At the heart of Britain’s care settlement lies a contradiction: unpaid carers are thanked for their work, while the growing responsibilities and stresses they face are ignored, with little to no reprieve.
Unpaid carers across the UK provide care worth approximately £184 billion a year, with more and more responsibilities absorbed by households, which increased by 29.3% between 2011 and 2022. Those same care responsibilities usually fall on one family member, with women aged 55-59 years old and living in the highest levels of poverty being most likely to provide unpaid care in Wales alone.
Public Health Wales found that roughly 10.5% of the Welsh population are unpaid carers, who are more likely to have poor health and use NHS services more than non-carers. Throughout the COVID-19 pandemic, the difference between carer and non-carer health only increased, with 58% of carers citing worsening physical health, and 64% citing worsening mental health.
The Health and Social Care Committee published “Adult Social Care Reform: the cost of inaction”, a parliamentary report documenting the actions, or rather inactions, taken by successive UK governments. The report states that, “Time and again, governments have stepped back from reform when faced with the cost”. One carer who contributed to the report stated that, “there is a confident expectation that unpaid carers will continue to pick up the slack.”
That is not to say that local authorities don’t try to support carers. In 2023/24, £32 billion was spent on adult social care in England, an increase of £1.9 billion from the previous year. But that investment doesn’t translate into delivered services: only 42% of support requests receive any service, and 31% receive none. This unmet need for support only places more pressure on unpaid carers to fill the gaps, feeding back into the rise in worsening physical and mental health in unpaid carers.
When accounting for Wales, the story is very similar. While the Social Services and Well-being (Wales) Act 2014 provides a framework for improving the rights of vulnerable people and their carers, reality does not match up with the policy. The Public Services Ombudsman for Wales’ 2026 report on social care and support for unpaid carers found that, while local authorities were assisting to some extent, only a small proportion of carers received support, with many unaware of their rights.
These issues have even been acknowledged by the previous Welsh government in their 2026 report, “Unpaid carers at breaking point”, highlighting that as of March 2024, only 4,924 out of 310,000 carers received any substantial support. Carers contributing to this report spoke about how they had to “beg” and “fight” for help, noting that while actively caring for loved ones, medical professionals and local authorities didn’t recognise them or their efforts.
If local services were the only issue, that would be one thing. But unpaid carers are expected to operate within a wider welfare system that actively sanctions them for trying to combine care with paid work, and offers limited support to resolve these matters. The current rate of Carer’s Allowance is £83.30 a week. They are allowed to make an additional £196 a week in paid work; anything over that, and their Allowance is stopped.
To add to this, any elderly relatives they care for can claim Attendance Allowance, currently £110.40 a week. If that same elderly relative falls ill and ends up in hospital for more than 28 days, either for 28 days straight or cumulatively within a set period, the Attendance Allowance will be suspended, along with the Carer’s Allowance if linked. It will only be reinstated once they have been discharged.
This policy is built on the belief that if a family member is in hospital, caring responsibilities are alleviated, but this is far from true. Travel costs mount up with every hospital visit, and bills aren’t magically postponed during this period, either. Just because a carer isn’t carrying out their usual day-to-day doesn’t mean their obligations disappear.
The current UK welfare system has created a cliff-edge where unpaid carers are constantly worrying about whether they have unknowingly broken the rules, simply by trying to provide for their loved ones. The limit was designed, in theory, to accommodate 35 hours of care per week to supplement any lost income. In practice, however, carers are working beyond 35 hours a week, with Carers UK finding that 52% of carers are providing more care from 2024 to 2025, and 49% have cut back on food, heating and clothing to accommodate such a dramatic drop in income.
None of this has been accidental. While care is discussed as a social issue, Britain has privatised its handling within family life. Where the state should be supporting carers to allow them to balance familial responsibilities alongside personal development, it has instead handed all responsibility to its citizens, in many cases, women and poorer households, withholding opportunities to earn enough money beyond survival.
Britain’s approach to social care reflects the failure of a liberal welfare state: recognising the problem, yet expecting it to be addressed privately with minimal state support. This leads to families, already stretched to their limits, having to take on further responsibilities, embedding inequality further.
I believe the solution to this is simple: we must adopt a more social-democratic welfare settlement. It would reframe care as a collective responsibility, as it should already be, and allow us actually to treat it as one. Society would share the costs of dependency and care, rather than households absorbing them, thereby alleviating the strain on carers and allowing them to focus on improving their own quality of life while supporting their loved ones.
* Jack Meredith is a member of the Welsh Liberal Democrats and an active campaigner and canvasser with Swansea and Gower Liberal Democrats. His writing focuses on democratic reform, social justice, trade unionism, economic democracy, and the institutional foundations of effective government. He has written for the Fabians, Lib Dem Voice, Liberator, Nation Cymru, Bylines Cymru, and Centre Think Tank.
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8 Comments
I was taken by the title of this article – “Britain has privatised care into the family”. That, to me, seems an odd characterisation.
I was brought up to believe that our family was the most important unit to which we belonged…of far more importance than the town we belong to or our nationality. Families are the key building block of society – the place where we all care for each other. At some stages in our lives, like childhood, we receive much more care from family members than we give and at other times we give more care to family members than we receive. That is family.
