Public backs change to social care system, Health Foundation polling finds
New polling from the Health Foundation and Ipsos shows strong public support for reforming social care but a lack of consensus on how to pay for increased funding.
New Health Foundation and Ipsos polling supports the prime minister’s diagnosis that the current social care system does not work for the public.
The polling – which was carried out before Andy Burnham became Prime Minister – finds that the public is pessimistic about the current social care system. Four in ten people (40%) think that the standard of social care got worse over the past 12 months, and only 4% think it got better. Just 9% of people believed the government had the right policies for social care at the time the survey was carried out.
As the Casey Commission begins its ’Big Conversation’ on the future of social care in England, the polling finds misconceptions about the current system. Fewer than half of the public in England (44%) correctly understand that social care is not generally free at the point of need, while 39% incorrectly believe that it is. A third (34%) mistakenly think the NHS provides most social care for older people. These findings reinforce Casey’s view that previous attempts at major reform have failed due to a lack of public understanding and consent.
Our previous research has shown that an overwhelming majority of the public support a greater role for the state in funding social care, which remains a high priority for increased public spending, behind only the NHS and defence. But the new polling shows views are mixed on how to fund additional investment, underlining the political challenge facing Casey and Burnham as they seek to build the broad political consensus needed to deliver reform.
An additional tax earmarked for social care and reducing spending on other public services are the two most popular options from those presented, each supported by 23% of the public. Other options attract lower levels of support, including increasing income tax (16%), inheritance tax (15%) and National Insurance contributions (14%). Around one in five people (18%) do not think the government should increase spending on social care.
Views also differ by political affiliation. Support for a dedicated social care tax is higher among Labour voters (32%), but there is less support among those voting Green (18%) and Reform UK (20%), with Conservative voters (25%) aligned with the public overall. Conservative voters are more likely to favour reducing spending on other public services to fund social care (30%), with Green (22%) and Reform UK (26%) voters more aligned with the overall public view. Labour voters show less support for this option (13%).
With Burnham having raised concerns about taxpayers’ money being used to subsidise the profits of private providers, the survey also found that just 5% of the public think care providers should be private, for-profit companies. While there is a clear preference for social care to be provided by non-profit or state-owned organisations, 85% of care homes in England are currently run for profit, underlining the scale of change that would be needed to reverse this and the important role of the ‘Big Conversation’ in discussing trade-offs with the public.
In contrast to social care, public perceptions of the NHS have continued to improve, with pessimism at its lowest level (34%) since our polling series began in 2021. However, confidence remains fragile and the public continues to prioritise improving A&E waiting times (36%) and easier access to GP appointments (35%) over improving waiting times for routine hospital treatment (28%), the government’s top priority under Sir Keir Starmer.
Lucinda Allen, Senior Policy Fellow at the Health Foundation, said:
'Our findings suggest there is a significant gap between the social care system people want and the one that exists today. People remain deeply concerned about the quality of care, and many continue to misunderstand how the current system works.
'With care mainly provided by for-profit companies, the fact that only 5% of the public think this is how most care providers should be owned is striking. Attempting to reverse this would be expensive, time consuming and cause major upheaval in the sector, so needs to be carefully weighed against other priorities for improving care or alternatives like stronger regulation of providers.
'With many people going without the care they need and strain on the system high, Andy Burnham rightly wants to move quickly with reforming social care. The Casey Commission's Big Conversation provides an important opportunity to build public understanding of the current system and explore the trade-offs involved in reforming it. Meaningful social care reform will require state investment, but the cost of inaction for people who need care and their families is substantial, so the Prime Minister is right to put his political capital behind it.'