October was a significant month in Parliament for health, social care, and employment reform, with debates and committee hearings reflecting a renewed focus on workforce sustainability, equality, and the future of care provision. Across both Houses, ministers outlined ambitious strategies to strengthen the NHS, improve employment outcomes for disabled people, and reform local government and welfare funding, while peers raised persistent concerns about regional inequality, workforce shortages, and gaps in social care capacity. The period also saw major evidence sessions on the Budget 2025, ageing, fiscal reform, and the evolving structure of end-of-life legislation.
Crucially, Care England contributed directly to this parliamentary scrutiny, with Fraser Rickatson giving evidence to the committee examining the Terminally Ill Adults (End of Life) Bill. His testimony highlighted the deep interconnection between assisted dying policy and the long-term crisis in adult social care funding, calling for an opt-out for faith-based and resource-limited providers and a fully funded care package to ensure equity and dignity for all. Rickatson’s evidence underscored Care England’s position as a leading advocate for sustainable reform and fair funding across the sector.
Overall, the October sessions underscored Parliament’s recognition that social care reform, workforce stability, and health equality remain central to the UK’s recovery and long-term resilience. The discussions reflected a cautious optimism—acknowledging progress on fair pay, dementia care, and prevention—while warning that without sustained investment and structural reform, many of the system’s challenges will persist into the next parliamentary cycle.
Highlights
Care England’s Fraser Rickatson gives evidence to the Terminally Ill Adults (End of Life) Bill Committee
See the full transcript and notes here
The Committee’s session examined the Terminally Ill Adults (End of Life) Bill and its impact on palliative and social care. Witnesses agreed that end-of-life care in the UK is uneven and underfunded, warning that assisted dying must not proceed without stronger palliative provision and safeguards.
Fraser Rickatson repeatedly emphasised that the adult social care sector is “deeply concerned, deeply unaware and not consulted” about the Bill. He argued for an “opt-out option” for faith-based and resource-limited providers, alongside a “fully funded package” to ensure equitable care and prevent coercion. He warned of a “£5 billion funding gap” and a “postcode lottery” in care access, urging a long-term funding settlement for the entire sector. His evidence framed assisted dying as inseparable from the wider crisis in adult social care funding and workforce capacity.
Legislation
Employment Rights Bill
Volume 849: debated on Tuesday 28 October 2025
See the full transcript and notes here
The House of Lords debate on 28 October 2025, led by Baroness Monckton of Dallington Forest, focused on improving employment opportunities for people with disabilities and autism. Minister Baroness Sherlock (Lab) outlined the Government’s approach centred on the Connect to Work programme—providing specialist employment advisers and funding of £167 million to expand coverage across England and Wales. She rejected calls for tax exemptions for employers, instead prioritising tailored support, inclusive workplaces, and forthcoming findings from the Keep Britain Working Review.
Peers including Baroness Uddin, Lord Laming, and Viscount Younger raised issues such as regional inequality, transition from education to work, SME support, and the disability pay gap. The Minister confirmed additional initiatives, including the Support with Employee Health and Disability service and localised Get Britain Working plans. The discussion reflected cross-party agreement on the need for inclusion but highlighted ongoing disparities in access, pay, and progression for disabled people within the labour market.
Chamber Business
HL: Alzheimer’s Disease
Volume 849: debated on Monday 13 October 2025
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The government confirmed plans for a new modern service framework for frailty and dementia, aiming to standardise diagnosis and care, reduce inequalities, and prioritise early diagnosis. Peers raised concerns over long waiting times, lack of national targets, and pressures on carers. The Minister said the framework would be informed by the independent commission on adult social care and would link closely with prevention work, research on new treatments, and innovation in diagnosis methods.
Unpaid Carers
Volume 849: debated on Wednesday 15 October 2025
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The government said the 10-year health plan would strengthen NHS support for unpaid carers through better data, involvement in care planning, and the launch of a “My Carer” NHS app. Peers raised concerns about ignored carers’ rights during hospital discharge, the neglect of young carers, low confidence among carers, and inadequate financial support. The Minister said the forthcoming Casey Review of Social Care would examine the carer’s allowance and wider support. She emphasised that the “golden thread” of policy reforms was to recognise, value, and embed carers’ voices across the health and care system.
Healthcare Provision: Inequalities
Volume 849: debated on Monday 20 October 2025
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The government said the 10-year NHS plan aims to tackle deep-rooted healthcare inequalities in access and outcomes, guided by the Core20PLUS5 framework and a neighbourhood-based approach. Peers raised concerns about women’s pain being ignored in hysteroscopy procedures, the 22-year life expectancy gap for people with learning disabilities, rural-urban disparities, and digital exclusion. The Minister said the plan’s core mission was to reduce inequality “no matter who you are or where you live,” supported by data improvements, the Women’s Health Strategy update, and ongoing focus on carers and marginalised groups.
