The government insists the Casey review will align with the government-wide spending review. But the commission will not start work until April and the spending plan is due to be finalised in June. So it’s hard to see how Casey will have much input – or whether the Treasury would want it.

Indeed, the delay reflects the darkening economic clouds hovering ominously over the government. Growth is disappointing and Rachel Reeves might have to choose between further tax rises, higher borrowing or a tighter public spending squeeze. She would probably opt for cuts, leaving even less money for social care. In which case, Casey’s report will join the others gathering dust on Whitehall shelves.

I suspect Labour will put what few eggs it has into the NHS basket. It will find the money to meet Starmer’s pledge to cut waiting lists. Labour won’t admit it, but it judges there are more votes in tackling the more visible, headline-grabbing problems in hospitals than the daily struggles behind closed doors of people in care homes and their own homes.

When Casey makes her final proposals, it will be exactly 40 years since Roy Griffiths delivered to Thatcher a report describing social care as “everybody’s distant cousin but nobody’s baby.”

What’s changed? Nothing.