I am sorry that Dr Paul Sagar experienced his injury, but grateful for his moment of enlightenment (The big idea: Could this policy fix the care system and slash student debt at the same time?, 30 August). It is the sort of suggestion that family carers such as myself have been making for years, having been failed by the statutory services for decades.
It needs backing up with some infrastructure: more special schools, more special colleges, better provision in mainstream schools for children with special needs via smaller class sizes, and through more care villages/intentional communities with accommodation, not only for those needing care and support but also for the staff and volunteers on the same site, and housing for family carers.
For our family, enlightenment came more than 60 years ago when my younger brother was born deafblind with additional complex multiple disabilities. When my parents asked the authorities which special school he could attend, the reply was devastating: there was nowhere in the north of England that could cope with the severity and complexity of his disabilities. My parents were left in despair.
Thankfully, we embarked on a tour of the UK as a family with our car and caravan in search of a special school that could help. By some form of divine intervention, we came across the Camphill Rudolf Steiner school in Aberdeen.
My brother started there at the age of five and a half, and within a few weeks was toilet-trained and feeding himself – something that the officials at South Shields town hall had said was impossible.
The houseparents at the school were supported by a team of unwaged voluntary workers, many of whom were from other European countries and doing their “civil service” – an alternative to military service in their own country.
Our family was saved by the conscription policies of other countries and the civilian alternative provided by Camphill. The young voluntary co-workers gained a lifetime of experience and expertise, a confidence in working with and supporting vulnerable children and adults, and training in social care, communication and life skills, as well as learning English with an Aberdonian twang.
Simon Burdis
Morpeth, Northumberland
Paul Sagar is right to think that radical solutions are needed to transform social care in the UK, but social care deserves more consideration than an amped-up Duke of Edinburgh award. Care work is too often unfairly maligned as unskilled work and kept on low wages by an economy that favours profit over worker wellbeing.
These proposals to incentivise participation in social care work through student debt forgiveness and voluntary service won’t change that without engaging with the poor working conditions and pay in the sector. Rather, we need to consider what an economy that centres care in all its decisions looks like.
Moving away from extractive capitalist models of care provision is an essential part of this, and one that Andy Burnham has acknowledged. So too is a new narrative about care as being valuable, alongside meaningful support for the 6 million unpaid carers and an investment in care work and conditions. Our welfare state, public services and communities all have a role to play in a more caring economy, and we shouldn’t have to twist anyone’s arm to know that.
Hannah Webster
Co-founder, Care Full, and former unpaid carer
Paul Sagar’s “Care First” proposal assumes that almost any school leaver can become a suitable carer after training. But caring is not easy or interchangeable work. It requires patience, judgment, emotional maturity, safeguarding awareness and the ability to preserve someone’s dignity during intimate or distressing situations.
What evidence suggests that school leavers motivated principally by reduced university fees would remain in demanding social care roles for a full year?
Social care already has a retention crisis. More than one in five domiciliary care staff leave their roles annually. Turnover rises to 38% among workers under 25 and 43.5% among those with less than a year’s experience. Recruiting a rotating supply of school leavers would do nothing to address the low pay, insecure hours, exhausting travel and working conditions driving experienced carers away.
Most importantly, people needing care have a right to choose who supports them and to expect competence, continuity and genuine commitment.
The proposed reward is also remarkably unequal. At current fee levels, one year in social care could earn a student up to £14,685 in tuition-fee reductions. A family carer providing at least 35 hours of care a week receives only £4,495.40 a year through carer’s allowance – and many receive nothing.
After more than 30 years as an NHS midwife, I left my career to care full-time for my mother, who has dementia. I lost earnings, pension growth and the freedom to work normally. If care is worth thousands when performed temporarily by a prospective student, why is sustained care provided by relatives valued so little?
Jacqueline Hylton
Leeds

3 hours ago
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