National Care Service

Caroline Nokes Excerpts

Thursday 15th October 2026 Commons Chamber

[The Minister for Social Care and Mental Health (Alison McGovern)]

With your permission, Madam Deputy Speaker, before I make a statement on the creation of the national care service, I want to pay my own tribute to Sir David Amess and his family. We are all thinking of them today, and I am reflecting in particular on how much Sir David gave to this House.

It is in the news this week that Audrey Joughlin is celebrating almost 80 years of service in the NHS. This remarkable lady has been working in the NHS since the day it was founded in 1948, and today she is volunteering at the Royal Liverpool hospital. I want to also wish a happy birthday to my constituent Vibeke Nicklin, who is turning 80, having spent 60 years as a nurse caring for patients.

When I read about these women, I feel nothing but pride; to know that they are from my home town in Merseyside just about makes my heart burst. These incredible women show what a wonderful thing it is that people are living longer—more grandparents are living to see their grandchildren as adults—but it also sets a test for our generation of politicians. When Audrey began her career, there were fewer than 6 million people aged over 65 in the UK; today, that figure is over 13 million. According to the Office for National Statistics, by 2050, 18 million people will be aged 65 and over; the number aged 75 and over will rise to more than 10 million; and the number aged 85 and over will have doubled. As the Prime Minister said yesterday, we cannot turn away from the question of social care. People who depend on care deserve better, and the dedicated staff deserve better, too.

This issue of social care has often been overlooked for two reasons. The first reason is who does most of the care. I can explain this simply in three words: working-class women. Working-class women never get a fair hearing in this country, but those in social care need to be heard right now. The second reason is what happens to people when they experience a failing care system. It is not that people do not like talking about getting old; too many people who go through our care system are traumatised by the experience, and it is too hard for them to talk about it. As the Prime Minister said at the Labour party conference, social care workers often feel invisible. Who can blame them, when 80% of care workers working for independent providers receive within 10% of the minimum wage?

We are all looking forward to the findings of Baroness Casey’s important review, but the truth is that we cannot afford to wait for her to finish that work before getting on with the job. Ask any family who have gone through the nightmare of trying to sort out care for their loved ones—the status quo cannot be accepted. Beyond the immediate impact on families, the NHS is paying the price of our failure to get a grip; hospitals are dealing with 999 calls from a failing care system, and we have the appalling spectacle of corridor care in hospitals across the country. If we carry on like this, our broken social care system will break the NHS, too. We cannot let that happen.

We on the Government Benches remember that we were elected on a manifesto that said that we would build a national care service, improve the lives of the people who draw on care, and build a system that puts people before profit, and we are already working hard to deliver Baroness Casey’s early recommendations, whether on motor neurone disease, dementia or safeguarding. That is why the Prime Minister has taken the decision to build a national care service, with free personal care, adjusting the triple lock to make it possible. Baroness Casey will report next summer; meanwhile, we will prepare the ground now for the new service.

I am sick of people looking down their nose at social care staff, who do a highly skilled job that could provide the young people of this country with a great career. Yesterday, I spoke to our partners at Skills for Care about our workforce action plan. At the heart of this is a commitment not just to older generations who need care, but to younger generations who just need their chance in life. Being unemployed for any period can damage someone’s confidence, but doing a skilled job like social care can give people a sense of pride, and a pay packet they earn themselves. That is why we will offer thousands more academy places to help young jobseekers into good jobs in care, and are bringing in the first national collective pension scheme dedicated to care workers; and it is why we have already passed the Employment Rights Act 2025, which gave more than a million people—many of them care workers—access to sick pay, and raised the minimum wage. We will introduce the first fair pay agreement in adult social care, backed by half a billion pounds. It will put care workers under the protective umbrella of collective bargaining and give them the power that they deserve—not just as a one-off, but forever.

For unpaid carers, we have announced the biggest expansion to the carer’s allowance since the 1970s. We will soon appoint the first unpaid carers’ champion to be a voice for people who provide unpaid care.

For too long, social care has been a Cinderella service, with care staff held back by not having the tools they need to look after people. Recently, however, we have been making good progress. Digital social care records are helping to reduce paperwork and improving the quality of information available to staff, which is vital for good care and saving precious time. Today, I can give the House the update that digital records are now used by 84% of care providers, compared with just 72% when this Government took office, and 92% of people who draw on care are now benefiting from that modernisation.

We are supporting the adoption of preventive technology that was the stuff of science fiction just 10 years ago—home monitoring kits to identify infections early, reminders to avoid missed medication, and specialised sensors to detect and prevent falls. If we can put the best technology in the hands of skilled and emotionally intelligent people, the result will be working-age adults with self-determination, choice and independence in life, and older people at home for longer, in better health, and with a much, much better chance of dying at home, in comfort and in dignity, when the time comes. As my right hon. Friend the Secretary of State for Work and Pensions said on Tuesday,

“A good retirement…is about more than income.”—[Official Report, 13 October 2026; Vol. 791, c. 198.]

There are those who say that we cannot afford the national care service; I say that they are asking the country to pay for the cost of failure. This issue is not going away. If our response to the test of an ageing population is simply to find an even larger bucket of sand to stick our heads in, the impact on the NHS—already plain for all to see—will only grow worse.

