Before entering Parliament, Luke Evans spent years working as a GP, including time supporting multiple care homes. Those experiences still shape how he sees the system today. “In general practice, you see social care every day,” he says.
“You see it when it works brilliantly, and you see it when it completely falls down. You see the families trying to hold things together, carers under pressure… [and] the NHS picking up the pieces.”
That frontline perspective has made him wary of grand promises and structural reorganisations. Social care, he argues, is too often discussed as a policy problem rather than as something that directly affects real lives.
“Most people don’t understand the system until they need it,” he reflects. “And by then it’s usually at a moment of crisis.”
From the surgery to Parliament
Evans grew up in a family of doctors, and he describes a household where conversations about health and care were part of everyday life. That background, combined with years in general practice, has given him what he calls “a very practical lens”.
“You see how disjointed things are,” he reflects. “You’ve got councils, the NHS, care providers and families all trying to do the right thing, but not always pulling in the same direction.”
Representing Hinckley and Bosworth has only reinforced that view. Constituents regularly come to him with problems that cut across health and social care boundaries, with delayed hospital discharges and confusion about who is responsible for what a regular occurrence.
“It’s the fragmentation people feel most,” he says. “No one experiences their life in silos, but the system is built that way.”
He points to familiar pressures, particularly Britain’s ageing population and the rising complexity of need. “If you speak to anyone in the sector, they’ll tell you the same thing,” he asserts. “Demand is going up, but the structures haven’t kept pace.”
A system stuck in silos
For Evans, the lack of integration between health and social care remains the central challenge. “We talk a lot about Integrated Care Boards,” he notes, “but we’re still not genuinely integrated in the way that matters to people on the ground.”
He estimates that “around 15 to 30 per cent of hospital beds at any one time are occupied by people who are medically fit for discharge.” The reason, he argues, is rarely clinical and almost always about the availability of social care.
“That’s not just a statistic,” he says. “That’s someone who should be back in their own home but can’t be because the system can’t join itself up.”
Local authorities, meanwhile, are under immense pressure, with 18 county and unitary authorities at risk of bankruptcy this year alone. Dr Evans points out one of the chief pressures causing this crisis is the growing cost of care. “Seventy to eighty per cent of many council budgets now go on [social care],” he notes. “That crowds out everything else they’re meant to be doing.”
“That’s not just a statistic, ... that’s someone who should be back in their own home but can’t be because the system can’t join itself up.”
Yet, despite this, he believes that accountability remains too diffuse. “When something goes wrong, everyone can point to someone else,” he says. “That’s not good enough for families, and it’s not good enough for providers.”
Politics and the Casey Commission
Few issues illustrate the difficulty of reform more clearly than social care. Successive governments have promised to tackle the problem; none have succeeded. Evans is frank about the political traps. “Every time someone tries to do something serious on social care, it gets weaponised,” he admits. “That makes politicians nervous.”
He is also sharply critical of recent decisions around National Insurance contributions and their impact on providers. Asked whether the Government fully understood the consequences, he doesn’t hold back. “I can’t decide whether it was willful ignorance or something more Machiavellian,” he says. “But either way, the effect on the sector has been huge.”
Looking ahead, much attention is focused on the independent review of adult social care being led by Baroness Casey. Evans supports the idea of taking time to get reform right, but worries about how long the process may take.
“As I understand it, the final report isn’t due until 2028. That’s a very long time for a system already under enormous strain.” He emphasises that the sector cannot afford years of drift. “Providers need certainty now,” he argues. “Families need support now.”
With figures such as Wes Streeting driving the Government’s agenda, Evans argues that the debate must be grounded in realism rather than rhetoric. “We need honesty with the public about what social care is and what kind of system we actually want,” he says.
Part of that, he suggests, involves having more open conversations about later life and planning ahead. He notes that recent debates, including around assisted dying, have highlighted how reluctant society can be to confront questions about ageing and care needs.
“We’re not very good as a country at talking about those final 10 or 15 years of life,” he says. “But social care is fundamentally about helping people live those years with dignity.”
Technology and accountability
If funding and workforce are the perennial challenges, Evans believes technology offers one of the biggest opportunities, provided it is used properly. He gives a simple example: live data on care home capacity. “At the moment, we don’t have a reliable, real-time picture of where beds are available. That means hospitals ring around, social workers ring around – it’s incredibly inefficient.”
Evans argues that better interoperability between systems could transform the way care is coordinated. “This is basic, practical stuff that should already be happening.” He is enthusiastic about the potential of digital tools to support both providers and families, from electronic medication systems to platforms that help carers manage complex needs.
But, at the same time, he warns against assuming technology alone will fix deeper problems. “Tech can enable good care, but it can’t replace people,” he says. “You still need trained, valued staff… you still need proper funding. [But] technology should make their jobs easier.”
A more honest conversation
Throughout the discussion, Evans returns to the point that social care must be treated as a core public service rather than an afterthought, as successive governments have done. “For too long it’s been the poor relation to the NHS,” he says. “But you can’t fix one without fixing the other.”
He wants to see a system that supports independence rather than simply managing decline, and a workforce that is properly recognised for the skilled work it does. Above all, he believes the sector deserves straight talking. “There are no easy answers in social care,” he says. “Anyone who pretends otherwise isn’t being honest.”
When asked what success would ultimately look like, Evans returns to a simple principle. “Social care should be about helping people live their lives with dignity and choice,” he says. “If we keep that at the centre of everything, the rest follows.”
