The episode of Newscast delves into the persistent issue of adult social care in England, a matter that's been revisited numerous times by various administrations. The latest attempt by British politicians to address this issue sees the Health Secretary, Wes Streeting, announcing the formation of an independent commission led by Baroness Louise Casey. Despite numerous past efforts through reforms and reports, tangible changes have been limited, sparking skepticism about the success of this new approach and its timeline.

The discussion includes insights from BBC Deputy Political Editor Vicky Young and Mike Padjam, chair of the Independent Care Group. They review the announcement and address the challenges in executing social care reforms, particularly the timeline extending to 2028. The conversation highlights issues like the need for political consensus and the difficulty of balancing state funding and public contribution. Although some parties express optimism, past failures and looming elections cast uncertainty on the effectiveness of these new measures.

Main takeaways from the episode:

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Key Vocabularies and Common Phrases:

1. instigation [ˌɪnstɪˈɡeɪʃən] - (n.) - The initiation or start of something, often implying encouragement or provocation. - Synonyms: (initiation, inception, commencement)

...Wes Streeting, about the instigation of a new independent commission looking at adult social care in England...

2. fruition [fruːˈɪʃən] - (n.) - The point at which a plan or project is realized or completed. - Synonyms: (realization, attainment, fulfillment)

Probably many, many promises. I'm sad to say not many have come to fruition, but I'm forever hopeful one day it'll work.

3. consternation [ˌkɒnstəˈneɪʃən] - (n.) - Feelings of anxiety or dismay, typically at something unexpected. - Synonyms: (dismay, trepidation, anxiety)

The timetable of all of this, it is as what is causing a lot of consternation.

4. consensus [kənˈsɛnsəs] - (n.) - General agreement among a group of people. - Synonyms: (accord, concurrence, agreement)

What he's talking about is getting consensus, political consensus, but also, you know, across the country as well.

5. consternation [ˈkɒnstəˌneɪʃən] - (n.) - A strong feeling of surprise or sudden disappointment that causes confusion. - Synonyms: (dismay, disquiet, alarm)

But the timetable of all of this, it is as what is causing a lot of consternation

6. tempting fate [ˈtɛmptɪŋ feɪt] - (phrase) - Risking bad luck by tempting or inviting trouble through one's actions or words. - Synonyms: (courting disaster, asking for trouble, taking a risk)

But they are worried that 2028 is sort of tempting fate by running potentially into another general election

7. grasp the nettle [græsp ðə ˈnɛtəl] - (phrase) - To tackle a difficult problem or situation boldly and effectively. - Synonyms: (deal with, confront, tackle)

It's quite a kind of eye opening reminder of how many times politicians have tried to grasp the nettle before.

8. incremental [ˌɪnkrəˈmɛntl] - (adj.) - Characterized by gradual, step-by-step progression. - Synonyms: (gradual, progressive, step-by-step)

There have been some incremental changes, little things, but we still haven't got far enough.

9. divert [daɪˈvɜːrt] - (v.) - To redirect or reroute from one place or use to another. - Synonyms: (redirect, reroute, reallocate)

One quick thing the Social Secretary could do is to actually divert some funds.

10. behemoth [bɪˈhiːməθ] - (n.) - Something enormous in size or power, often with a negative connotation of being unwieldy or overbearing. - Synonyms: (giant, colossus, leviathan)

And, I mean, Mike, would you be okay with being absorbed into the massive behemoth that is the NHS?

Can Keir Starmer solve Britain’s social care problem? - BBC Newscast

We have had five health secretaries, 18 ministers, eight green papers, four white papers, two inquiries and numerous reports all saying what needs to be done. Why do we have to reinvent the wheel? And this latest generation of British politicians have decided they're going to have another go at trying to solve the problem of adult social care in England. We will discuss whether they might succeed or not and how long it could take on this episode of Newscast.

Hello, it's Adam in the newscast studio and we're going to focus today's episode entirely on this big announcement from the Health Secretary, Wes Streeting, about the instigation of a new independent commission looking at adult social care in England, something that many, many administrations have looked at. Many, many administrations have introduced reforms, but few have actually implemented them. We've come quite close to changes being made, but they've never quite happened.

