REAL Challenge annual lecture: A radical new vision for social care

By Hillary Cottam
Public Service Reform

Hilary Cottam argues that the COVID-19 pandemic has laid bare the deep-rooted failures in the organisation, funding, and cultural framing of social care, exposing a sector treated as a cost-centre rather than a cornerstone of societal wellbeing. She calls for a fundamental reimagining of care, shifting from transactional service delivery to systems grounded in relationships, community involvement, and collective responsibility. Care should no longer be siloed; instead, it must recognize the interconnectedness of housing, education, health, and social bonds-effectively positioning care as an investment in social flourishing rather than a short-term expense.

To turn this vision into reality, Cottam promotes bold, structural innovations: designing care systems from the ground up with communities at the centre; integrating technology to inform rather than replace human relationships; and redefining success metrics to measure human connection, trust, and collective well-being. This requires purposeful institutional redesign and cultural transformation, supported by collaborative governance among citizens, social entrepreneurs, local bodies, and state actors-moving care from the margins of policy to the heart of what makes society thrive.

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