Politicians Must Show Courage To Prioritise Social Care Reform, Report Says
Politicians putting social care on the agenda is key to generating public support for much needed reform, but they fear discussing the issue because of previous high-profile election rows costing them votes, a new report by The King’s Fund highlights.
The analysis found that the public’s prioritisation of social care has peaked when politicians propose changes to the system – but the failure of those proposed changes to get off the ground and the intense opposition and media backlash to them has now made it an electoral taboo.
This is most acutely outlined when looking at the ‘dementia tax’ row during the 2017 General Election following Theresa May’s proposed social care reforms, leaving future politicians fearful of tackling the problems in the sector.
In the years since the 2017 election, when the public’s prioritisation of social care as a major issue facing the country reached its peak of 18%, it has only fleetingly crossed 10% and now sits at record lows of between 1% and 3%. For example in October 2025, when asked what are the most important issues facing Britain today, 47% said immigration, 33% said the economy and 24% said the NHS. In contrast, only 3% said social care.
The analysis forms part of a major new report from The King’s Fund, titled ‘Not my priority: how the public sees social care (and what can be done about it)’. It looked at extensive polling and focus group research by The King’s Fund and other organisations since 2011 to evidence how the public currently views social care, its appetite for reform and the most effective ways of communicating about the issues in the sector. This work marks the start of major work on social care reform options from the think tank as part of its new strategy.
The report highlights low public understanding of adult social care – around a third of the public think, wrongly, that social care is provided by the NHS and/or free – which is driven by confusion between social care and the NHS, the wide range of services covered by social care and the reality that relatively few people draw on care at any one time.
As a result, social care is not a ‘top of mind issue’ for the public. Unprompted prioritisation of it as a major issue facing the country has never exceeded one in five people and has fallen sharply since Covid-19, as people worry more about the cost of living, jobs and immigration. It is also an issue that most people do not like to think about despite people underestimating the odds of needing care with one in seven of those aged 65 requiring care costing £100,000 or more in their lifetime.
However, when people are reminded about it through prompted polling (where social care is given as one option in a list), far more people – close to one in three – say it should be a priority. They recognise its importance to the NHS, and they consistently agree that the government should take more responsibility for funding it.
To break the logjam, The King’s Fund recommends that more effort is put into cross-party dialogue, so that future politicians have ‘air cover’ for social care reform proposals. To date there has only been one reported cross-party meeting hosted by the ongoing Casey Commission and the report says that campaigners will need to think about how to expedite this process. Without it, the ‘air cover’ needed through broad agreement across party lines will be missing and likely damage any hopes of a public consensus too.
The report also recommends that those advocating for reform should consider how they use the 1.5 million people who work in the social care sector as ambassadors for change through their own personal networks and learn from the decades of experience of those who market their services.
More work also needs to go into building public awareness of care, with the report urging campaigners to talk about the tangible difference that social care reform would bring similar to the way NHS funding is talked about in the context of ‘more doctors and more nurses’. Examples of this could be – as with the NHS – shorter waiting times for care and more people receiving it.
Simon Bottery, Senior Fellow for Social Care at The King’s Fund and co-author of the report, said: ‘Social care reform is caught in a political Catch-22: it needs politicians to build support for change, but they avoid talking about it for fear it will lose them votes. It will take more courage and leadership from them if social care reform is going to happen and realise the electoral and societal benefits that fixing this failing system would bring.
‘The social care sector also needs to play its part and recognise that its current approach has not brought change. When advocating for reform it needs to meet the public where they are, not where it wishes they were.
‘That means talking about the benefits of reform to the NHS, which the public uses more and prioritises more than social care. Also, speaking to the tangible improvements that reform would bring like shorter waiting times to receive care and more people receiving it, rather than focusing on abstract concepts such as ‘wellbeing’.
‘People know that social care is not working as it should and they want it to be better. But they have become fatalistic about the chances of reform and suffer from ‘social care fatigue’ after hearing for years about the system being in ‘crisis’. Only if politicians and the social care sector itself step up to plate will this ever change.’