And Wes Reading is now going to have another go, this time with an independent commission headed by Baroness Louise Casey, who has done many previous investigations into things like the Metropolitan Police or child sexual abuse. So she's no stranger to trying to grasp the nettle, a terrible cliched phrase that we will probably hear lots of times in this episode. And here to help us pick through all the details of this announcement is BBC Deputy Political Editor at Westminster, Vicky Young.

Hi, Vicky. Hi, Adam. Happy New Year. Happy New Year to you, too. And also joining us is Mike Padjam, who's chair of the Independent Care Group, which is the association for all the care providers in York and North Yorkshire. Hello, Mike. Hello to you. Well, before we dive into the news, Mike, just want to give us a sense of the scale of what you do. I don't know how many people you're involved in looking after or how much money you spend or just give us something that gives us an idea.

We're a small provider, really in the picture. We look after 137 people and I've been in the sector 35 years. We employ 240 staff in North Yorkshire. And in 35 years you will have seen maybe about 25 or 30 different social care reforms. Probably many, many promises. I'm sad to say not many have come to fruition, but I'm forever hopeful one day it'll work. Okay, a bit of optimism for the new year.

Vicky, do you want to just set out what Wes Streeting, the Health Secretary, has actually announced today in terms of commission. Yeah, that's right. So he has talked about a commission that's going to look into the issues that there are and it's going to be Baroness Louise Casey, who's going to be in charge of it now. She is very much seen as a fixer in Whitehall, someone who tells it straight, gets things done.

But the timetable of all of this, it is as what is causing a lot of consternation. There's going to be two parts to it. The first part, as I say, is looking at the scale of the problems. The medium term, what needs needs to be done, that's going to report in 2026. The second part, which looks at longer term changes and crucially, the funding, who's going to pay for all of this? That is going to report sometime up, potentially up until 2028.

So there's been an awful lot of reaction to that, saying that this is kicking into long grass yet again. We've had all sorts of commissions and, and reports that have gone on for years, for decades. You know, why do we need to do all this again?

And I suppose the reason 2028 is significant is that on the current parliamentary timetable, the next general election would be in 2029. So there wouldn't be a lot of time for the late stage Labour government to actually implement anything. Yeah. And this is what's causing an awful lot of questions and Wes Streeting was asked about this because Labour, of course, has a massive parliamentary majority. If it wanted to, it could just come up with the proposals and vote it through.

What he's talking about is getting consensus, political consensus, but also, you know, across the country as well. This applies to England, making sure that people are on board with all of this. So he wants a political consensus. And I think actually, for me, one of the most striking things he said in his interviews today was when he talked about wanting. This might be the triumph of hope over experience, but he said he was excited about the possibility of change and that's because, you know, these things have run into problems before.

And the idea of getting a political consensus, particularly, you know, maybe a few months or a year before a general election, you know, that really is making it pretty hard. And we will explore all of those things in detail in this episode. But let's hear a little bit from Wes treating when he was doing media interviews on Friday morning. It's not a shortage of good ideas on social care that we have, it's a shortage of good politics. And that is why we're determined to work together across the party divide.

I've spoken to my Conservative and Liberal Democrat counterparts in recent days who are on board. I'm writing to the leaders and spokespeople from all of the Westminster parties today and also my counterparts in the devolved government because we really want to work together to grip this issue.

And Vicky, the first thing that happens though is that Wes treating is going to get together with his opposite numbers in the other political parties to sort of prepare the ground before the commission even starts. Yeah, that's right. So next month there will be these talks and as he said there, he's spoken to his opposite numbers and to the leader of the Liberal Democrats, Ed Davy, to Ed Arga, who is the Shadow Health Minister, and talk to them about it. And you know, I've, we've heard them talking today.

I've talked to, to them as well, the parties, the other parties and you know, they want to be optimistic about this. They are worried about the timetable. They said to me, look, we shouldn't be doomed to fail, we've got to transcend that electoral cycle. But they are worried that 2028 is sort of tempting fate by running potentially into another general election. They're open minded, but of course it's all about the detail. What they're not doing is saying now, yes, we are going to come along with whatever this comes up with.

