‘I have no problem with providers, whether they’re public sector, not-for-profit or private. I think there's a strong case for diversity.’

Sir Ed Davey

Sir Ed Davey is clearly looking forward to the cross-party discussions planned for restructuring social care arrangements across the United Kingdom. It's good to see Andy Burnham taking such an open approach to resolving this major challenge.

As The Sunday Telegraph reported last week, there is projected to be a ‘demographic time-bomb’ by 2072, with over 22 million people (that's 27% of the then population) aged over 65 compared with 7.5 million, or 13%, one hundred years earlier. And whereas ‘free at the point of use’ Attlee-an universality became the increasingly dysfunctional standard for health care since the Second World War, there is no equivalent for social care.

Now we face the dual problem of a hopelessly expensive and inefficient health care service together with the urgent need to address the chaotic state of residential care for the elderly, where 85% of today’s 18,000 care homes are operated by ‘For-Profit’ providers. The New Economics Foundation discovered that these companies, largely run by Private Equity, had taken about £250 million in profits over three years in just three English regions.

A solution needs to be found urgently: but, as Ed Davey says, not by attempting to replicate the dysfunctional NHS model. A proper system of regulation and appropriate funding is required, but not another attempt at state monopoly.

The diversity for which Ed Davey calls should certainly include re-activated involvement from charities, including the Church of England. The Church Times editorial on 31st July hoped that Andy Burnham had received a copy of its 2023 report ‘Reimagining Care’, endorsed by the General Synod in February ‘26. One of its authors, Dr. Anna Dixon, is now a Labour MP, and the editorial drew attention to the importance of ‘social prescribing community activities, many run by churches, that support older people and those with dementia’.

More recently, at the July 2026 General Synod, a Private Member’s Motion calling for greater focus and action on behalf of young people in care was passed unanimously, tabled by Billy-Jo O'Leary from Rochester. This was encouraging news for those hoping to see more reliable points of reference for adult care leavers, and it’s further evidence of a welcome, more outward-looking approach.

Diversity provides choice: and choice is essential in order to keep care homes for the elderly efficient and focused on the needs of their resident customers. If old people are simply viewed as a burden on the state to be kept out of sight and out of mind, that is an awful indictment on our society.

The problem is that, as a senior citizen, it is too easy to fall into the routine of becoming a couch potato, particularly as families become nuclear in character and generations become more vertically-stretched. So, we need to start with re-planning the process of old age. Here are some suggestions:

  1. There needs to be a training programme for how to look after yourself — and others — post-retirement. We spend years preparing young people for their working lives, but there’s no equivalent preparation for the years, potentially decades, of old age;
  2. There needs to be encouragement for families to take more interest, and to become more involved in the lives of their senior generations;
  3. The mind needs regular exercise, not just watching TV. This could be 2-3 hours a week spent writing commentaries like this — or writing your memoirs (never mind if no-one reads them!); or, if writing is not to your taste, how about a regular game such as Scrabble, bridge or chess?
  4. The body also needs regular exercising: stretching exercises first thing in the morning, because your tendons shrink overnight thereby pulling together all your joints, and a safe way to exercise your muscles and lift your heart rate, such as on a rowing machine.

The problem is that if you don't use your mind and body each day, you are at greater risk of losing them. That's no fun for you, and it's simply increasing the risk of you being treated as a burden by everyone else (including the state) rather than an asset.

Then you need to be presented with a choice of social care provision, bearing in mind all the above: but what about the need for a better organised system of financing it? 

We should start by challenging the whole basis of ‘free at the point of use’ universal care and that, of course, includes the NHS. Government financial support should be targeted for those who need it, not applied universally. For the NHS, this means that people who are able to afford private health insurance should be required to have it, and keep it going throughout their old age; when they use NHS services, those costs should be covered by their private health insurers. This will also encourage people to keep fit and healthy in order to minimise the cost of their insurance premiums.

For social care, the state should provide vouchers for those in need of publicly-funded support, based on a means-tested process covering both income and assets (including property). Families should be encouraged to stay much more involved in the provision of social care, and a system by which they are reimbursed — either through the voucher system or from their elderly relative’s financial resources — should be introduced.

Regulation of these processes should be the Government's main priority, with a proper system of Powers of Attorney in place, provided by Local Authorities if not available from the family itself.

Finally, care must be taken not to permit these processes to further disadvantage younger generations. With this in mind, the Government should place a high priority on introducing a constitutional hypothecation of Inheritance Tax receipts. These so-called ‘death taxes’ should not be used to fund social care for old people, but they should be ring-fenced for targeted support for disadvantaged young people; thereby enabling the human life-cycle to provide proper support for inter-generational rebalancing.

So, there are our recommendations for the cross-party working group on social care: ensure that diversity and choice feature strongly, albeit properly regulated by a body with powers equivalent to the Financial Conduct Authority; draw a line under the past 75 years of universality for the health service and, going forward, for social care; provide targeted support only for those who really need it; and bring into being a proper system of inter-generational rebalancing, based on the hypothecation of inheritance tax receipts.

Gavin Oldham OBE

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