Successive governments "asleep at the wheel" on social care, Casey says
Successive governments have been "asleep at the wheel" on adult social care, Baroness Louise Casey has said.
Baroness Casey leads the independent commission on adult social care in England, which looks at the support given to people who need help with daily living. She made her remarks in an interview with BBC Radio 4's Today programme on Wednesday 11 November 2026. Social care is a devolved matter, so the commission's work covers England only.
She said care services for older people and adults with disabilities had developed in a largely uncontrolled and unintended way. By contrast, she said, the NHS was deliberately designed in 1948. She also said a postcode lottery has emerged, with different levels of care depending on where people live.
Research published by the commission found that two people with the same condition can have very different experiences depending on their area. The differences include how their needs are assessed, how long they wait and what support they receive.
The research also found that people who pay for their own care are charged on average 40% more than councils pay for care they arrange. Baroness Casey said the care market is dominated by private providers. She described the regulator, the Care Quality Commission, as a "spectator at the site of a car crash".
A separate piece of the commission's research found that England is an international outlier, with no "clear system of stewardship" for social care. It compared England unfavourably with countries such as France and Germany.
The commission was set up by the Starmer government. Its final recommendations on services for older people and adults with disabilities are due to be published next summer. Baroness Casey was scheduled to address a conference of social care leaders later on Wednesday.
