Parliamentary Wrap-Up: Prime Minister Resigns, Casey Commission Update & Report on Physical Activity in Care
The Prime Minister has this morning announced his resignation, following a disastrous set of local election results, which seemed to evidence his deep unpopularity amongst the public, with the Labour Party losing many of their “core votes” to their left flank. With former Manchester Mayor Andy Burnham now elected to parliament and Wes Streeting announcing he will back Burnham, the leadership election is increasingly looking like it will be uncontested, with Sir Keir’s successor likely to be in place in just over three weeks.
Burnham, in his last cabinet role, pioneered the idea of a National Care Service, a plan that was ended by a change of governing party following the 2010 election. We hope that the same enthusiasm for addressing the social care crisis head-on remains so many years later, with little having changed for the sector during the intervening years. This Wednesday, the Health and Social Care Select Committee will hear from Baroness Casey and Minister Stephen Kinnock on the possible creation of that service as set out in the 2024 Labour manifesto.
In the meantime, local authorities have been undertaking their budget-setting process and outlining fee increases for providers for the new financial year. A recent King’s Fund report highlighted that recent real-terms increases in funding for local councils have failed to meet the increasing costs of delivering care, which have risen faster, primarily due to increases in employment costs. Care England is in the process of compiling data on this year’s increases and is particularly concerned about the number of authorities that have yet to confirm their uplifts, nearly three months into the current financial year.
Baroness Casey gave a speech at the Nuffield Trust summit, which landed well with the sector, boosting confidence in the work of her independent commission on adult social care. Casey described the crisis in social care as a sixth of Beveridge's “five giants” and highlighted that councils are not able to meet their statutory duties as the cash and systems aren’t available, such that the care market simply doesn’t work at present. She made some immediate recommendations ahead of the publication of her interim and full reports, including the appointment of a Dementia Tsar, creation of a National Safeguarding Board and a fast-track passport for people diagnosed with Motor Neurone Disease.
Casey’s ‘national conversation’ is due to start this year, and her first stage report is also expected no sooner than July; however, concerns still remain within the sector over the likelihood that the necessary cross-party consensus will form to implement her recommendations and ensure that her commission leads to the wholesale change required.
Following the speech, Professor Martin Green OBE met Baroness Casey to discuss the issues in more detail. The conversation reinforced the sense that there is a clear understanding of the structural problems across both social care and the NHS, the imbalance between the two systems, and how this is experienced in practice. There was also a strong emphasis on pace. While the commission’s full report is not due until 2028, the view was that action should not be deferred until then, and that there are steps that can be taken now to ease pressure and improve alignment.
Drawing on his experience of previous reviews, Martin noted that Casey’s approach feels different in tone. Her clarity, the strength of her vision, and her willingness to speak directly about putting social care on a par with the NHS stand in contrast to earlier commissions. He also pointed to the wider system changes underway, including NHS England’s dissolution and the reorganisation of ICBs and local authorities, as a genuine opportunity to reset how the system operates. The potential is there to shift the focus towards people and outcomes, rather than organisations and processes. The remaining question is whether there is sufficient political will to follow through and deliver that change.
Social care has been generating significant parliamentary interest over recent months, with questions covering everything from dementia and NHS Continuing Healthcare to workforce pressures, learning disabilities and the longer-term question of how adult social care is funded and reformed.
On the back of this, we have been reaching out to those MPs and peers who are clearly engaged on these issues, meeting with them and sharing feedback and evidence directly from our members. It has been a productive period, and those conversations are ongoing.
The areas attracting the most attention have been dementia, especially the Modern Service Framework, in which we are directly involved, the case for a National Dementia Care Pathway, and access to timely diagnosis and post-diagnostic support. Workforce and immigration have also generated significant interest, and the volume of questions reflects the very real anxiety in the sector about the government's proposals. The Earned Settlement consultation and the proposed 15-year qualifying period for indefinite leave to remain have featured heavily, and we have been making the case directly to MPs about what these changes would mean for providers and the people they support.
NHS Continuing Healthcare has also been a consistent theme, with MPs pressing on eligibility inconsistency, the transparency of the appeals process, and the impact of funding decisions on unpaid carers. On adult social care funding more broadly, questions have ranged from the Casey Commission and long-term settlement to National Insurance contribution pressures, hospital discharge delays and the future of oversight following the abolition of Healthwatch.