How do you fix a problem like social care? If you’re Boris Johnson circa 2019, you simply stand outside No 10 and tell the country you have prepared “a clear plan” in the hope no one will ask you what it is. (The plan never materialised.) Seven years later, the question of how a developed country funds the care required by an ageing population remains unsolved. The pressure this creates is shunted on to front-line health services, resulting in a crisis in A&E departments and ambulance provision every winter, which melts into a psephological crisis come spring when councils face local elections.
If, for example, you want to know why your council tax has just gone up by 5 per cent when your bins are only collected every fortnight, the roads are full of potholes and the local leisure centre has shortened its opening hours to the point at which you are more likely to achieve your fitness goals by walking around it than by going inside, the answer probably lies as much with Johnson as with your councillors. Not just Johnson – it’s been 15 years since Andrew Dilnot published his David Cameron-commissioned review into the social care system, which itself came after a decade of warnings about the demographic challenges on the horizon.
Westminster leaders preferred to outsource the burden to local authorities, which are legally required to provide certain services regardless of whether they have the funds to do so. Today, councils in England spend an average of 78 per cent of their budgets on adult and child social care. Given that four in five over-65s are anticipated to need social care at some point, this is a challenge that affects us all. It is also politically toxic, as Theresa May found out in 2017 when she suggested people who have experienced the tremendous good fortune of being on the right side of booming house prices should perhaps contribute some of that unearned wealth towards their own care needs.
Fortunately, toxic is of no concern to think tanks, the Westminster equivalent of a plant nursery in which exotic policies are nurtured. On 16 April we got one such specimen, from the Re:State (formerly Reform, before Nigel Farage stole the name), the non-partisan public services think tank. In “Beyond Caring”, authors Alice Semark and Simon Kaye urge us to completely rethink later-life social care. They call for a prefunded social insurance model to replace the present system, with mandatory income tax contributions of 1.8 per cent for the over-34s. This, crucially, would be put into a fund and invested for their futures – as opposed to today’s pay-as-you-go system of workers funding the care of their parents and grandparents via taxation.
To pay for the transition, they suggest a range of options including later-life taxes such as National Insurance contributions for pensioners and a high-value property levy on wealthy homeowners. Justifying what will inevitably be characterised as an assault on people who believe they have “paid into” the system through taxes during their working lives, the authors point out: “Older cohorts had to fund far fewer later-life adults’ state-funded care needs, divided amongst far more of them (compared to current working-age adults), and the later-life care needs older cohorts funded were less complex and thus less costly. This means current older cohorts did not pay enough into the system to have accrued the right for their later-life care needs to be funded by current or future working-age adults.”
This is radical – not because it is untrue (look at the numbers: I dare you), but because no politician would ever say it. Alas, any party adopting Re:State’s bold proposal would quickly be toast. Next month, we’ll have another round of local elections in which councillors are voted out in part because they could no longer shoulder the burden imposed on them by Westminster. Maybe eventually a government will be desperate enough to try something new. Maybe one day voters will demand honesty about how care is paid for and by whom. In the meantime, there goes your leisure centre.
[Further reading: The Great British defence con]
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This article appears in the 22 Apr 2026 issue of the New Statesman, All alone
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Subscribe here to commentThatcher taught us to look after ourselves so many of us took her at word for it and tried to make sure that we had enough money for a middle class life and a secure retirement. If you were from the working class and took the benefit of a free university education it could pay off but it was hard in the UK so a few years abroad could do wonders for your career and bank balance if you played your cards right. Working in the private sector for industrial companies that were bought and sold, merged and demerged, sliced and diced……it was a precarious life but reasonably well paid if not by finance job standards. All the while you voted Labour because of what your working class dad taught you and you hoped the UK would stay in the EU. Now retired you still vote Labour but you lived your working life working for the capitalist system and now your pension depends on the stock market and the price of government bonds. We ended up with private wealth, health and public squalor but all you wanted was a bit of solidarity. No chance – we learned Thatcher’s lessons too well!
A lot of loyal Labour voters from 1979 onward continued to vote Labour through thick and thin – mostly thin. Now they are retired or perhaps many were made redundant they reflect on the world Thatcher’s reforms created. In fact this creation went further than Thatcher could have dreamed. Society is disintegrating due to social media and artificial intelligence to be replaced by what? Finance rules and the stock market and bond market will determine your future whether you have a private pension or not! Some inheritence!