This one is time sensitive, so I will come straight to it.
On 29th July, Baroness Casey launched the Big Conversation on Care, part of her Independent Commission on Adult Social Care. It asks the public what a future National Care Service should be: who it should support, what families can reasonably be expected to do, and how we pay for it. More than 350,000 votes have already been cast.
The first online phase closes this Wednesday, 23rd September, and the platform will not reopen until the new year. New proposals can no longer be submitted, but you can still vote on what others have put forward, and it takes minutes.
Why this is more than another consultation
To understand why I am making a fuss, it helps to remember how we got here.
Andrew Dilnot delivered his report on the funding of care and support in July 2011. It was clear, costed and broadly welcomed. Fifteen years on, its central recommendation, a cap on the care costs any one person can face, has been legislated for, delayed, delayed again and finally scrapped in 2024 without ever taking effect.
The reason is not that the problem is misunderstood. It is that politicians have learned to fear it. In 2010, Labour’s plans for a National Care Service were branded a “death tax” before they got anywhere near the statute book. In 2017, the Conservatives’ own manifesto proposal was labelled the “dementia tax” and abandoned within days. Two attempts, two humiliations, and one lesson absorbed by everyone in Westminster: touch social care and it will hurt you. Since then the pattern has been the one Baroness Casey described at the launch: “crisis, promises of reform, another review, and then retreat, while the people who need care, and their families, bear the brunt.”
Insequa has had a front row seat for most of this. We have worked with hundreds of care providers over more than 14 years, and the story they tell us has barely changed. Fees that do not cover costs, ongoing recruitment challenges, regulatory demands that rise while funding does not. Above all, a sense that the sector is an afterthought in Whitehall. The government department responsible for it did not even have social care in its title until 2018, and the person in charge is still routinely referred to as the Health Secretary, as if the second half of the job title were optional.
That is the background against which the Casey Commission should be judged. For the first time in 15 years, somebody with a serious mandate is putting the hard questions to the public directly, and doing it before the answers are drafted rather than after. Previous reforms failed because they tried to settle the difficult issues without first building public consent. This one is trying to build the consent first. If the sector does not turn up, the picture the Commission forms will be built from whoever did.
This is not a consultation to observe. It is one to join.
I understand the scepticism. We have been consulted before and watched the findings gather dust. But the questions being asked this time are the ones we have always said were dodged. Ducking them would be a strange response to years of complaining that nobody asks.
Two things to do before Wednesday
The first is easy. Vote, before 23 September, at caseycommission.co.uk/bigconversation/take-part. You work inside this system. You see what it does well and where it fails people, and your view is worth as much as anybody’s.
The second matters more, and it is harder. Make it possible for the people you support to take part. Read the proposals aloud at a coffee morning. Sit with somebody and go through them properly. Ask a relative to help. There is an Easy Read guide to the platform on the same site. The people with most at stake here are often the least likely to find an online voting platform on their own, and we are the ones standing closest to them.
The Big Conversation runs until April 2027 and the Commission’s recommendations are due next summer, so there will be other chances to contribute. But this phase closes on Wednesday, and how many of us showed up will be part of the record.
We have spent a long time asking to be listened to. Somebody is finally asking. Let us not be quiet.
