Baroness Casey says governments were 'asleep at the wheel' on social care

Care grew without a plan, Casey says

Baroness Louise Casey, who leads the independent commission examining adult social care in England, said on Wednesday, 11 November, that successive governments had failed to keep watch over the sector. She told the Today programme on BBC Radio 4 that care for older people and adults with disabilities grew up in a haphazard way, lacking the deliberate design that shaped the NHS in 1948. In her view the NHS has since become a national hospital service centred on medical care, and she linked these weaknesses to the failings identified by the Covid inquiry report on social care.

“Successive governments have been asleep at the wheel. We've got our heads in the sand.”

Postcode lottery and self-funders

The commission's research found that people with the same condition can have very different experiences depending on their address, with differing assessment processes, waiting times and levels of support. Casey suggested this amounted to a postcode lottery. Because social care is means-tested, people who pay for their own care are charged on average 40% more than councils pay for the care they arrange. The market is dominated by private providers, and Casey described the Care Quality Commission, the regulator, as a 'spectator at the site of a car crash'.

Covid findings and an international comparison

The Covid inquiry published its report in October 2026, finding that care appeared to be an afterthought in the early stages of the pandemic, when the virus spread like 'wildfire'. Casey said the findings were 'so awful' and 'a national shame'. The commission's research also places England as an international outlier, with no clear system of stewardship for social care, unlike countries such as France and Germany. Final recommendations on services for older people and adults with disabilities are due in summer 2027.

Government response

Andy Burnham, who has become prime minister, said social care was one of his key priorities, although the commission was set up under the Starmer government. Following Mr Burnham's address, the Institute for Fiscal Studies said savings would not be enough. Casey told PA she regarded the announcement as a significant gain for the sector.

“I felt that was a very significant win for adult social care”