Louise Casey has warned that millions of unpaid carers across the UK are “living an agony” while supporting what she described as an outdated, fragmented and increasingly unsustainable social care system.
Speaking at a major Carers UK conference in London, Casey delivered one of her strongest criticisms yet of Britain’s adult social care structure, arguing that the system continues to rely heavily on unpaid carers — especially women — to fill widening gaps in public services.
The comments come as pressure intensifies on the Labour government to reform social care amid rising demand linked to Britain’s ageing population, increasing life expectancy and growing numbers of people living with long-term conditions such as dementia, disability and chronic illness.
Casey, who is leading an independent government review into adult social care, said the current model leaves families overwhelmed, exhausted and often abandoned while trying to navigate complicated health and social care systems.
UK Social Care System Under Growing Pressure
Casey said the care system “still behaves as if we are living in 1948 and not 2026,” criticising what she described as an outdated reliance on unpaid family support instead of properly funded and coordinated services.
According to official estimates, there are around 5.8 million unpaid carers across the UK, including approximately 1.7 million people providing more than 50 hours of care every week.
Many carers support elderly parents, disabled children, partners with chronic illnesses or relatives suffering from conditions such as Alzheimer’s disease and severe mental health disorders.
The economic contribution of unpaid carers is estimated at roughly £184 billion annually, making them one of the largest invisible pillars supporting Britain’s healthcare and welfare systems.
Casey warned that relying on unpaid carers and underpaid care workers to keep the system functioning was no longer realistic.
“It is no longer sustainable,” she said, adding that carers are often expected to absorb “risk, stress and responsibility so the system doesn’t have to.”
Emotional and Financial Burden on Families
The social care commission chief described the emotional toll experienced by unpaid carers as severe and deeply damaging.
She said many carers were left feeling isolated and unsupported while spending enormous amounts of time battling bureaucracy instead of caring for loved ones.
“Carers spend more time sorting out problems with the health and social care system than spending time with their loved ones,” Casey told delegates at the conference.
She said families frequently struggled to understand what support was available, who was responsible for providing it and how services could be accessed.
Every organisation involved in social care often applied different rules, eligibility tests and interpretations, creating confusion and frustration for families already under immense pressure.
Casey said carers repeatedly described themselves as “unpaid project managers” forced to coordinate complicated systems without guidance or continuity.
The situation has become especially difficult for older carers who are themselves ageing while continuing to provide physically demanding care.
Casey highlighted cases where elderly parents in their seventies still carry adult disabled children upstairs every night because they fear asking for support could make their situation worse rather than better.
Women Continue Carrying Most Care Responsibilities
The review also highlighted the unequal burden placed on women within the UK care system.
Approximately 60% of unpaid carers are women, many of whom reduce working hours, leave employment entirely or sacrifice financial security to care for relatives.
Campaigners and charities have repeatedly warned that unpaid caring responsibilities contribute to gender inequality, lost income, reduced pension savings and increased mental health pressures.
Casey argued that governments have historically depended on women to compensate for weaknesses in public services.
“The system assumes women will continue to plug the gaps,” she said.
Social care experts say many carers experience burnout, exhaustion and declining physical and mental health due to the intensity of their responsibilities.
Research from Carers UK has previously shown high levels of anxiety, depression and financial hardship among unpaid carers, particularly those providing round-the-clock care.
Labour Government Faces Pressure for Reform
The Labour government commissioned Casey in January 2025 to lead a two-stage independent review aimed at creating a National Care Service, one of the party’s major manifesto commitments.
The first report from the review is expected later this year and is likely to shape future reforms to adult social care policy in England.
Successive British governments have faced criticism for failing to deliver long-promised social care reform despite growing warnings from health experts and local authorities.
The NHS has also faced increasing strain because many vulnerable people cannot access adequate community care, leading to hospital delays and pressure on emergency services.
Britain’s ageing population has intensified concerns further. By 2040, millions more adults are expected to require long-term support due to illness, disability or age-related conditions.
Casey previously warned that the social care sector faces a “moment of reckoning” unless major structural reforms are introduced.
Calls for Simpler and Better Support
Carers’ organisations welcomed Casey’s remarks, saying they reflected the reality experienced daily by millions of families.
Carers UK has consistently called for improved financial support, respite services, mental health assistance and clearer access to care.
Campaigners argue that many carers avoid asking for help because they fear losing limited support already in place or facing complicated reassessment procedures.
Casey said the care system often leaves families feeling trapped in constant uncertainty.
“The system can make the carer feel like they are living an agony,” she said.
“And frankly, I think we should be able to take the agony out of care.”
Despite the challenges, Casey also acknowledged that caring for loved ones can be deeply meaningful and emotionally rewarding.
However, she stressed that without major reform, millions of carers will continue carrying unsustainable responsibilities while Britain’s social care crisis deepens.
Growing Demand for Social Care Across Britain
Experts say demand for care services is expected to rise sharply over the next decade as the UK population ages and more people survive serious illnesses requiring long-term support.
Local councils, which fund much of England’s adult social care system, continue facing severe financial pressure after years of budget constraints and rising demand.
Care providers have also warned about workforce shortages, low wages and difficulties recruiting staff.
Health charities and economists increasingly argue that without major investment and reform, unpaid carers will continue acting as the hidden backbone of Britain’s healthcare system.
The debate over social care funding is now expected to become one of the most important domestic policy issues facing the Labour government in the coming years.