Baroness Louise Casey, the Whitehall troubleshooter leading a government review into social care, has accused health chiefs of effectively "ignoring dementia" for years amid a repeated failure to overhaul England's social care system. She warned that the current "patchwork" arrangements have made accessing care for elderly relatives "almost impossible" for many struggling families, and called for a "moment of reckoning" to finally reform the system. The intervention matters because it highlights long-standing dysfunction in how care is funded and delivered, and signals that fresh proposals — potentially including tax rises — are on the table.

Casey, a crossbench peer, made the case for a combined health and social care service in a keynote speech to the annual conference of town halls in England and Wales, noting that 22 previous reviews over nearly three decades had failed to bring change. She said families are forced to navigate multiple confusing systems, juggling questions of means-testing, local authority eligibility and NHS responsibility, particularly for those with significant dementia lasting 10 to 15 years. Her team will launch an open public consultation on how the system should change. Separately, Greater Manchester mayor Andy Burnham has floated a possible new care levy to fund reform, raising the prospect of tax hikes should he become prime minister.