I mean, that's just not going to happen. There is no guarantee that any of the opposition parties will go, yep, great, we're going to put that in our manifesto. You know, it doesn't always happen like that. And can they have an agreement, particularly over the funding of all of this? And Mike, I want to drill into some of the real problems that you are facing that could potentially be fixed by this commission or at least will have to be investigated by this commission.

But just get your reaction to today's announcement. First of all, and the various bits of it. First of all, Dame Louise Casey, who is a newscaster. So if you're listening, Dame Louise, you're welcome to come on anytime so you can spell out your initial thoughts. What do you think, Mike, about hiring her to do this?

Well, I don't know much about her in the past, but what I've read since it was announced is that she seems a very able person and I think that she does things quickly and speaks her mind. So I think that's a good thing. My fear is the length of time that set out to achieve the end report, which as you said, is 2028. So in my view that's far too long. I would like them to speed things up. And why they can't start work until April puzzles me as well because we've

Been waiting at least I've been waiting nearly three decades for some reforms coming and to wait another few years doesn't seem. Well, I was flabbergasted when I knew how long it was going to take, to be honest. Don't you take any heart from the fact there's going to be an interim report which could be quite a kind of powerful moment next year in 2026? Well, I suppose in a way, and I always try and be glass half. The problem is I've seen so many recommendations, reports of what we should do and the, the crux is really making sure it happens. Because even if the report comes mid next year is then how long is it going to take to put things into place?

Because we're having challenges today, tomorrow and next week that need solving and to wait at least another year to see what might happen again, it's far too long. The issue I see is that we already know what needs to be done. We have had, and I've just noted these down in the 20 years we have had five health secretaries, 18 ministers, eight green papers, four white papers, two inquiries and numerous reports all saying what needs to be done. Why do we have to reinvent the wheel?

There are many experts who could tell the minister straight away, get on with it. With such a large majority, I would like them to press forward and do something and be bold. They're my words, not Edward Agar's. I think he said that a few hours ago on the radio is we want this gum to be bold. Come on, let's do it. And I should say that the, I do a little shout out to the Kings Fund who are the health think tank. They've got a page on the, on their website where you can look at all the different reviews and commissions and studies and cross party negotiations that have been going on around this issue.

Since, since the 1940s when the NHS was first set up. And it quite a kind of eye opening reminder of how many times politicians have tried to grasp the nettle before, to use that terrible cliche. Vicky, we should say, I mean Mike is right there, there's, there's a sort of, there's, there's a toolbox of things that politicians have had ready to go for quite some time and I'm thinking it's, it's mainly based on the, the inquiry that was done by Sir Andrew Dillnot under George Osborne and David Cameron in 2011 and the two main things were a cap on the lifetime cost of care so that you were never going to be Whacked by massive, massive, massive costs. You could know the maximum you were ever going to have to pay yourself.

And also changing the means tests to increase that so that more people got help with the cost of their care from estate. Those are kind of like the two main kind of building blocks, aren't they? Yeah. And I think, look, how it's paid for, who pays for it is the really difficult, knotty part of this. And so by putting that later, I suppose, I don't know, maybe they're, you know, I think they're thinking is, well, look, once we've come up with this idea of what needs doing, and if it's a big conversation, a national conversation, everyone's talking about it, everyone's deciding, we've got to get something sorted, maybe that helps that second bit.

But this is where it's fallen down in the past. And actually, even before that, if you look at Andy Burnham, who was the last Labor Health Secretary, you know, they were in talks, there were cross party talks behind closed doors between the Liberal Democrats, labor and the Conservatives. They thought they had an agreement about, we're not going to use this in our election campaigns. And a couple of days later, the Tories had come out with posters saying, this is Labour's death tax.

