National Care Service

Damian Hinds Excerpts

Thursday 15th October 2026 Commons Chamber

[Damian Hinds (East Hampshire) (Con)]

I thank the Minister for advance sight of her statement. I join in what she said about Sir David Amess. Today, again, we remember his service and remarkable contribution to Parliament and public life, including through today’s Children’s Parliament.

In my lifetime, life expectancy has risen by almost a decade. That is wonderful, but as the Minister said, it means that many more people now need care for extended periods—sometimes very extended periods—and that number is only likely to grow. It is imperative for society to address this issue, and it is imperative for us as politicians to find a system that is compassionate, sustainable, affordable and fair. So much the better if we can find common ground across the House on this subject, because a sustainable approach can survive multiple changes of Government. We will approach this subject constructively and positively.

I was surprised to hear the Prime Minister announce fundamental and apparently fixed parts of this policy at the Labour party conference. What are the implications for the Casey review? We do not yet know what the big conversation on care will yield. Is the noble Baroness free to make recommendations that may not fit the model that the Prime Minister has announced?

Apparently, the Prime Minister managed simultaneously to set constraints and to omit a huge amount of practical information that people need. I think one could say charitably that today’s statement adds limit detail to what he set out. Given the use of the phrase, “national care service”, people may understandably be thinking of something more comprehensive than is being proposed, for this is not about all the costs of long-term care. It is not about what, for many people, is the biggest part: residential care. It is only about personal care. Terms like “personal care” and “social care” often get conflated, but the two things can be different, so what is the Government’s definition of what this service is to cover? The statement on the Government website says that the service will be based on need, rather than ability to pay. Does that mean that they do not envisage a fixed contribution for those in a care home, as in Scotland? Is this instead about meeting the cost of individually assessed needs? Will there be any changes to continuing healthcare or funded nursing care?

Half of those receiving local authority long-term social care support in the community are working-age adults, and we assume that what the Government have said about staff also applies to this important part of the care sector, but what else applies? Speaking of staff reforms, the Prime Minister spoke about integrating the care and NHS workforces, but how is that to work in care, which is overwhelmingly in the private and voluntary sectors?

The Government’s statement also says that this system will be

“introduced in phases, so its scope can grow as the savings increase from adjusting the Triple Lock, and as workforce and provider capacity are built up.”

Is spending on the national care service dependent on savings being made from the triple lock? Those are not currently budgeted costs, so the definition of “savings” is itself an interesting one. Does the Minister clearly commit to no new taxes or borrowing under this plan? The part about allowing capacity to be built up suggests not only a transfer of costs from individuals to the state but also a net increase, so how much of a net increase in provision are the Government projecting?

There is one change that it appears may affect the cost of being in a residential care home. The Prime Minister said that no care charges would be paid out of people’s basic state pension. That seems to imply an end to payments from income for care home residents below the lower capital limit down to the weekly personal expenses allowance. Is that interpretation correct?

When she answers, please will the Minister not just say, “These are all details for the Casey review,” because the Government cannot have it both ways. Personal care costs are closely linked to these other aspects of the system, and if the Government had wanted to allow space for the commission to look at the system in the round, they could have done. If they had really wanted to allow time to develop a cross-party consensus on the structure, they could have done. The Government themselves call what the Prime Minister set out at the party conference

“a clear plan to fix the system”,

so please can we have these answers?

[Alison McGovern]

I thank the shadow Health Secretary for his response. I will try to respond to his questions, but if I miss anything I will follow up in writing afterwards. Let me say to him that he is absolutely right that while politics is what it is, as much as possible we want to work across the House on this issue. For that reason, I would be very happy to meet with him regularly to discuss this.

The right hon. Gentleman asked whether Baroness Casey is free to consider issues as she wishes. She obviously has terms of reference, but my personal experience of Baroness Casey is, just you try stopping her having opinions about anything she wants to have opinions on! We are obviously working closely with her. I have met her a number of times and was really pleased to welcome her to my constituency too.

What we mean by personal care is help using the toilet, cleaning, having a shower and so on—

[Damian Hinds]

Cleaning?

[Alison McGovern]

Cleaning oneself. I will happily pick up the question that he raised with me in writing.

On continuing healthcare, there are a number of ways in which, as was the case under the previous Government, the interface between NHS funding and social care funding really matters—not least the better care fund and continuing healthcare. We continue to look at those, and I will happily discuss them. There are improvements we can make in the short term that will help, even as we wait for the Casey review next summer. Likewise on integration with the NHS, Members across the House will all know of good examples where, because of collaborative working on the ground, we see systems that are well integrated. The problem is that that is due to good fortune and good relationships rather than a system and structure that enables it.

The right hon. Gentleman asked about taxation. That is a matter for the Chancellor. We will have the Budget shortly, and I am sure that there will be many questions asked of the Chancellor. He asked me a couple of other questions that I did not quite catch, but I will review them and write to him.