To mark the 70th anniversary of the NHS, the BBC asked the Health Foundation, Institute for Fiscal Studies, The King’s Fund and the Nuffield Trust to look at five central issues currently facing the NHS. These issues are the relative strengths and weaknesses of the national health service, its funding, the state of social care, the public’s expectations of the NHS, and the potential of technology to change things in the future.

This is the second of five briefings intended to inform and encourage a national conversation about the past, present, and future of the NHS. The briefings are supported and informed by opinion polls that looked into these five issues that are currently relevant to the NHS.

Key points

  • The social care system is also 70 years old this year but unlike the NHS, its anniversary will pass largely unnoticed. The fault-line established 70 years ago between health care which is free at the point of use and social care which is means-tested, remains a fundamental source of inequity and unfairness today.
  • The current social care system is not fit for purpose and is letting down service-users, families and carers, as vulnerable older and disabled people fall through a safety net riddled with holes.
  • An ageing population and increase in the number of younger adults with disabilities is pushing up the cost of caring for older and disabled people, placing the social care system under huge strain. Based on current spending, a funding gap of £18 billion will open up by 2030/31.
  • Despite 12 green and white papers and five independent commissions over the last 20 years, successive governments have ducked the challenge of social care reform. This time, the Prime Minister must live up to the promise she made to ‘act where others have failed to lead’ by delivering substantial and wide-ranging reform.
  • The social care system is complex, poorly understood and widely perceived as unfair. Reform will require an uncomfortable process of public education and political collaboration.

Further reading