Introduce free personal care

Policy baseline

The manifesto pledges free personal care. Party costings include it inside an GBP 8.35bn NHS and social-care package.

• Targets adults needing personal care.
• Accommodation and living costs remain separate.
• Demand and workforce responses are uncertain.

Core trade-offs

The direct beneficiaries are care users and unpaid carers. The costs fall mainly on taxpayers and the care workforce. The main economic question is expanded entitlement may reveal unmet demand.

• Care users and unpaid carers gain most directly.
• Costs fall mainly on taxpayers and the care workforce.
• Key risk: expanded entitlement may reveal unmet demand.

Fiscal impact by 2028-29

+GBP 4.0bn to +GBP 14.0bn. Central estimate: +GBP 6.0bn.

• Positive numbers mean net fiscal cost; negative numbers mean Exchequer savings.
• Main channel is the scored tax, spending or delivery change.
• Offsets depend on tax receipts, behaviour and pass-through.
• Range reflects uncertain implementation and economic response.
• This is not an official costing.

Economic impact by 2028-29

• Jobs: NHS and care demand for staff rises; shortages may bid workers away from other sectors.
• Wages: Direct gains for health and care staff if pay or hours rise.
• Prices: Public provision limits prices; agency costs can rise under shortages.
• GDP / productivity: Potentially positive if health improves labour supply; delivery bottlenecks may limit gains.

Assessment

This is a real trade-off, not a free gain. Care users and unpaid carers benefit, while taxpayers and the care workforce bear most costs. Overall output depends on behaviour, capacity and pass-through.

Confidence: Medium-low. Higher on the policy target and fiscal channel; lower on behaviour, pass-through and economy-wide effects.

Main risks

• Workforce shortage: More money may bid up scarce labour rather than expand capacity.
• Productivity risk: Extra appointments or care hours need workflow changes to improve outcomes.
• Cost drift: Health and care commitments tend to grow with demographics and wages.

Safeguards

• Tie funding to workforce plans.
• Track outputs and outcomes, not just spending.
• Limit agency-cost leakage.

Academic evidence

UK government evidence

Sources

• PolicyLens illustrative scenario methodology for introduce free personal care Internal - PolicyLens, 2026
• Long-term Care Spending and Hospital Use Academic article - Crawford, Stoye and Zaranko, Journal of Health Economics, 2021
• Why Don’t Markets Insure Long-Term Risk? Academic article - Cutler, Harvard working paper, 1996
• Funding a Fair Deal: Liberal Democrat Manifesto Costings Party costing - Liberal Democrats, 2024
• Liberal Democrat Party manifesto summary Manifesto summary - Local Government Association, 2024
• For a Fair Deal: Liberal Democrat Manifesto 2024 Party policy source - Liberal Democrats, 2024

Other Liberal Democrats policies

• Raise Carer’s Allowance by GBP 20
• Create a Carer’s Minimum Wage
• Scrap two-child and benefit caps
• Recruit 8,000 more GPs
• Guarantee urgent NHS dentist access
• Put counsellors in schools
• Extend free school meals
• Introduce a Tutoring Guarantee