Plans for NHS-Style Social Care in England Could Take Decades, Says Expert

England’s social care system might not see a full NHS-style overhaul for many years, possibly even decades, according to economist Sir Andrew Dilnot. He led a commission 15 years ago that looked at reforming social care funding and now says the cost of such a system would be very high.

Currently, unlike the NHS, social care in England is not free at the point of use. People often face large bills, especially for residential care. Prime Minister Andy Burnham has talked about creating a National Care Service offering free social care, including residential costs, but no final funding plan has been announced yet.

Burnham wants to present his detailed plans to voters at the next general election, which is not due until 2029. Because of this, Sir Andrew thinks real change is still far off. The cost could be more than £18 billion a year, according to his estimate, although others suggest it might be somewhat less depending on the model used.

The government recently sped up an independent review led by Baroness Casey, aiming for a report by summer 2027. This review will help shape how social care might be integrated with the NHS and how it will be funded.

Social care is closely linked to the NHS because delays in care affect hospital services. Many older people face long waits in hospitals simply because suitable social care isn’t available to help them return home. Fixing social care could ease pressure on the NHS and improve lives.

While the idea of free social care is popular, it’s a huge financial challenge. Politicians have struggled with this issue for decades, and many reforms have been delayed or dropped. There’s no clear answer yet on how the system would be paid for, though tax rises or other contributions have been mentioned as possibilities.

For now, families and care workers continue to face a system that many see as broken. The upcoming review and government talks are a start, but it will take time before any big changes reach people who need care every day.