The government's vision for adult social care
The Minister of State for Care delivered a keynote speech at the National Children and Adult Services Conference in Liverpool.
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Good afternoon everyone,
And thank you for that very kind introduction and thank you so much for welcoming me here today. It’s such a privilege to be here with you and to share the stage with Louise, Kate and Melanie.
And to speak to you, the people who make a such huge a difference to the lives of children and adults. Be that on the frontline or behind the scenes, thank you for all of the vital work you do.
As the Minister of State for Care, I, unsurprisingly, am responsible for adult social care. But my brief also covers dentistry, pharmacy, end-of-life care, general practice and community health.
In each of these areas, on 4 July, we inherited a system in crisis: there are over 130,000 vacancies in adult social care; GPs are taking collective action; nearly 30 pharmacies are closing every month; tooth decay is the leading cause of hospital admission for 5- to 9-year-old children. That is nothing short of a Dickensian situation to be in.
So, I’d like to thank the Prime Minister for giving me such an easy job!
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It’s truly heart-breaking that in the 21st century people are not getting the service they should, that health inequalities are worsening, that your statutory duties have become harder to deliver.
We clearly need a vision and plan to build a better, stronger future.
But in order to shape your future, you’ve got to know your past.
I was born in Tredegar, the very same town as Aneurin Bevan, the health minister who built the NHS.
And I think about this legacy a lot. I guess you could say it’s in my DNA.
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‘Nye’ built a national health service that was fit for the 20th century…
And now together we must build a national care service that is fit for this one.
A service that, as Bevan said, will ‘universalise the best’.
So, we stand on the shoulder of giants.
But we are a very long way from where we need to be.
The Prime Minister and my friend, the Health and Social Care Secretary, Wes Streeting, have already set out how we’re going to fix what’s broken.
Not with sticking plasters, but through fundamental reform.
There are 3 big shifts we need to make, to ensure that our services are fit for the future - moving from hospital to community, from sickness to prevention, and from analogue to digital.
And social care will play a pivotal role in all 3 of these shifts.
By keeping people healthy, out of hospital, and getting them home as soon as they’re ready.
And by supporting independence through early intervention, including by harnessing technology and digitisation.
Now I take these shifts very seriously - they are the fundamental building blocks of the radical reforms that this government will deliver.
And our manifesto commitments are the first steps.
This government stood on a promise to build a National Care Service that will be delivered locally but underpinned by consistent national standards.
Because there has been a failure to deliver reform, we’ve all got some blame and responsibility to bear.
I am not interested in being a minister who ramps up expectations, blithely passing legislation, saying that the system must do more but without building capability.
The best legislation in the world is not worth the paper it’s written on if you don’t have the ability to enact it.
Bevan understood this.
He used a moment of political consensus after the Second World War to realise his plans for the NHS.
Now we’ve got to do something similar with care and support, through cross-party working.
Adult social care has been a political football for far too long, with every previous attempt to put it on a more sustainable footing undermined by partisan politics.
This weaponisation of care for narrow party-political ends has to stop.
So, I’ve been encouraged, actually, by my colleagues in Parliament’s willingness to work together - since I took up this post in July, it’s been a note I think of conciliation and consensus which has been noticeably absent in our politics for too long.
Ultimately, they want to work with me on this because they know how important it is, and they know we are at an inflection point.
So, at present, we, across government, are thinking very carefully about how we go about building a vehicle for that cross-party consensus.
Now, I understand scepticism about more consultation. But this genuinely is not about kicking the can down the road - it’s about being realistic, about the need to secure cross-party support for our reforms, modernisation and investment agendas.
The time for progress is now. Let’s get politics and the policies right and let’s move forward together.
But I’m not going to promise that change can be achieved overnight.
I can, though, commit to being robust and honest about what we are seeking to achieve, how we’ll go about it, and how we’ll ensure that the changes we put in place are durable.
Now you’ll no doubt be aware that we’ve already started on this path beginning with a new deal for care professionals.
Last month, we introduced landmark legislation, the Employment Rights Bill, setting the stage to negotiate a fair pay agreement in the adult social care sector.
We want a fair pay agreement to improve pay, conditions and give staff the status and respect that they deserve.
Better pay and conditions will ensure that care professionals feel valued and supported, which in turn improves the quality of care.
This will be a foundation of the National Care Service that we’ve committed to building.
And when talking about the workforce, we must remember the family carers on which our system depends.
I’ve met many family carers in my constituency, including young carers. Their resilience is inspiring, but in the face of truly immense challenges.
