If Javid expects families to do all the work, social care is not being ‘fixed’

“We shouldn’t always go first to the state. What kind of society would that be,” health secretary Sajid Javid asked the Conservative party conference this week. “Health and social care begins at home. It should be family first, then community, then the state.”

The idea that the British public need to be lectured into caring for their own family will be news to the more than 9 million people who are already unpaid carers for their loved ones. As it will to the additional 4.5 million people who have started caring unpaid since the start of the pandemic. This country’s reliance on family carers is so extreme that we even expect children to do it.

It is a brazen insult to these families to imply they need to do more. Many have been pushed into poverty as a result of giving care and are struggling with their mental or physical health. Countless others are racked by guilt because they can’t help their loved ones, either because they live too far away or are too old or disabled themselves to cope with caring demands.

Javid’s comments are not simply offensive – they are a worrying sign about the future of social care. It is worth reflecting on what Javid’s speech means: the health secretary believes that government should not take overall responsibility for health and social care. That is not a minor thing. It is a radical rewrite of the social contract, and an abandonment of basic ministerial duty.

Last month, Boris Johnson’s social care plan gave minimal extra funding to the sector, and no word on how to meet unmet care needs. Javid appears to see himself as building a repackaged “big society”, where the market and individuals rule supreme, the state collects rising taxes but delivers little more for it, and disabled and older people will be cared for as long as they do not expect the state to do it.

It isn’t “fixing” social care for the government to tell families to do the care themselves. It is passing the buck. Why bother solving staffing shortages or unmet care needs when you can just shift the burden on to the public?

Putting the burden of care on individuals rather than the state is clearly ideological, but it has real consequences. It leaves those without family – or those without family with flexible jobs or who live nearby – alone. It creates a mental and physical health crisis, where unsupported relatives give 24/7 care. It perpetuates gender inequality; 72% of those who receive carer’s allowance are women. A call for care “to begin at home” is really a call for women to go out to work all day, fitting in care on top. Or to quit their careers altogether and labour at home for free. Javid can implore for “care to begin at home” because wealthy men such as him will never have to do it.

Above all, “family and community first” rhetoric underpins a system where disabled and older people are expected to rely on piecemeal charity rather than a dignified entitlement.

There is a reason modern societies ditched Victorian-era philanthropy and built infrastructures to deliver care when we’re sick or old. A well-funded social safety net provides security and dignity, something that even the most loving individual will struggle to. Family and friends will always be part of the care system but they should never be its centre. Similarly, care should be undertaken out of choice because it suits both the care giver and user, not out of desperation because public services are underfunded. A young disabled man wants a personal assistant to help him to the pub, not his mum; just as an elderly woman deserves to go the toilet when she needs, not when her daughter can rush back from the office. That’s what their taxes pay for, as do the taxes of their unpaid carers.

Javid asks what kind of society it would be if we turned first to the state for help. But the real question is surely, what kind of society it would be if the state didn’t help us. For too many years, family carers have been the backbone of this country’s broken care system. Javid’s comments suggest there is no reprieve in sight. There’s only one group failing to take responsibility for social care: the Tories.

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