If the decade after 2010 taught me anything, it is that we do not save money by tearing chunks out of the fabric of our society and then making the NHS pick up the pieces. Most importantly, if we improve population health, people will have a much better quality of life. I do not pretend that it is easy, but our pensioners deserve security and peace of mind. Our national care service will be better for them, families and the NHS. It will ease the pressures we see today; failings in our social care system mean that many pensioners are kept in hospital for longer than they need or want to be, because social care beds are unavailable. The cost of inaction will only be more pressure on the NHS through more ambulance call-outs, more A&E admissions, more corridor care and more people stuck in hospital when they do not have to be there.

We are at a crossroads. Our choice is: either pay the financial and human cost of the failed system that we have now, or build the national care service, stabilise our public finances and enable people to live happier and healthier lives. I urge colleagues to think of not just the consequences of inaction, but what it means for our constituents if we get this right. In place of fear, the rising population of elderly people we represent can grow old in a good society. Instead of corridor care, we would have a thriving NHS, in which unnecessary admission was prevented and people who become unwell recovered quickly and enjoyed their life. Care workers would be recognised for their work, and all of us would gain peace of mind about what happens later in life.

When Audrey began her lifetime of service to our country, she was part of a generation that left the greatest legacy that anyone could hope to build. It meant that when a person falls ill, they never have to worry about the bill. Today we have the chance to carry her generation’s torch into the 21st century, and to leave to our children and grandchildren something as significant as the creation of the NHS. We are ripping off the plaster. I commend this statement to the House.

[Madam Deputy Speaker (Caroline Nokes)]

I call the shadow Secretary of State.

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[Alison McGovern]

My hon. Friend is right that at the heart of the problems we have in the social care system are the way in which the workforce are looked down upon by others and the problems with low and uncertain pay in too many areas. We are cracking on with the fair pay agreement for all the reasons that I mentioned and that she knows only too well. It is about time that social care was seen as the great and fantastic career that it is.

[Madam Deputy Speaker (Caroline Nokes)]

I call the Liberal Democrat spokesperson.

[Clive Jones (Wokingham) (LD)]

I welcome the Minister’s statement on the national care service and thank her for early sight of it.

My Liberal Democrat colleagues and I believe that everyone deserves to be able to live independently with dignity and to receive the care they need in their own home when possible. Hundreds of thousands of people are desperately waiting for the care they need and 13,000 people every day are left stranded in hospital beds, unable to leave because their care packages have not been put in place.

One in seven people over 65 now pay more than £100,000 for their care in their lifetime. Spiralling social care costs have left many councils, such as my own in Wokingham, struggling to fulfil other basic services that residents want to see. Social care services are in crisis and have been for too long. That has been recognised for many years by Ed Davey, the leader of the Liberal Democrats and a carer himself.

[Madam Deputy Speaker]

Order. The hon. Gentleman will know that he must refer to his party leader by his constituency, not his name.

[Clive Jones]

Apologies for that, Madam Deputy Speaker.

We are pleased that the Prime Minister has recognised from his own experience that social care needs fixing. The Liberal Democrats are keen to work on a cross-party basis to fix social care. Failure to act on social care would be a catastrophe for families, for the NHS and for local services.

The Liberal Democrats have set the Government three tests for the social care reforms. First, they must put family carers front and centre, with guaranteed rights for every carer, and replace the broken carer’s allowance system. Secondly, the reforms must include a universal safety net of care, including free personal care. Thirdly, the Government must protect people from catastrophic costs so that family finances are not decimated and people do not have to lose the family home.

I am pleased that the Prime Minister committed yesterday to arranging another round of cross-party talks to fix social care. The Liberal Democrats will engage in those discussions and we urge others in the House to do the same.

--- Later in debate ---

[Alison McGovern]

I thank my hon. Friend for all she did as a Health Minister and for raising that extremely important question. It is an often overlooked fact that in end-of-life care, the members of staff who might see a person and their family the most will be social care staff. If we cannot get the NHS working together with social care for people when they are dying, we will not be able to do it at any time. That is a priority for the work that we can do before the Casey review, and I will happily meet my hon. Friend to discuss that further, if she would like.

[Madam Deputy Speaker]

I call the Father of the House.

[Sir Edward Leigh (Gainsborough) (Con)]

The average cost of a home in the Gainsborough constituency is just £204,000. Typically, someone spends three years in a care home in their lifetime, which will cost them £150,000. Everything over £23,000—the upper capital limit—is taken. All over the country that really upsets people who have contributed for a lifetime, and it is a real issue outside London and the south-east, which have much higher house prices. If the Minister is to abolish the triple lock and change it to a double lock, which most commentators think is now inevitable, will she look at this issue and either raise the upper capital limit so people keep more of their money or have a cap on lifetime contributions, which was the policy of the last Government?

--- Later in debate ---

[Alison McGovern]

I thank my hon. Friend for that contribution. He is absolutely right: people feel as if the current system is a fog, at best. It is totally fractured, and it is too hard to navigate for people already dealing with some of life’s biggest challenges. Those Co-op values are an important factor in our thinking as we move forward with the national care service. He mentioned the Prime Minister’s comments yesterday; I am glad to confirm that those are exactly the values that we want to bring to this discussion. We are trying to ensure that people are empowered and have their voices heard, and that they work together for the good of those who need care.

[Madam Deputy Speaker (Caroline Nokes)]

I thank the Minister for her statement.