As announced by the Chancellor at the budget, from April we are increasing the Carer’s Allowance weekly earnings limit from £151 a week to the equivalent of 16 hours at the National Living Wage.
This change amounts to the largest ever cash increase to the weekly earnings limit since Carer’s Allowance was introduced in 1976, and it is the highest percentage increase in more than 2 decades.
I’m also delighted to reassure you that we’ll shortly be providing over £22 million of funding for scaling innovations, including innovative support for unpaid carers through the Accelerating Reform Fund.
This will kickstart a change in services to make sure that family carers are supported through innovations, providing tools to ensure they are recognised at a local level and have improved access to breaks.
The government recognises the challenges that the changes to employer National Insurance contributions will have on adult social care, and on care providers in particular.
In response to the range of pressures facing local authorities, the government is providing a real terms uplift to core local government spending power of around 3.2%, which includes £1.3 billion of new grant funding for 2025 to 2026.
I know that there will be a lot of directors of adult social services here today and I know that you will be working closely with providers in your local area to give further reassurance about how you will use the funding made available to reflect these pressures.
Supporting providers to meet these pressures is a high priority for the Secretary of State and for myself.
Reform will not happen overnight, but in line with our big shifts, the government has also taken action to help people live independently.
The Chancellor announced an £86 million increase to the Disabled Facilities Grant, enabling home adaptations for many more disabled people across the length and breadth of our country.
So these are just some examples of the things we are doing now to deliver on our manifesto commitments and to realise our vision.
Workable long-term plans need to be based on lived experiences.
I recently had the privilege of shadowing Comfort, a dedicated homecare professional.
From the moment we met, Comfort’s passion for her work was unmistakable. She spoke with warmth and pride about the relationship she has built with the people she cares for.
Comfort gave me a glimpse into her unique connection with Rosemary, a 96-year-old doctor of philosophy with an incredibly sharp mind. Together, they enjoy tackling crosswords, which Rosemary would generally complete with ease.
Rosemary told me about how much she values having a familiar, trusted carer by her side. When she was recently hospitalised, Comfort went above and beyond, visiting her every day in hospital. The compassion Comfort brings to her role was nothing short of inspiring.
And the experience left me with an even more profound appreciation for what carers do. They provide not just practical support but reassurance and contentment.
It also underscored the importance of continuity of care, something I know many of you in this room work tirelessly to make a reality.
We, collectively, need to co-design systems that fit around the specific needs of individuals. A one-size-fits-all approach will never work.
We must listen to the voices of people that draw on care and support, understand their aspirations, and work together to overcome the barriers that they face.
Be that… ensuring that older people like Rosemary are empowered to maintain their independence, with reliable and supportive care that evolves with their changing needs.
Be that… enabling young people with learning disabilities to access education, secure employment, and develop the social connections that so many of us take for granted.
Or be that… ensuring smooth transitions from children to adult services so that no family fears a cliff edge in necessary care - an issue that I will actually be discussing soon with my colleague Cat McKinnell, a minister in the Department for Education, with our 2 departments working as a team.
The fundamental point I’m making is that government can’t do this on its own.
We couldn’t get anywhere close, because real change can’t be delivered from behind a desk in Whitehall.
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Real change comes from within teams and communities that have skin in the game.
So, we need you to join us in a genuine partnership.
We need social care professionals, local authorities, policy makers and, crucially, the people who draw on care and support, to work together.
Because together we can design a system that works better for everyone. One that is fair and inclusive and puts people first.
And my door will always be open to the wealth of knowledge and expertise and experience and insight in this room, as we work together to make progress, as partners.
In that vein, I urge you to get involved in the national conversation we’re currently having about our 10 Year Health Plan, by visiting change.nhs.uk.
It’s the biggest conversation in the history of the NHS and I would like your voices to be strong in that process.
Although adult social care reform will be considered in a complementary way, as I outlined earlier, the 2 processes are of course going to mesh together.
We know the need for symbiosis across the system of health and social care.
And the importance of being joined-up to ensure that the outcomes are right for the people that really matter, the people that use the services.
So that’s the message I want to leave you with, really, which is that partnership is key.
It’s about what we learn from listening to one another, celebrating the success of our colleagues, sharing our challenges so we can tackle them head on.
I am ready to work with each and every one of you on this.
So let’s seize this once in a generation opportunity.
Let’s channel our inner Nye Bevan, if you like, and start to build something that is truly fit for the future.
I want you to know that as your minister for this area, I am in your corner, I’m backing you, and I’m just so looking forward to working with you on the challenges that we face together.
Because together, we can deliver an adult social care system that supports people to become full and active members of their communities, with agency, purpose and dignity.
Thank you.