And his idea was a levy of £20,000, which would be deducted from estates on death. So, you know, there's been a lot of different issues. Theresa May as well, in 2017, that was dubbed the dementia tax, and again, that almost cost her the election. So, you know, I think there's a problem here about the funding around it all and how you do it. And it's about who pays. It's about that balance.

Is it the state paying? Is it general taxation that everyone contributes to it in the same way as the nhs? That's what Andy Burnham thinks should happen. He says it's unfair. This is a feeling for many people that it's unfair that if you have a disease like cancer or your treatment is free and the nhs, if you have Alzheimer's, that's not the case, you could rack up bills of tens, if not hundreds of thousands of pounds.

So should the individuals be paying if they are unfortunate enough to get one of those illnesses, should families be paying? Should it be paid after someone has passed away? There's all these issues and no one has really resolved that. And I think, you know, Andy Burnham has said earlier today, and I think he's right here, it's about political choice. In the end, someone has to make a decision that is going to upset somebody. And the problem is that politicians don't like upsetting people, they don't like upsetting voters and saying, do you know, you're not going to get this social care for free.

It's not like the nhs, it's not going to be free. You might have to pay for it and, you know, someone's got to have, I guess, the political guts to do that. And I just really remember during the Boris Johnson era, when I was a political correspondent working at the desk opposite you, Vicki, there. So basically, David Cameron and Osborne had laid the groundwork to put this cap in to the lifetime costs and to increase the means test so that more people got, got help with their care costs. They, they passed the legislation but they never actually implemented it and it, so it never happened in the real world. Then Boris Johnson revived it when he was Prime Minister, having said on the steps of Downing street on his first day as PM that he had a fully worked out plan to solve the crisis in social care.

And it was going to be a cap and an increased means test funded by a new Health and social Care levy, which Rishi Sunak, the then Chancellor, had insisted on. But then Liz Truss came in, scrapped with Kwasi kwarteng the tax, and then, then Rachel Reeves came in as Chancellor and said, well, hang on, the cap. And the means test wasn't funded. So the New Labour government scrapped that as well. So it was back to square one as far as that was concerned. And also remember at the time, the biggest kind of the big complaint from the Conservative backbenches was that if you cap the lifetime cost of care, then that means you actually are.

The state is effectively helping richer people more. Because the idea of a cap is it means that you get to keep more of your assets at the end of your life. And so if you've got a house that's worth £1 million, the cap means that you benefit a lot more than somebody whose house is worth, I don't know, £92,000. Mike, what's your view about, about what's the best way to, to pay for social care in the future and the balance between the taxpayer and the individual person? Or do you maybe you don't care, you just, you just want to make sure the money flows at all. I want to see it happen, but I'm more with Andy Burnham is I think that the state should pick up the majority of the costs and be free at the point of need, such as the NHS, because I think if, if 1948, when the NHS came into being.

If people live much longer past retirement, it would have been dealt with at that time. I think a small contribution from the individual would help, but I just want the problem solved. My view is that the public is prepared to pay a little bit more for good quality social care, perhaps by taxation, because I think that people don't realise that when they need social care, it's means tested and it is a frightening cost when you have to look at it. But I do think the public will maybe make this more of an issue for the next election if it's not solved, because I think more and more the problems are coming. The sector's on its knees and I just might say to Rachel Reeves, really is that in fact, social care can be an economic contributor to the economy.

For every £1 invested, it brings £1.75 back. It's not a drain. And therefore she should make sure that some of the funding is moved from the NHS into social care to help. And I think that could happen. It's not all about new money, it's about rediverting it. And the politicians and we're treating in particular, talks about hospital as a community. And every government I've known since I've been around said the same thing, but it's never actually happened.

Is still arguing about who pays for what. And the NHS gets the biggest share and it's got the strongest voice, unfortunately. But, Mike, isn't the problem, though, that the. The NHS and emergency care and people needing operations to replace a hip, that's always going to be need money straight away at the expense of social care. It's so easy to say, oh, let's divert some money from the NHS to social care. But actually, who do you take each NHS pound away from?

