To assess and compare the four care systems of the four nations of the UK it is important to have a clear sense of what they are trying to achieve. In this chapter we focus on how policy documents in the four systems frame social care, and how care policy supports the aim of improving social care. This is what Pollitt (2002) calls the discursive aspect of convergence (or divergence). We look at what policy makers have set out in the documents as being their vision of sustainable care and a good life for people with care needs (in other words, the ends of care), and the ways in which this is reflective of their distinctive policy communities and identities. In later chapters we look at the means (or, in realist language, the mechanisms) through which to achieve these ends, which encompasses care funding, access, regulation and integration with health.

Solving the ‘problem’ of care

Care policy documents – White and Green Papers, legislation, formal policy commissions – provide an insight into the aims and aspirations of care policy. They identify the problems that need to be solved, the outcomes that are to be achieved and the mechanisms for achieving them. Of course, these documents do not all have the same status – some are embedded in legislation whereas others contain proposals that may never become formal policy. Together, as a body of documents, we see them as articulating what social care policy is designed to achieve in each of the four nations.

Almost all of the documents start with an account of the ‘problem’ of social care: the crisis that must be solved, the dysfunction that must be addressed. There is remarkable consensus across the four nations over more than two decades on what the problem is: the existing social care system cannot cope with the demographic changes that have led to rising demand and unmet need. Staff are insufficiently ‘regarded, rewarded and supported’ (Feeley, 2021), leading to high staff turnover and workforce shortages. The growing acuity and complexity in conditions of people using care services have further added to the strain, with a greater concentration of higher packages of care assigned to fewer people (Reed et al, 2021). The system has been put under additional pressure by funding cuts in England and Wales, which have only been partly mitigated by short-term cash fixes.