Baroness Casey criticizes UK governments for neglecting adult social care

Baroness Louise Casey told the BBC’s Today programme on Wednesday that successive governments have been “asleep at the wheel” on adult social care in England, warning that the sector has been built in an uncontrolled way and now operates as a postcode lottery. She made the remarks while promoting the independent commission she chairs, which is reviewing care for older people and adults with disabilities.

The criticism comes as the commission’s research shows England lacks a clear system of stewardship for social care, unlike France or Germany. The Covid‑19 inquiry released last month described the sector as an afterthought in the early pandemic, allowing the virus to spread “like wildfire” in care homes. Casey said the National Health Service has become a “national hospital service” focused on medical care, while essential services such as home adaptations and personal care are undervalued. She highlighted that self‑funding users pay on average 40 % more than councils do for the same level of support, and that the market is dominated by private providers. The Care Quality Commission, she added, has been a “spectator at the site of a car crash”.

Casey will deliver the commission’s final recommendations next summer, outlining a new settlement for care based on “decency, contribution and a duty to care”. She will address a conference of social‑care leaders later on Wednesday, calling the findings “so awful” and a “national shame”. Prime Minister Andy Burnham, who took office after the Starmer government set up the commission, has pledged social care as a key priority and promised to work with the review. The next steps will test whether the government can move from criticism to concrete reform, and whether the sector can shift from a fragmented, market‑driven model to a more coordinated, publicly overseen system.