A letter to the Chancellor
iCG Honorary President sent a letter to John Healey, Chancellor of the Exchequer on the eve of the Budget
Dear Chancellor,
I recognise that you face many difficult choices in the forthcoming Budget. There are
competing demands on every pound of public money, and no shortage of urgent priorities.
But social care must be among them.
The Prime Minister, Andy Burnham, has spoken passionately about his determination to
reform a system that has defeated successive governments. I warmly welcome that
ambition. After almost four decades working in social care, it is encouraging to hear a
Prime Minister acknowledge the fundamental changes needed.
However, with the proposed National Care Service tied to the next Parliament and funding changes beginning in 2030, my fear is that those who need help today will once again be asked to wait.
People needing care cannot put their lives on hold. Neither can their families, unpaid
carers or the providers struggling to keep services open.
You have an opportunity in this Budget to begin making meaningful changes now.
A starting point must be to shift resources towards social care and community support,
helping people leave hospital safely when they no longer need hospital treatment.
The King’s Fund estimates that delayed discharges cost the NHS £2.7 billion in 2025/26.
That is an enormous sum tied up in hospital care when many patients would be better
supported elsewhere.
Not every delay is caused by a shortage of social care, and that expenditure cannot all be
released overnight. But surely there is a compelling case for redirecting a proportion of
resources into services that prevent unnecessary admissions and help people return
home, or move into appropriate care, sooner.
That requires investment upfront, clear responsibility and the removal of bureaucracy that prevents health and care services working together.
Give local authorities the resources to commission care at sustainable rates. Enable
providers to plan, recruit, and retain staff. Make it easier for the NHS to use the capacity
and expertise available in care homes and home care.
We cannot fix the NHS without fixing social care. Your Budget should put that principle intopractice.
There is also an immediate opportunity to help struggling providers through the tax system many of whom are small family businesses.
The Government has recognised the importance of pubs and other community businesses through targeted support. I welcome that recognition. But care providers are essential to their communities too. Why should they continue to struggle without comparable attention?
Please address the burden of irrecoverable VAT. Although qualifying care services are
exempt from VAT, that generally means providers cannot recover the VAT paid on the
goods and services needed to deliver that care. Exemption does not remove the cost; it
leaves it embedded in providers’ bills.
A targeted VAT recovery or relief mechanism could help money go further towards care,
staffing, and maintaining services. I urge the Treasury to examine a practical, fair solution
in this Budget. After all social care contributes over £77bn to the economy and for every £1 spent in the sector it contributes £2.40 in wider economic and societal benefits.
After more than three decades of promises, reviews, and postponed decisions, we need
evidence that this Government will act differently.
Investment in social care can improve lives, relieve pressure on hospitals, and reduce
avoidable costs across public services. There is a potential prize worth billions, but
achieving it requires the Treasury to look beyond individual departmental budgets and
consider what works for the country as a whole.
Chancellor, please make this the Budget that begins turning the Prime Minister’s ambition into action.
Support providers now. Invest in community care now. Begin the reforms now.
Social care must no longer be an afterthought. We need action this day.
Yours sincerely,
Mike Padgham
Honorary President, Independent Care Group
Executive Chairman, Saint Cecilia’s Care Group