Oral Answers to Questions: Health and Social Care
Volume 773: debated on Tuesday 21 October 2025
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The Health and Social Care Oral Questions of 21 October 2025 centred on NHS reform, patient care improvement, and the modernisation of healthcare delivery. Key priorities included addressing failures in maternity care, expanding digital health access through the NHS Online hospital, and shifting resources from hospitals into community and preventative care. The Government reaffirmed its commitment to fair pay for care workers, improved funding for children’s hospices, and the expansion of virtual wards and diagnostic centres. Ministers repeatedly contrasted Labour’s investment and reform agenda with what they described as years of Conservative mismanagement, pledging to deliver a modern, accountable, and equitable health system grounded in scientific evidence and responsive to patients’ needs.
Local Government Funding: North-west England
Volume 773: debated on Tuesday 21 October 2025
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The debate on Local Government Funding in the North-west of England on 21 October 2025 highlighted the deep financial strain faced by councils across the region. Mr Tom Morrison MP (Cheadle, LD) warned that years of cuts had left local authorities “on their knees”, forcing them to raise council tax, sell community assets, and reduce essential services. He cited Stockport’s £63 million funding gap and called for urgent reform of the “regressive” council tax system, along with greater investment in social care and community infrastructure.
Responding, the Minister for Local Government and Homelessness, Ms Alison McGovern MP, acknowledged the “long-term damage” of austerity and outlined the Government’s plan to rebuild local government finances. She confirmed a £69 billion national settlement for 2025–26, with £9.4 billion for the north-west and £146 million allocated through a new Recovery Grant. Broader reforms include multi-year settlements, funding consolidation, a revised needs-based formula, and major investment in social care, housing, education, and homelessness prevention. The Minister affirmed that these measures mark the first phase in restoring stability and fairness to local government and devolving greater powers to northern regions such as Greater Manchester and Merseyside.
NHS Workforce Levels: Impact on Cancer Patients
Volume 773: debated on Thursday 23 October 2025
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The House of Commons debate on NHS Workforce Levels and the Impact on Cancer Patients on 23 October 2025 underscored widespread concern that staff shortages are delaying diagnoses and worsening cancer outcomes. Mr Elliot Colburn MP (Con) argued that chronic gaps in diagnostics, radiotherapy, and oncology were causing “systemic delays” and called for a dedicated Cancer Workforce Strategy, annual workforce projections, and targeted recruitment funding.
Responding for the Government, Ms Ashley Dalton MP (Minister of State for Health) acknowledged the legacy of underinvestment and confirmed a £750 million Cancer Workforce Expansion Fund to recruit and train 10,000 nurses, 2,000 doctors, and 1,500 allied health professionals. She announced additional measures including regional cancer academies, National Cancer Fellowships, 48 operational Community Diagnostic Centres, and new retention and wellbeing initiatives worth £400 million. The Minister further committed to ethical international recruitment, annual equality reporting, and ongoing consultation ahead of the National Cancer Plan (2026). She concluded that rebuilding the cancer workforce was essential to improving early diagnosis, treatment capacity, and patient outcomes across the NHS.
Oral Answers to Questions: Cabinet Office
Volume 773: debated on Thursday 23 October 2025
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Health and social care issues featured prominently in the Oral Answers to Questions session on 23 October 2025. Key exchanges addressed the expansion of community healthcare services to reduce hospital pressure, the integration of voluntary organisations into social care delivery, and the role of public procurement reform in promoting fair pay and secure employment within the care sector.
Ministers confirmed that the NHS 10-Year Plan aims to shift care closer to communities, while the Civil Society Covenant will embed voluntary partners into local service delivery. The Government also committed to a public interest test for outsourcing decisions, potentially favouring in-house provision in social care and NHS contexts. Further updates were given on infected blood compensation, pandemic preparedness, and digital transformation through a universal digital identity system to improve service access.
Oral Answers to Questions: Work and Pensions
Volume 774: debated on Monday 27 October 2025
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The DWP question session on 27 October 2025 focused on pensions, disability employment, welfare reform, and child poverty. Key discussions included the Access to Work scheme, criticised for long delays and inconsistent assessments; the two-child benefit cap, which Ministers said remained under review; and new measures to link skills, apprenticeships, and employment more closely with business needs. The Government outlined forthcoming strategies on child poverty and disability employment, emphasising devolution, co-production with disabled people, and reform of PIP. While Labour Ministers defended their early record on jobs and welfare reform, the Opposition accused them of increasing unemployment and failing to deliver on promises to improve benefit delivery. Social care was mentioned in connection with disability and carers’ policy, underscoring the Government’s aim to integrate health, skills, and employment support.