So the idea that the starting assumption that it is the State’s job to provide care is completely alien to me. It is the State’s job to step in when care within the family is not happening or can’t happen for whatever reason.
I would ask: if you think we have witnessed care being privatised in Britain, when had it been nationalised in the first place?
Hi Kira,
So, I understand the sentiment behind what you’re saying, as I agree that family is so important in society.
But the pressure placed on families, especially women, to provide care for loved ones, sometimes with complex needs, while the state is willing to clap and applaud and reward their hard work with just £86 a week – especially when, like my own mum, she is unable to work or and has no personal/leisure time due to caring responsibilities as it is a 24/7 duty, is ridiculous.
If your only issue is with the title of my piece, then I’ve not too much to discuss as it is the content of the work I look forward to hearing your view on 🙂
@ Kira,
“I was brought up to believe that our family was the most important unit to which we belonged….”
I’m sure many of us were, but should we have been?
The conservative notion of an ideal family unit can probably be described as one with a male breadwinner accompanied by a dutiful wife who stays at home to help raise children in her younger days, and later to help look after ageing family members once the children leave.
Such families would have been commonplace in the earlier periods of the 20th century. They are not so easy to find now. It’s next to impossible for young people to create such a family on their own from scratch even if they wanted too.
The nature of the family has changed to serve the needs of a changing economic system. The need has been for each family to provide more than one worker. The demands of the system have also led to the creation a very much smaller family unit which is far less able to provide the health and social care for the elderly than used to be the case..
Just what the nature of the family is any society is a political question that Lib Dems might want to try to answer. You don’t have to agree with the left POV that is primarily a method for keeping wealth and privilege within the same class lines but maybe you could start from there.
Somewhat echoing Kira’s point, your title, ‘privatised… into the family’ seems to imply care being primarily done by families is something new. I’m pretty sure that actually, throughout almost all history, when people needed social care, it would usually be their immediate families who would provide it. It’s only very recently that we’ve swapped to the idea that, if someone needed to be cared for, then the state should step in and (somewhat impersonally) do it all: As an example, just 30 years ago my mother spent months caring for her dying father, believing that for him to spend the last part of his life with his family was the kindest thing; and she did so without any expectation that the state (ie. other taxpayers) would step in and start paying her to do that: To her it was simply part of being a family.
Now I wouldn’t argue for that situation to be the norm today: Being a carer is tough and I think we do need to support carers adequately: There is room for a debate on how best to do that, and you do rightly point out some of the issues involved. But at the same time, I feel uneasy about making assumptions that it should automatically be the state (ie. other taxpayers) picking up the tab for everything.
How does society share the costs?? In my day ( I was a juniour doctor in the late 70s/80s) this wasn’t called care. It was called nursing and there were several ‘geriatric wards’ for long stay. There were old peoples homes too. I asked Chat GPT how all this was funded and got a very interesting answer. Conclusion: We need to turn back the clock
The short answer is that in the 1960s and 1970s old people’s homes were financed largely by local authorities using public funds, supplemented by residents’ pensions and means-tested contributions, with charities playing a significant supporting role. The large, predominantly private care-home sector we know today had not yet developed.
One interesting consequence was that local councils often regarded residential homes as a normal municipal service—rather like libraries, schools or parks—whereas today residential care is usually purchased from independent providers rather than directly provided by councils.
Interesting post from Meg Thomas. I well remember the final days of my dear old Granny living on an isolated hill farm in the Durham Pennines. She was helped and comforted by daily visits from the District Nurse arriving (in her little Morris Minor).
I strongly believe now that the District Nursing service needs to be strengthened. It has been been severely diminished.
Some facts : Analysis from the Nuffield Trust shows that full-time equivalent district nurse numbers dropped by 43%.This decline has created significant challenges for the service:
Staffing Shortages: For every five district nurses in 2009, there are now only three.
Decreased Patient Contact: The number of recorded nursing visits dropped significantly, despite a 24% increase in the need for community-based care.
Increased Workloads: Because of staff shortages, many remaining nurses are performing substantial amounts of unpaid overtime, resulting in exhausted teams and “task-based” rather than holistic care.
Under-grading of Roles: Over one in four district nurses are operating below the typical starting band for the profession, which limits front-line experience.
Thanks Jack, really interesting read.
I’d be really interested to explore how this issue interacts with widening inequality within our society. I see these two issues as very closely connected, each driving the other.
Where families were once comfortable on a single wage, families with two wages can now be turning to food banks. Where care could be provided in the home more readily, two working adults means that for many this is not an option. The result is either a weakening financial outlook for the family or or the need for state funded social care. Providing care makes you poorer and presents people with an impossible choice. This position is worsened by the stress caused in simply navigating and complying with benefits policies.
I see no good short term solution to these challenges. Instead, long term investment to reduce inequality (through fairer taxation) could offer a route where we stop degrading living standards. Work that pays offers citizens the opportunity to either provide more care themselves or to collectively fund social care. The position we see today puts carers in an impossible situation – that must end.
The decision whetherto become a carer for relatives is a challenging one that too many make on expediency grounds. We look at the possible effect of doing so on our quality of life and our goals and life purpose. For too many the decision is made quickly and defended by rational argument. A culture where caring is valued and the people doing it are respected is probably the single most important change that is needed.