Well, I think that's where the government, again needs to be bold, is I want to see the nhs. Sorry, I don't see social care come into the NHS and be one organization, perhaps the National Care Service, which brings health and social care together. Because I still see the arguments between local authorities and the nhs, who pays for what. And I do think if the public could see more of what's happening in hospitals nowadays, with lots of people queuing up on trolleys, older people in hospital because they can't get a bed because there's no capacity in the community, they would vote with their feet, as I don't think they see the bigger picture. We've got a bit of work to do to tell the public how bad the system is at the moment.

Well, do that now. Paint a picture of how bad the system is and why we should all care like 10% or 100% more. There are over 2 million people in England not getting any care whatsoever. But nowadays there is capacity in the independent sector to deliver services for people so they could be discharged from hospital quicker when they're fit to do so. But there is a blockage. People are in hospital for longer than they need be because they're in the capacity in the community, because local authorities can't afford the costings of what it takes for social care because their budgets are stretched.

And I think that's the fundamental problem also with GPS now not able to work 247 is to get a lot of people going to AE because they can't get a service from the gp. And this community is on its knees. And I think one quick thing the Social Secretary could do is to actually divert some funds. I know it's politically difficult, but the lion share in the budget went to nhs. Local authorities need more funding and therefore we can unblock the system. But it's a political choice and I don't think politicians think there are any votes in social care. But I think that's going to change very soon.

But, Mike, is it that providing social care is very expensive and local authorities can't afford it, or is it just that local authorities just don't have enough money for it, full stop? I'm trying to work out where that. Where the pressure is there. It's certainly not cheap, but if you're providing service 24. 7 to people, it's going to cost now, particularly because of the actual costs of providing the services, particularly on staff, because it's very heavy on staff. But is it less expensive than care in the nhs? So we are spending more than we need to in the NHS because we can provide the care for less expense in the community.

But there's a disconnect between health and social care, because local authorities are responsible for social care and the NHS is health. And I think that's why, rather than tinkering around the edges, we talk about integration, but it's been going on for many, many years, is we need to be bold and bring them together with one body, with one source of funding. And, I mean, Mike, would you be okay with being absorbed into the. Into the massive behemoth that is the nhs? Yes.

Well, the principle, I would say, is it's no different to how GPs work. They're independent contractors, they're a franchise, but they're inside the service. Whereas, opposed to us, who deliver in public sector Care are outside. I would willingly, from my perspective, come into the NHS, still remain the independent status GPs have got, but feel that we're valued and more part of the solution rather than the problem. Interesting, though, because, well, you talk about GPs being in the NHS, but they've got quite a lot of independence and actually quite a lot of them are run as more like small businesses.

And that means that actually sometimes they can provide, not provide the service that people necessarily want and it's okay, they can sit back and say, no, we don't need to do that. Well, I think there's a model that could be followed similar to GP's work, but I know a lot of providers will want to provide the service. What we want to do is provide the public the best care we possibly can and also deliver for the health service as well. But the sector doesn't have the best reputation out there and I think it's a challenge. There are many different sizes of businesses in the independent sector, small family businesses and corporates at one end, some of which might be making what people might see as vast profits.

The majority are just about making ends meet. And, Vicky, it was interesting when Mike mentioned the idea of a national care service, because he's not just plucked that idea of nowhere. That is something that Wes, treating the Health Secretary, has mentioned today. It's in the Labour manifesto. It's been in Labour manifestos at the last few general elections. Do we have any idea what. What they mean when they say that?

I think what they mean is it's about national standards, because, as we were hearing there, because local councils provide some of this service or the funding for it, it means it's. It's pretty patchy. So depending on where you are in the country, you might not get the same access. And so it is trying to make sure that there's a more, you know, uniform approach. Now, whether it means, as we're saying there, that the social care sector does get subsumed into the nhs, I. I don't know, but I think part of this is, of course, how those two are completely linked.

And we've heard for so long, haven't we, the issue about people being in hospital, who shouldn't be there, and it is having an effect on the nhs. You know, there was someone earlier talking about the fact that actually, if social care isn't improved and sorted out, it's going to drag the NHS staff down, down with it. And actually, that could be the actual incentive for the politicians to make what might be unpopular choices, because, you know, labor has come into power, saying that this is one of their top priorities is sorting out the nhs and really that can't be done without sorting out social care. Which again brings you back to the idea of why this time scale is quite so long.