People with Disabilities: Employment
Volume 849: debated on Tuesday 28 October 2025
See the full transcript and notes here
The 28 October 2025 House of Lords debate on People with Disabilities: Employment focused on how to increase job opportunities for people with disabilities, especially those with learning disabilities and autism. Baroness Monckton (Con) called for National Insurance relief for employers hiring such individuals, while Baroness Sherlock (Lab) outlined the Government’s alternative approach through the Connect to Work programme providing local authority-led specialist employment support.
Peers including Baroness Uddin, Lord Laming, Viscount Younger, and Lord Sikka raised issues such as funding ringfencing, transition from education to work, SME support, and the disability pay gap. The Minister confirmed £167 million in new funding to expand Connect to Work, a forthcoming Charlie Mayfield report, and new resources to help employers support disabled staff. The debate showed broad agreement on the need for inclusion and opportunity, though peers differed on whether targeted financial incentives or structural programmes would best achieve this goal.
Committee Hearings
14 October 2025 – Budget 2025 – Oral evidence
Committee Treasury Committee
Inquiry Budget 2025
New 2025 Budget series begins with session on Chancellor’s tax options
See full transcript and notes here
The Treasury Committee’s October 2025 hearing underscored the UK’s urgent fiscal challenges ahead of Budget 2025. Witnesses agreed that while tax rises may be inevitable, reform must prioritise simplicity, fairness, and pro-growth outcomes. They condemned decades of piecemeal tax policy and called for structural modernisation—particularly of corporation tax, VAT, and capital gains tax—alongside better evaluation of tax reliefs. On spending, experts urged reforms that improve productivity rather than blunt cuts, stressing fiscal credibility and market confidence. Overall, the consensus was clear: the UK must pursue growth through simplification, reform, and long-term strategic planning, not short-term fiscal patchwork.
14 October 2025 – Preparing for an Ageing Society – Oral evidence
Economic Affairs Committee
See full transcript and notes here
The Committee’s session highlighted the complex interdependence between demographic ageing, fiscal sustainability, and economic productivity. Treasury officials recognised that while longer lives are a social success, they require systemic adaptation—from pensions and healthcare to labour markets and education. The Government’s strategy emphasises prevention, participation, and productivity: promoting healthier ageing, supporting later-life work, reforming social care, and embedding lifelong learning. However, peers warned that without coherent leadership, integrated data, and targeted investment, the UK risks facing an unsustainable dependency ratio. The witnesses concluded that sustained growth and productivity—not austerity—must underpin a long-term fiscal response to the ageing challenge.
15 October 2025 – Social Security Advisory Committee – Oral evidence
Work and Pensions Committee
See full transcript and notes here
The Social Security Advisory Committee outlined how it balances independence with constructive engagement to ensure social security policy is effective, evidence-based, and fair. Witnesses criticised the uneven quality of impact assessments, lack of policy clarity, and weak evaluation culture within DWP. They called for long-term evidence generation, better cross-departmental coordination, and clearer links between policy intent and regulation. Key concerns included the hurried design of winter fuel payment changes, overreliance on work coach discretion, and the absence of robust evaluation of policies such as the administrative earnings threshold. On health and disability benefits, the Committee warned against conflating distinct systems like UC and PIP. Overall, they urged a move from reactive policymaking towards a disciplined, research-informed, and transparent welfare system that supports both efficiency and social justice.
16 October 2025 – Government services: Identifying costs and generating income – Oral evidence
Public Accounts Committee
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On 16 October 2025 the Public Accounts Committee examined why many government charging bodies fail to achieve consistent full cost recovery and what the Treasury can do about it. Treasury officials accepted past passivity and set out reforms: tighter guidance in Managing Public Money, a standardised costing template (inspired by New Zealand and the Environment Agency), routine two-year spending-review stocktakes and improved annual disclosures to Parliament. Departments (notably DVLA and MOJ) described practical challenges — forecasting demand, legislative timetables, major shocks (COVID/Brexit), and necessary access-to-justice trade-offs — and explained steps taken (activity-based costing, smoothing overheads, section 102 pooling). The NAO’s findings on inconsistent reporting and occasional large deficits (eg passports) underpinned the Committee’s calls for annual review cycles, better cross-Government learning, clearer ministerial decisions where under- or over-recovery is chosen, and improved auditability. Overall the hearing concluded that the problem is fixable with stronger Treasury oversight, standardised methodologies, faster but proportionate processes for fee changes, and greater transparency to Parliament.
