Intended for healthcare professionals


Barker & Burstow’s care packages for England

BMJ 2014; 349 doi: (Published 29 September 2014) Cite this as: BMJ 2014;349:g5879
  1. Steve Iliffe, professor of primary care for older people1,
  2. Jill Manthorpe, professor of social work2
  1. 1University College London, London, UK
  2. 2 Social Care Workforce Research Unit, King’s College London, London, UK
  1. Correspondence to: S Iliffe s.iliffe{at}

A tale of two markets pointing in the same direction

The market in social care has failed. This is the conclusion of two reports on social care from different perspectives, the Barker report and the Burstow report.1 2 The Barker report is the product of wide discussion following the publication of an interim report3 and explicitly rejects an unplanned and under-resourced social care market. The Burstow report explores the problems of providing acceptable housing based care services, draws on third sector and commercial experiences, and is an implicit cry for help.

The Barker report depicts relations between health and social care as opaque, inefficient, inequitable, and weighted towards individual rather than collective responsibility. Noting that the Poor Law still casts a long shadow, it argues that social care needs to be more generous and to be based on the principle of solidarity. This requires the allocation of an increased proportion of gross domestic product to social care. The option of developing insurance products that people could buy to prepare for their future care …

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