And we should say that, I mean, this whole conversation is about England, because in Scotland, for example, people, there's been free personal care since that, since the early noughties. And that's, that's a useful reminder that A, the system is different in different parts of the country and B, we're also talking about paying for different things here. This is all about, about personal care so that the help that a person needs to, I don't know, get changed or to get washed or to take their medication or monitor their blood pressure and get help getting around. This isn't about what they call the hotel costs if you're living in a care home and having to pay for your, your meals and the electricity that you use. Where actually when we talk about social care funding, it's quite, it's quite a narrow thing.

And then the other thing that struck me as I was going down, down memory lane, looking at some of the other reviews of this is that actually when you go back to the Dillnot review where they propose that the cap and the increased means test, so much of that is actually about creating new financial services products, so new insurance policies that people could pay into throughout their working lives to cover them up to the cost of the cap. And you realize actually we could be talking about some quite massive kind of changes to not, not just, not just care, but actually financial services as well. And, and that you'd have to take out potentially a, a care insurance policy in your 20s to pay for you when you're in your 70s, which just sort of gives you an idea of how, how big and kind of far reaching this could all end up being.

And it does, I mean, again, it does depend obviously with what Louise Casey comes up with and she might come up with something which, you know, the labor government might think, well, we couldn't possibly countenance that. I mean, this is, this is the problem. When you, you know, do bring in an independent reviewer, if you like, of the situation, you're almost, you know, passing those difficult decisions potentially on to somebody else. And in the end, as I said before, someone is going to just have to make a decision.

Can I add something in? Please do, Mike. Only in. The fact is, I think that the mistake we do, we try to find the perfect solution. My view is we may not be able to get it perfect. The system we've got is imperfect at the minute, is let's do something and refine it as we go along, rather than waiting three years to actually come up with something. Everyone agrees I don't think that's possible. I would like to make a start now and refine as we go along, because anything is better than the system we've got at the moment.

And I suppose we have had tweaks, for example, the social care precept, so local authorities in England being able to add a bit extra onto the council tax if they have got to pay for those social care. So it's not fair to say that nothing has happened for 30 years. There have been some incremental changes, little things, but we still haven't got far enough, because I don't think. And again, local authorities have had to drive down the cost of care over more than a decade, which resulted in challenges for providers to actually deliver the best wages they can for staff.

Because one thing we need to solve is what we pay social care staff. They need to be on a par, at least with the nhs. That would be one quick fix for the government to sort to help on the recruitment crisis. And that's the thing, Adam, it cuts across so many different departments and actually, the idea of staffing, that is a big issue as well. So if you look at what's happened there, you know, the changes to foreign workers and you know, them not being able to bring their family in with them, what's the impact of that? The national insurance for employers, those rises, there's all these different decisions being made in different parts of government which are having an impact here.

And so I suppose that is part of Louise Casey's role, isn't it, to bring that all together and say, actually, you know, if you want to make this work, you're going to have to make some changes about how you approach immigration. You know, I don't know, but I think it's very far reaching. We look forward to perhaps providing a bit of help and information to Baroness over when she comes to look at things, because I think there's a lot of expertise. We're more than happy to help solve the challenges ahead.

Thank you very much, Mike. Yes, thank you. And it was good, good to speak to you both. And Vicky, lovely to catch up with you as well. And you too. And that's all for this episode of Newscast. Thank you very much for listening. And if you want to feedback about anything with your experiences or your observations, the address is newscastbc.co.uk for your emails or you can WhatsApp us on 033-01-2391 and I know that Laura in particular will like reading all your messages because this is a subject that she is very, very invested in journalistically. And she and Paddy will be back with the first weekend newscast of the year very, very soon. Bye.

POLITICS, ECONOMICS, INNOVATION, SOCIAL CARE, WES STREETING, ADULT SOCIAL CARE REFORM, BBC NEWS