Fund free personal care: note

Central fiscal result

+£20.0bn - Net fiscal impact in 2028-29

Low case: +£15.0bn. High case: +£38.0bn. Positive numbers are fiscal costs or borrowing pressure. Negative numbers are Exchequer savings or receipts.

Scenario and baseline

• Models fund free personal care by 2028-29.
• Baseline is current policy or published departmental plans.
• Central case uses published party or official anchors where available.
• Wider manifesto interactions are excluded unless stated.

Affected population

• Affected units are people, firms, households or providers depending on policy.
• Direct exposure follows the manifesto or government target group.
• Indirect exposure includes suppliers, workers, consumers and taxpayers.
• Weakest counts are widened in the low and high cases.

Gross impact

• Published anchor or scenario central is +£20.0bn in 2028-29.
• Gross costs or receipts are adjusted for behaviour and delivery risk.
• Tax, benefit or procurement offsets are separated in the fiscal build-up.
• The range is deliberately wider where implementation detail is thin.

Fiscal build-up, central case

• Gross programme or delivery cost: +£23.0bn
• Tax and receipt offsets: -£1.6bn
• Administration and evaluation: +£0.1bn
• Behavioural and pass-through effects: -£1.5bn

Central net impact: +£20.0bn in 2028-29.

Behaviour and pass-through

• Low case assumes stronger delivery or receipts than central.
• Central case applies moderate behavioural leakage and pass-through.
• High case allows weaker delivery, larger take-up or higher costs.
• Output effects follow incidence, capacity and investment channels.
• Distributional gains do not automatically imply GDP gains.

Phasing

• 2026-27: +£2.0bn. Phased implementation and take-up.
• 2027-28: +£11.0bn. Phased implementation and take-up.
• 2028-29: +£20.0bn. Phased implementation and take-up.
• 2029-30: +£20.0bn. Phased implementation and take-up.

Main source groups

• Crawford, Stoye and Zaranko, "Long-term Care Spending and Hospital Use" (Journal of Health Economics, 2021): Long-term care spending can interact with hospital use among older people; relevant to care spending and NHS offsets.
• Cutler, "Why Don’t Markets Insure Long-Term Risk?" (Harvard working paper, 1996): Private markets struggle to insure long-term care risks, supporting a role for public insurance; relevant to free personal care.
• Institute for Fiscal Studies, "Green Party manifesto: a reaction" (2024): Used to define the pledge wording, policy scope and implementation scenario being modelled.
• Local Government Association, "Green Party manifesto summary" (2024): Used to define the pledge wording, policy scope and implementation scenario being modelled.
• Skills for Care, "State of the adult social care sector and workforce in England 2025" (2025): Skills for Care reports a large, low-paid care workforce and persistent vacancy and retention pressures; anchors labour-cost exposure and capacity constraints.
• HM Treasury, "Spending Review 2025" (2025): Adult social-care funding baselines shape whether the proposal is additional spending; used to set the counterfactual.
• Green Party of England and Wales, "Manifesto for a Fairer, Greener Country" (2024): The manifesto defines the tax, spending, climate, housing and public-service proposals modelled here; used to define the scenario, not as an official costing.