The Budget and Beyond: Finding a Sustainable Funding Model for Care

In a candid and deeply informed discussion, Damian Green, Chair of the Social Care Foundation and former Deputy Prime Minister, explores why social care funding has repeatedly failed to reach the top of the political agenda, and what a genuinely sustainable model might require.

Grounded in lived experience, policy history, and cross‑party insight, the session goes beyond short‑term budget fixes to examine how care is paid for, who bears the risk, and why avoidance has become the default political response.

Key themes explored

1. Social care’s “quiet crisis”

Social care has remained politically marginal for decades, not because it lacks importance, but because:

• Its impact is concentrated among fewer voters at any one time
• Responsibility is fragmented across local and national systems
• It lacks a single, unified voice

The result is chronic underfunding, masked by the extraordinary commitment of people working in the sector.

2. Why sticking‑plaster funding doesn’t work

The current approach, annual top‑ups through local government settlements and short‑term grants, is acknowledged as:

• Insufficient
• Inefficient
• Unsustainable

Each year buys time, but not stability. The underlying funding question remains unanswered.

3. Two unavoidable funding truths

At its core, the session makes one unavoidable point:

care must be paid for, either collectively, individually, or through a combination of both.

The discussion explores:

• Tax‑based approaches (including revisiting a health and care levy)
• Insurance‑style models that spread risk across the population
• The role of personal savings and housing wealth
• The need for generational fairness

No option is presented as painless, but inaction is framed as the most damaging choice.

4. Learning from pensions reform

A key comparison is drawn with pension auto‑enrolment:

• Initially controversial
• Politically risky
• Ultimately successful

The suggestion: care funding reform may require similar long‑term thinking, normalising preparation for care needs in the same way we now prepare for retirement.

5. Commissioning for outcomes, not activity

The session challenges one of the system’s most entrenched problems:

• Providers are paid for volume, not results
• Supporting independence can reduce income
• Prevention is financially penalised

A shift towards outcomes‑based commissioning is proposed, rewarding providers for improved independence, reduced hospital admission, and sustained wellbeing.

6. Workforce status and sustainability are inseparable from funding

Funding reform is linked directly to:

• Fair pay and professional recognition
• Career progression visibility
• Retention and domestic workforce growth

Care is framed as skilled, responsible, and life‑shaping work, not a minimum‑wage occupation, requiring funding models that reflect that reality.

7. The need for a unified voice

One of the strongest messages is the absence of a single, authoritative voice for social care:

• Providers are fragmented
• Messages to government are inconsistent
• Influence is diluted

The case is made for:

• A stronger, unified sector body
• Clear, shared principles
• Cross‑party engagement that reduces election‑cycle weaponisation

Watch the full discussion to hear a rare, unfiltered perspective on why reform has stalled, and what it will take to move beyond short‑term fixes towards a funding model that is fair, credible, and sustainable.