How should we care for one another? And what might it take to turn our current thinking about care and the care system on its head? How might we tell a new story in which care is not seen as a cost but as an investment in social flourishing?

In the annual REAL Challenge lecture, acclaimed author and social innovator Hilary Cottam argues that the COVID-19 pandemic has been a cataclysm, ‘brutally exposing the crisis in the funding, culture and operation of our care systems’. Hilary argues that we can only honour this recent experience and the deeper legacies of injustice, by creating something new. And by daring to imagine what it really means to care.

In A radical new vision for social care, Hilary points to examples of the forms of care and support she believes are needed and calls for a new framework that could allow these models to grow and, in turn, enable us all to thrive. In the closing section, Hilary looks at five areas largely absent from the current debate, which she views as a necessary foundation stone of any new system.

The REAL Centre invited Hilary to deliver the 2021 REAL Challenge lecture to generate fresh ideas and debate. The views expressed in this publication are those of the author and do not necessarily reflect the views or position of the REAL Centre or the Health Foundation.

Cite this publication

Cottam H. A radical new vision for social care: how to reimagine and redesign support systems for this century. The Health Foundation; 2021 (

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A radical new vision for social care

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