Social care is at breaking point, it cannot afford another three years of inaction - Mike Padgham

The government's approach to social care reform is emblematic of a decades-long pattern: endless promises with little delivery. We have been waiting for real change for more than 30 years. Successive governments have acknowledged the urgent need for reform, yet each time they have failed to take meaningful action. The gap between political rhetoric and reality continues to grow and the social care sector is now at breaking point.

The sector cannot afford another three years of inaction. Providers, workers and those who rely on care are facing the consequences every day. Care providers in the charitable and private sectors are struggling to stay afloat, social care workers are leaving in droves due to low pay and stressful working conditions and families are burdened with uncertainty.

Meanwhile, the pressure on the NHS continues to increase as people are unable to access the care they need at home or in the community, leading to greater demand for hospital services.

One of the key reforms we must urgently see is the establishment of a National Care Service. We strongly back the calls for such a service to be introduced as quickly as possible. It would ensure that care is standardised, properly funded, and treated with the same importance as the NHS.

The current fragmented approach to care provision simply isn’t working, and we need a national system that guarantees quality, equitable care for all. We do not want to wait any longer - this is something that must come into force without delay. Yes, we must address the full scope of reform, but implementing this national framework should be the first step. Let’s see what we can achieve in the short term and then build on that progress.

A notable aspect often overlooked is that investing in social care now will actually save the government money in the long run. Social care isn’t just an expense; it’s an investment. By improving the efficiency of the system, including merging the NHS and social care together, making the Care Quality Commission (CQC), local authorities, and Integrated Care Boards (ICBs) more streamlined and effective, significant savings could be made. Efficiency in administration and delivery of services will reduce waste and ensure that resources are directed where they are needed most. Furthermore, improved social care services can help avoid costly hospital admissions and prevent the escalation of health issues, saving the NHS from further strain.

However, beyond these immediate changes, we must also address the fundamental question of how social care will operate in the future. We urgently need a national debate on the future structure and delivery of social care.

One model worth considering is the way GPs currently work within the healthcare system. GPs operate as independent contractors while being part of the wider public sector network. Could a similar model work for social care?

If we had a system where care providers could operate independently but within a national framework, this could help increase innovation, attract a broader range of professionals into the sector and better balance the needs of providers, workers and service users. A national care system, but with space for flexibility and independent operation, could be a key to revitalising the sector.

In addition, we must look at bringing efficiencies into the way the market development system works in this country. The way the market is managed at present is not working. The social care sector faces constant pressure from an underdeveloped, poorly regulated market system that fails to ensure fair competition, transparent pricing, or sustainable care provision.

A more coherent, well-regulated market structure could drive up quality, encourage innovation, and ensure that services are better matched to the needs of individuals, rather than relying on the patchwork system we have now. Improving market efficiency will not only improve service delivery but could also help control costs, making the system more sustainable in the long term.

We must also acknowledge the economic contribution of social care, which generates over £68bn a year. This is a significant sum that not only sustains a vast workforce but also supports local economies.

The sector provides jobs, stimulates economic activity, and helps to reduce the strain on the NHS. The government's failure to invest in and reform social care is not just a moral and social issue—it is an economic one as well. Ignoring social care's potential to contribute to economic growth is short-sighted and damaging.

Mike Padgham is chair of the Independent Care Group.