A recent report by the House of Lords Adult Social Care Committee has shed light on the “invisible” nature of adult social care, highlighting the lack of understanding and recognition it receives from the public, media, and policymakers. The report argues that this invisibility has led to underfunded services, an undervalued and underpaid workforce, and a system that is often only seen in relation to its impact on the health service, rather than its intrinsic value.
The committee’s findings cite several examples, including former Secretary of State for Health and Social Care, Jeremy Hunt, who described the invisibility of adult social care as deeply ingrained in society. A survey conducted in November 2021, which involved 1,561 unpaid family carers in the UK, revealed that over 90% of them felt ignored by the government. The report also highlighted a limited understanding among the public, who mistakenly believed that future care would be funded through taxation and had not considered their own care needs.
During the pandemic, the immediate focus of many countries, including the UK, was on acute hospital care, which resulted in adult social care being overlooked. This had devastating consequences for individuals and the well-being of care workers. While hospitals received extra funding and personal protective equipment (PPE), social care staff were initially neglected. Restrictions on visitors to care homes further isolated residents, including those with dementia, denying them the opportunity to see their loved ones.
The report reveals that the prioritisation of health over social care stemmed not only from a desire to protect hospitals during the crisis but also from a failure by policymakers and society at large to understand and value social care as an essential service. In England, the government faced severe criticism for discharging individuals from hospitals to care homes without initially testing them for COVID-19, inadvertently spreading the virus to vulnerable populations. Sweden’s initial emphasis on advice and guidance was criticised for being “too little, too late” in protecting older and at-risk groups. In the Netherlands, the focus was primarily on hospital and intensive care capacity, neglecting the quality of life of frail or disabled individuals and the well-being of care workers.
The invisibility of social care was further exacerbated by long-term neglect, including funding cuts and delayed reforms. In England, the House of Commons Public Accounts Committee highlighted years of inattention and a negligent approach by the government in supporting the sector during the pandemic. Chronic underfunding, fragmentation, staffing shortages, and inadequate support were also exposed in Sweden. In the Netherlands, the expert committee advising the government lacked social science input, leading to a focus on clinical issues and shortages of PPE in social care settings.
While the pandemic brought greater recognition to the challenges faced by adult social care, policies and media coverage often failed to consider social care in its entirety, focusing predominantly on care homes and services for older people. The experiences of disabled individuals of working age and community-based services supporting independent living were often overlooked. Consequently, care packages were reduced or cancelled, day centres and respite units were closed, and personal assistants providing care were unable to access PPE.
The report emphasises the need to value social care as a social and economic investment in society, rather than viewing it as an expense to meet basic needs. It suggests raising the profile of adult social care within health services, promoting interprofessional education, and building stronger community-oriented and strengths-based support systems. The report also calls for long-term government action, including realistic funding settlements, workforce strategies, and the establishment of a national commissioner for care and support to amplify the sector’s voice and identity.
Ultimately, the goal is to transform the perception of social care and recognise the essential role it plays in enabling individuals to lead meaningful lives. While the challenges of achieving this vision are significant, the report suggests that the pandemic has created an opportunity to understand, value, and reform adult social care for the better.
