The Big Conversation on Care: Funding, Pay and Community in England's Social Care Reform

The Conversation brings together expert perspectives on England's social care reform, examining how pay and prestige for care workers, funding mechanisms, public attitudes and the role of technology and communities intersect in Burnham's big plan. The piece draws on analyses by Anna Barford, Conor O'Kane, Anthony Kevins, Kathrin Cresswell and Robin Miller to outline the challenges and potential paths forward for reforming adult social care in England.

• Care as an investment: improving pay and prestige for the sector is linked to better outcomes for families and communities.
• Funding questions: comparisons with Ireland's Fair Deal model illustrate potential costs and tax implications for the UK.
• Public attitudes: most people want the state to share care costs with users, with wealth taxes and higher earners’ income taxes among popular options.
• Technology is not a silver bullet: real transformation requires better governance, co-operation across organisations and sustainable digital infrastructure.

Authored by The Conversation. Author: Anna Barford et al. Publisher: The Conversation.

Overview

The article surveys the ongoing political and policy push to fix England’s social care system, described as a “big conversation” that follows at least two decades of attempts. It collects expertise from five contributors who outline the core challenges and potential avenues for reform, including pay and career progression for care workers, protection from costly residential care, and the broader ecosystem of unpaid and paid care that largely falls on women. The piece frames care as an investment rather than a cost and situates reform within a wider debate about funding, equity and the interface with health services.

What care means in England

Anna Barford emphasizes that care is a broad concept spanning cooking, cleaning, childcare, teaching, and healthcare. These labour-intensive tasks enable individuals and communities to survive amid poverty, shocks, and climate change. She notes that England’s social care budget does not cover the full range of care activities, and that improving pay and prestige in the sector could lead to better outcomes for families and greater gender equality by addressing the disproportionate burden on women. The piece also highlights the network of actors delivering care, including families, volunteers, not-for-profit organisations, private enterprises, and the state, with a portion of this work paid and underpaid.

Fixing social care is a huge, expensive job

Conor O’Kane surveys the political terrain, noting broad consensus on reform but little agreement on funding. He compares potential UK approaches with Ireland’s "Fair Deal"—a system that factors in income, savings and assets to determine state contributions, with asset considerations limited to the first three years of residential care. He estimates the UK cost could be around £13 billion per year, a figure that still leaves pay increases for care workers unaccounted for. He also mentions possible funding options, including adjustments to income tax or even wealth taxes, while acknowledging constraints around borrowing and tax increases. He predicts a political path where Labour outlines a reformed system and funding plan ahead of the next general election, albeit with uncertainty about voter mandates.

Public are confused – but clear that the state should pay

Anthony Kevins provides a political science lens, noting public unease with the current system and a lack of understanding about how it is funded. His research points to a public preference for shared costs, with wealth taxes and higher earners’ income taxes among more popular choices than council tax increases or inheritance taxes. Kevins presents a funding hierarchy from council tax to wealth taxes and highlights that any real plan will face backlash as details emerge. The narrative underscores the challenge of translating public opinion into policy design that is both affordable and politically feasible.

Technology is not a silver bullet

Kathrin Cresswell argues for an integrated approach that treats health and social care as interdependent rather than fully merged systems. She stresses that technology can support transformation but is not a cure-all; historical NHS digital initiatives have overpromised relative to implementation realities. Successful reform requires governance, shared ways of working, and a culture that enables information and services to flow across organisational boundaries. Social care, with its fragmentation and variable digital maturity, requires reliable connectivity and basic digital infrastructure that supports day-to-day care and independence rather than flashy innovations.

Better connections with communities

Robin Miller highlights the need for closer collaboration between health and social care, situating the reform within integrated care systems and community hubs. He points to tensions arising from professional dominance in healthcare, framing the national care service as a possible step toward consistency while insisting that sustained collaboration will come from joint work between professionals, voluntary groups and local communities. He also cautions that improving social care will require NHS re-prioritisation toward prevention and community-based models to align with local needs.

Across these sections, the authors argue that reform is feasible but requires careful design of funding mechanisms, clear governance structures, and a reorientation of health and social care priorities toward community-based and preventive approaches. The piece ends with a pragmatic note on political feasibility and the likelihood of backlash as details of funding and reform unfold.