You can’t fix the NHS without fixing care – this spending review proves the government still doesn’t get it

12 June 2025, 09:59

By Jonathan Byrd

The Chancellor’s Spending Review was delivered with a clear sense of urgency about the future of public services.

With almost £30 billion of further funds directed to the NHS and a 3% annual real-terms rise for health, there is no question that healthcare remains a top priority for the government.

Broadly, I welcome this. However, there are systemic and strategic issues at the heart of the NHS that have still not been addressed, and the age-old political strategy - whichever colour rosette you wear - of pumping more and more money into the NHS, which is struggling across the board, seems to remain de rigueur.

The provision of care for the elderly, severely disabled, and those living with life-altering diseases and conditions like dementia was conspicuous through its absence from the Chancellor’s comments.

The care sector is on its knees, owing to a wide range of challenges, from rises in employers’ national insurance, a workforce crisis and the inescapable reality that Britain’s population is ageing - and living - longer than ever before.

For those of us working in the care sector, the announcements also laid bare a persistent and troubling gap in policy thinking—one that risks undermining the very system the government seeks to strengthen.

Health and social care are not separate worlds; they are intimately connected. When hospitals are full, when beds are blocked, when patients can't be discharged safely, it is often because care in the community isn’t adequately funded or staffed.

What we urgently needed from the Spending Review was a clear commitment to growing and supporting the care workforce, both professional and unpaid.

Attracting new talent into care roles and retaining experienced professionals depends on providing career progression, training opportunities, and most of all, fair pay. Care workers remain under-rewarded for work that is deeply skilled, emotionally demanding, and essential to the fabric of our society. While investment in the NHS workforce is welcome, the absence of parallel measures for social care risks deepening an already critical staffing crisis.

Moreover, the prevailing sentiment in government towards carers seems to, on the face of it, belie a lack of understanding at best towards the “unskilled workers” as Yvette Cooper characterised these hard-working professionals, in the context of migrant visa issuance.

We also needed recognition of the distinct challenges regulated care providers face. The government has rightly prioritised digital transformation and improved oversight in other sectors, but care providers must be part of that conversation. Without adequate funding for compliance, technology, and governance, we limit the potential of regulated home care to deliver safe, sustainable services at scale.

And then there are the millions of unpaid carers across the UK. Family members, neighbours and friends, who provide extraordinary support behind closed doors. They deserve recognition and political attention. Whether it’s through respite care, mental health services, or direct financial support, a more ambitious plan to support unpaid carers would not only honour their contribution but also help prevent burnout and breakdowns in care.

Estimates suggest there are well in excess of 7m unpaid carers across the country, many of whom have to give up their careers, and struggle to secure any kind of sufficient government support when they are caring for loved ones.

The Chancellor spoke of rebuilding Britain and delivering change that people feel in their everyday lives. There is no more tangible place to begin than care, where compassion meets necessity, and where the impact is felt not in headlines, but in homes.

The Spending Review sets the tone for how the government is going to spend its (our) money. What matters now is whether the government will ensure that care, in all its forms, is finally given the central role it deserves in the national recovery and long-term strategy, that the Labour Party says is focused on delivering for all of us.

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Jonathan Byrd is Managing Director of The Good Care Group.

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