Social care commissioner warns of ‘moment of reckoning’ as unpaid carers prop up fragmented system
The government’s independent review into adult social care highlights systemic failures and bureaucratic burdens facing millions of unpaid carers across the UK.
Louise Casey, the UK government’s social care commissioner, has issued a stark condemnation of the adult social care system, stating that millions of unpaid carers are “living in agony” while sustaining an outdated and fragmented model. Speaking at a Carers UK conference in London on Thursday, Casey criticised the current reliance on predominantly female unpaid carers to plug service gaps, describing the system as unsustainable and likening its operation to that of 1948 rather than 2026.
Casey, who is leading an independent review of adult social care commissioned by the Labour government in January 2025, warned that the system faces a “moment of reckoning” due to an ageing population and rising numbers of people living with chronic conditions such as dementia. She argued that the model depends on female carers and poorly paid care workers to hold the system together until they reach a crisis point, a dynamic she stated could no longer continue.
The commissioner highlighted that carers are frequently forced to navigate complex bureaucratic hurdles, often spending more time managing administrative issues than caring for their loved ones. Casey cited specific examples of systemic failure, including elderly parents in their 70s carrying their 40-year-old disabled sons upstairs to bed, and carers fearing that asking for help will make their lives worse rather than better.
Carers often feel like “unpaid project managers,” trying to figure out what is happening within a system where every agency has its own rules and interpretations. Casey noted that these variations are placed on the public’s plate, effectively making the navigation of the system the public’s problem rather than the government’s. She stated that the experience of being a carer can be tiring, uncomfortable, repetitive, distressing, and downright frustrating.
There are an estimated 5.8 million unpaid carers in the UK, with 1.7 million providing 50 or more hours of care a week. Approximately 60% of unpaid carers are women, and the economic value of unpaid care is roughly £184 million. The first report from Casey’s two-stage review, aimed at delivering the government’s manifesto commitment to create a national care service, is expected to be published later this year.