Select committee: Health and Social Care Committee
Recommendation 27
2nd Report - Adult Social Care Reform: the cost of inaction
Published 5 May 2025
Addressed to Department of Health and Social Care
Health and Social Care Committee Adult Social Care Reform: The Cost of Inaction All items in this report Report on parliament.uk ↗ Inquiry on parliament.uk ↗
Recommendation (the committee's words)
We recommend that the Government commissions research with the aim of fully quantifying the cost of doing nothing on adult social care reform. That research should seek to quantify costs to individuals, including unpaid carers and care workers, to local authorities, to care providers, to the NHS and to the economy. Cost is not just about money, it is also about non-monetary personal costs, including individual wellbeing across these specified groups. This research should be completed ahead of the final report of the Casey Commission, to enable a full cost-benefit analysis of 57 any recommendations she puts forward and to ensure that the Government can start building the public and political support it will need to guarantee the longevity of reform. The moral case for reform has never been stronger, but this must be accompanied by a robust financial case. Without this we fear that the reforms that come out of the Casey Commission will be doomed to failure, leaving everyone continuing to suffer under the current unsustainable system. (Recommendation, Paragraph 137) 58
From: Health and Social Care Committee, 2nd Report - Adult Social Care Reform: the cost of inaction (HC 368), 5 May 2025
Government response
The government responded to the whole report on 9 July 2025 (deadline 5 July 2025).
Summary written by Accountability Index from the government's response. It is not the government's own words.The government shares the committee's view that adult social care is under significant pressure and needs reform, responds to each recommendation, and says it does not accept some, including a new cross-government impact assessment, while referring others to the independent commission led by Baroness Casey.
- On unmet need, the government says it would be "challenging to publish an annual assessment of the level of unmet care needs", citing limitations in existing data and the complexity of defining care needs.
- It says it "does not, therefore, accept" the recommendation for a new cross-government impact assessment on workforce policy changes, preferring existing impact assessment procedures. It also does not intend to commission a dedicated study of the cost of inaction, and does not think a separate growth strategy for the sector is "proportionate or necessary".
- On the Fair Pay Agreement, it will "begin the Fair Pay Agreement consultation this year", with secondary legislation and the negotiating body to follow in 2026. It is committed to establishing the first agreement within this Parliament.
- It agrees that publishing delayed discharge cost estimates would "in principle" improve transparency, and will "explore how best to publish cost data" with caveats. It will set out the Better Care Fund approach for 2026 and beyond "in due course".