Labour says it will create a National Care Service if it wins the general election

The Labour party has said it will work towards creating a National Care Service if it wins the next general election, following a new report published by the Fabian Society.

The report, Support guaranteed: the roadmap to a National Care Service, is published following a request from UNISON and the shadow health secretary, Wes Streeting MP, for the Fabian Society to examine how to gradually build a new system of adult social care in England.

The authors of the report outline 48 key recommendations for the next government, and a suggested timeline to develop a National Care Service over the course of a decade.

Since the Labour party’s commitment to fixing social care more than a decade ago, no detailed work has taken place to flesh out what a National Care Service might look like or how it should be implemented.

Why is a National Care Service needed?

The authors of the report, Andrew Harrop and Ben Cooper, emphasise that the ideas set out in the report are that of the Fabien Society, and the recommendations set out are advice and not policy.

At a speech at Westminster, which launched the report, Andrew Harrop explained the thinking behind the report and why a National Care Service is needed.

“The backdrop of the project is an adult social care system on its knees. This winter’s hospital discharge crisis was only a symptom of much wider problems. Since 2010, spending on adult care has fallen hugely relative to levels of need, access to care has been unfairly rationed, and many people who need help aren’t getting vital support.

“Publicly funded provision is often patchy, impersonal and inadequate. Poor pay and conditions have helped trigger a staffing crisis in the sector, with 165,000 vacancies. Unpaid family carers are left to pick up the pieces and people receiving support are paying charges they often find punishing. But, extra spending will not be enough to address these problems on its own. Money must come with reform,” he said.

Harrop and Cooper then went on to outline the key recommendations of the report, which are grouped into five themes:

1. A fair workforce settlement: a sector wide fair pay agreement for care workers which solves recruitment and retention issues.
2. Building a service for everyone: support would be made available to anyone needing help regardless of their means. This would bring an end to the binary divide between those receiving local authority support and self-funders. There would also be a focus on providing help at an earlier stage, so that people are supported as their care needs develop. Carers and people with disabilities would be automatically referred to service, making it easier to access support.
3. Building a system with stronger rights and entitlements: the new service would be set out in a National Care Service constitution, coproduced with disabled people, older people and carers. The new system would give people greater control and choice over support they get, with everyone choosing where they want to live (i.e. independently or with high levels of support).
4. Adult social care turned into a comprehensive public service: The new system would end postcode lotteries in support and provision, and the National Care Service would offer comprehensive help under a shared brand, uniting government, councils and licensed care providers in a shared purpose. Care providers would be fairly paid but expected to operate as part of a public service with new standards in care quality, workforce investment and financial conduct
5. Services become more affordable over time: the Fabian Society recommends that the next government matches any funding reforms announced before the election. As the new service develops, other options should be considered, including making support free for people with lifelong disabilities.

“A shared national endeavour”

Harrop and Cooper say that the plans would take at least 10 years to realise, but note that with the political will from the next government, a National Care Service can be built just as the National Health Service was built 75 years ago.

“The National Care Service would amount to a shared national endeavour to give every individual the right support, in the right way, at the right place, at the right time, to live well and independently. It would be transformative to the lives of hundreds of thousands of disabled people, older people and carers,” Cooper said.

“Just as the past generation build a National Health Service for the 20^th century, we can build a National Care Service for the 21^st,” he concluded.