For Tom Gordon, the pressures facing adult social care are not abstract policy questions but issues he encountered first within his own family. Shortly before beginning his master’s degree in public health, his mother was diagnosed with breast cancer. He reduced his studies to part-time and took on a caring role for her and his younger sister.
“It was quite a traumatic time for the family,” he reflects. His mother continued working minimum wage shifts while undergoing chemotherapy. “Statutory sick pay just wasn’t enough,” he says. The experience exposed how quickly families can be pulled into the role of carer and how limited support can be.
A few years later, his grandfather’s illness highlighted the system’s fragility from a different angle. After recurring infections left him hospitalised, attempts to secure a care package to allow him to return home repeatedly failed. “He was bed blocking for well over six months,” Gordon says. “Not because he needed to be in hospital, but because we couldn’t get anyone to provide the care, and the local authority couldn’t fund it.”
These experiences underpin his work co-chairing the All-Party Parliamentary Group on Adult Social Care. “People don’t really think about social care until they need it,” he says. “[And] then they see how much depends on family members filling gaps and that has real consequences.”
Social care and the NHS
For Gordon, attempts to debate the NHS separately from social care misunderstand the problem. “If we don’t fix social care, then we’re not going to be able to get the NHS in a fit state,” he says. The pressures move both ways: insufficient support in the community leads to avoidable hospital admissions, while delayed discharges create blockages throughout the system.
However, he cautions against reducing care to an extension of the NHS. “A lot of people who need care aren’t patients,” he says. Social care must also be seen as about living well: participating in work and the local community. “It’s not just about hospital discharges,” he says. “It’s about life.”
Structural fragmentation, he argues, makes this difficult. Budgets, decisions and responsibilities sit in separate organisations that do not always align. “People’s lives don’t fit into departments,” he says. Integration must be practical, not just administrative.
Reforming the workforce
Representing a largely rural constituency shapes Gordon’s thinking on workforce challenges. In North Yorkshire, carers often travel long distances between visits. “If they’re not being paid for the travel time or the petrol, it’s just not sustainable,” he says. People leave the profession, and the gaps widen.
“It’s a real disparity between what we see in urban and rural areas and that is something that has to be factored in,” he explains.
If we don’t fix social care, then we’re not going to be able to get the NHS in a fit state
The workforce challenge is also cultural. “Social care has been done down,” he says. It is often seen as a last-resort job, despite being emotionally demanding and requiring skill. “You can be paid more in a supermarket,” he notes, “with a lot less emotional burden.”
For the Liberal Democrats, professionalisation must be part of the answer. He points to the party’s call for a £2 uplift in the minimum wage for care workers, alongside the creation of a Royal College of Social Care Workers to provide accreditation and progression routes.
“If we want people to see social care as a career, not something you fall into, then we need to treat it as one,” he says.
Local responsibility
On whether social care funding should move from local to national government, Gordon is careful. “I’m quite agnostic on that,” he says. If a national model can deliver better outcomes and reduce regional disparities, he is open to it. But simply shifting responsibility does not guarantee improvement.
What concerns him more immediately is the financial position of councils. “Their budgets are absolutely bust,” he says. Several local authorities have effectively gone bankrupt. Without change, more will follow.
Recruitment pressures are also made worse by immigration policy. He warns that restricting international recruitment without a domestic workforce plan will “shut down that route” without providing an alternative. “Where are we getting the staff from?” he asks. “At the moment, it’s like whack-a-mole. You [try to] fix one problem and another pops up.”
The question of timing is crucial. Gordon believes reform must be sequenced carefully, rather than rushed into headline solutions that collapse under political pressure. He references the history of proposals labelled and attacked as “the death tax” or “the dementia tax” by opponents.
“Every time someone proposes a fix, it gets weaponised,” he says. “If we’re serious about reform, we have to stop treating it as a political football.” He believes progress must start with the workforce and with communication that brings the public along. Reform must be understood, not just announced.
“There isn’t a magic fix,” he says. “But there is a direction. We need to value the workforce, join up health and care, and make sure local government is funded sustainably.”
“A sustainable social care system is not a cost,” he says. “It’s an investment in dignity and independence.” Improving care, in his view, is not merely about easing NHS pressures or reducing waiting lists but about supporting people to have more secure lives. “It should mean fewer falls and people in A&E, but it should also mean people being able to work and stay connected. That’s the point.”
Looking ahead, Gordon is realistic about the scale of work required. But he argues that progress is possible now, particularly around fairer local funding settlements and ensuring that rural areas are not structurally disadvantaged.
“We have to start,” he says. “Because the longer we wait, the harder and more expensive it becomes ... and in the meantime, it’s families, like mine, like so many others, who carry the strain.”