22 October 2025 – Terminally Ill Adults (End of Life) Bill – Oral evidence
See full transcript and notes here
Across both sessions, the Committee heard a nuanced but consistent message: while the Terminally Ill Adults (End of Life) Bill embodies compassion and autonomy, its practical implementation, safeguarding structures, and relationship to palliative and adult social care systems require careful revision. Witnesses called for clearer procedural rules, stronger workforce training, and guaranteed separation between assisted dying services and core medical practice. They warned that without sustained investment in palliative and social care, assisted dying could be perceived as a substitute for good care rather than an expression of choice.
Ultimately, the evidence converged on a cautious consensus: choice at the end of life must be matched by protection in life’s final stages. For that to happen, assisted dying legislation must operate within a fully supported framework of health, social, and palliative care, ensuring dignity, equity, and safety for all.
Terminally Ill Adults (End of Life) Bill – Oral evidence
See full transcript and notes here
The oral evidence to the committee on the Terminally Ill Adults (End of Life) Bill revealed broad agreement that any change in the law must be cautious, clear, and strongly safeguarded. Witnesses, including Sir Chris Whitty, doctors, lawyers, and disability advocates, focused on how an assisted dying system could be made safe rather than whether it should exist. A central concern was the difficulty of defining “terminal illness” and predicting life expectancy, as medical prognoses are often uncertain. This raised fears that rigid criteria might exclude some people in severe suffering or, conversely, open the law to misuse. Safeguards and consent were recurring themes, with witnesses warning that vulnerable people must be protected from pressure and that clinicians should retain a right to conscientious objection. Disability groups cautioned that a “right to die” must not become a “duty to die,” especially where care or support is lacking. Clinicians stressed that assisted dying must not undermine investment in palliative care, and legal experts questioned whether too much detail was left to secondary legislation. Comparisons with other countries highlighted the need for rigorous oversight and ongoing review. Overall, the evidence combined compassion for those seeking choice at the end of life with a clear warning against haste or weak safeguards, echoing Sir Chris Whitty’s view that such a change must not be “done at speed.”
28 October 2025 – The UK’s fiscal framework – Oral evidence
Economic Affairs Committee
See full transcript and notes here
The Committee examined the UK’s fiscal framework with Helen Miller and Ben Zaranko of the IFS. Both argued that fiscal rules have improved transparency and accountability but now drive short-termism and excessive focus on narrow “headroom” targets. Small buffers make fiscal policy unstable and give the OBR outsized influence. They called for a broader, more flexible system—such as a multi-indicator or “traffic light” approach—while preserving the OBR’s independence. Growth, not austerity, was identified as the key to long-term fiscal sustainability.
29 October 2025 – Healthy Ageing: physical activity in an ageing society – Oral evidence
Health and Social Care Committee
See full transcript and notes here
This Committee session underscored that healthy ageing policy must be preventive, cross-sectoral, and mission-led. Physical activity was positioned as a foundational intervention capable of extending healthy life expectancy, reducing health inequalities, and easing pressures on adult social care. The evidence revealed structural challenges—short-term Treasury models, departmental silos, local funding cuts, and digital divides—that impede progress. Key policy priorities emerging from the session include:
- Establishing a national strategy on ageing, possibly led by a Commissioner for Older People and Ageing;
- Embedding prevention and physical activity within NHS and social care planning;
- Investing in housing, local environments, and social infrastructure as health interventions;
- Strengthening voluntary sector capacity and social prescribing networks;
Care England’s Despatch Box: Our Right Honourable Responses to Parliament
The Fair Pay Agreement Resource Hub
The Fair Pay Agreement (FPA) is set to be one of the most consequential changes for the adult social care workforce in England. Under this new framework, care workers will have legally enforceable minimum standards covering pay, working hours, and additional employment conditions.
Fair Pay Negotiating Body for adult social care
On 30 September, the Government launched a consultation on the fair pay agreement process in the adult social care sector (England only). This consultation covers who and what should come within the scope of negotiations, as well as how the negotiation process should work.
Care England Publishes Two Papers Focused on Practical Cost Savings for Care Providers to Drive Long-term Investment
Care England, the largest and most diverse representative of adult social care providers in England, has today (28 October) published two pieces aimed at promoting solutions that are readily available out there for social care providers to implement, making the most out of limited budgets.
Care England
Care England welcomes dementia research challenge but warns people “cannot wait years for change”
Care England, the leading voice of adult social care providers in England, has welcomed the government’s new R&D Missions Accelerator Programme as a positive step towards faster diagnosis and better support for people living with dementia, but has warned that urgent action is needed to tackle the long waits and gaps in care that exist today.
The Oliver McGowan Training: What You Need to Know
Training on learning disabilities and autism, which meets the standards set by the Oliver McGowan code of practice, is now a statutory requirement for all CQC-registered health and social care providers. The requirement was introduced under the Health and Care Act 2022, which came into force on 1 July 2022, and was strengthened on 6 September 2025 with the commencement of the Oliver McGowan Code of Practice.
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