A View from the Top
Paul Burstow

Paul Burstow is Chair of the Social Care Institute for Excellence.

Reflections on the last decade

While much has changed in social care in the past decade, there is very much a sense of Groundhog Day with many of the debates about the future.

A new Act of Parliament, the Care Act, which I helped to craft, now governs adult social care. Its central tenant of wellbeing is a break with the past. However, its ambition has yet to be realised. Clearly, funding of the social care system remains a major unresolved issue. Added to this, who pays for care and how, is still stuck in the mud too.

At the same time, it’s great that there is innovation going on. Some of it is driven by necessity but also it is developing out of a growing recognition that business as usual is not just unsustainable, it is undesirable too.

For me personally, the past decade has seen some of the most fulfilling and most frustrating years of my working life. The opportunity, as Minister of State for Care Services, to set in place a new Act of Parliament was extremely fulfilling. However, it has been tempered by the growing realisation that efforts to reform the way care is paid for have been kicked into the long grass.

Projections for the next decade

Looking forward to the next decade, whether government – of any persuasion – grasps the nettle on the funding of care and who pays for care, is hard to predict. For the sector to be sustainable for the long term, we need a cross-party settlement that will create certainty and allow people to plan for their future.

I am certain that the next decade will see a growth in asset-based approaches to promoting people’s resilience and wellbeing. We’ll also see more co-production and greater use of technology in the sector. I think that there will also be a number of successful accountable care models, which aim to promote population health and will embrace housing as a partner. The Social Care Institute for Excellence, of which I’m Chair, has a strong reputation and offering to the social care sector.

Already a key player in quality improvement and service redesign, the Social Care Institute for Excellence is well-placed to support NHS, local government and provider organisations in adopting asset-based thinking, co-production and as a go-to partner for the Department of Health and Department for Education.


Since leaving Parliament, I have developed a portfolio career which often puts me at the intersections between health, care, housing and technology.

As Minister, you are an executive, your days are often diced into time-pressured slots and you are juggling many priorities and problems.

As a Chair, the art is to be a strategic leader, helping to create the conditions in which your executive team give their best. It’s a fascinating shift and learning about how to manage the inherent tensions is very rewarding.


I got involved in politics because of Shirley Williams, The Rt Hon. the Baroness Williams of Crosby. She held many roles in Government, including Liberal Democrat Leader in the House of Lords and Secretary of State for Education and Science. It is her style and passionate belief in social justice and the power of community that have shaped my thinking.

My other influence has been my friend and mentor Graham Tope, elected Liberal MP for Sutton and Cheam in a famous by-election in 1972, who has always helped me to keep a sense of perspective and also to keep my feet on the ground.


I think an important lesson to share is to be thoughtful and respectful of people on your way up. It’s the right thing to do.


Building on this, as I say above, be thoughtful and respectful of people on your way up. And also, if you are planning a busy portfolio career, find a good Executive Assistant to help you manage the diary and to put a professional face on what you do.

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