Behind the UK’s £77.8bn care economy lies a hidden cost borne by care workers themselves. Here, Karolina Gerlich exposes who really pays the price for an undervalued, underfunded system.
The UK’s adult social care sector is often discussed through the lens of budgets and efficiency. Yet behind these figures sits a hidden economy, sustained by undervalued labour and personal sacrifice. The real economics of care are not defined by what Government allocates on paper, but by who absorbs the true financial and emotional cost every day.
Adult social care contributes £77.8 billion to the UK economy, yet the two million people delivering this value, most of them women, remain among the lowest-paid workers in the country. The Care Workers’ Charity’s 2025 Care Worker Wellbeing Survey of over 2,000 care workers exposes the human toll of this chronic undervaluation:
- 06% do not feel financially secure; over half say their pay is too low.
- 33% say their job harms their mental health; only 52.63% believed mental health support in their workplace was available.
- 53% indicated they are likely to look for a new job within a year; key reasons for leaving include pay (65.29%), wellbeing (60.95%) and lack of progression (56.52%).
- 12% said they had been directly impacted by the cost-of-living crisis.
These are not abstract statistics. They represent people holding up the lives of others while struggling to hold up their own.
Since 2020, The Care Workers’ Charity has awarded £6.3 million in crisis grants to 12,605 care workers, underlining how fragile the system has become. Of those supported, 83% are women and 53% work full time. Nearly three-quarters of grants (74%) cover urgent daily living costs, with further support needed for household essentials (6%), car repairs (4%) and preventing eviction (4%).
Crisis grants provide vital short-term relief, but the scale and nature of applications reveal a system that relies on care workers absorbing financial shocks and emotional strain so the state does not have to.
This burden is deeply gendered. According to Skills for Care’s State of the Adult Social Care Sector and Workforce in England 2025, women make up 78% of the workforce. Analysis from Carers UK and the Women’s Budget Group shows that inadequate social care provision pushes women into low-paid or insecure work and out of the labour market altogether. Around 600 people leave the workforce every day to care for a loved one, most of them women, representing a substantial and avoidable loss to productivity and income.
The sector is also grappling with 111,000 vacancies, with capacity shrinking as demand rises. Local authority budgets have failed to keep pace, leaving providers unable to recruit or retain care workers. The consequences are predictable and costly: unmet need grows, families step in, and hospitals struggle to discharge patients safely. The King’s Fund found delayed discharge remained acute in March 2025, with an average of 9,309 people delayed each day.
Despite delivering increasingly complex care, pay remains unacceptably low. In London, the average hourly rate is £12.20, £1.65 below the London Living Wage. In the East of England, it stands at £11.90, and in the West Midlands £11.77, with several regions paying even less. Large parts of the workforce continue to earn below the National Living Wage of £12.21 per hour, while NHS healthcare assistants start on higher rates with pensions, enhancements and clear progression pathways. This lack of parity drives people out of social care and destabilises both systems.
International recruitment has become a lifeline. Around 385,000 care roles are filled by migrant care workers, and over 80% of workforce growth since 2021 has come from overseas recruitment. Yet policies such as the proposed 15-year settlement route and the dependants ban are creating fear and insecurity, undermining retention when the system depends on these workers most.
The cost of an undervalued care system is being paid by care workers through low pay and burnout; by women through lost income and unpaid care; by families forced out of employment; by providers facing instability; by NHS services struggling with delayed discharges; and by people drawing on care whose needs go unmet. Underfunding does not save money; it shifts costs onto those least able to carry them.
If the Government is serious about growth, it must recognise the care workforce as essential economic infrastructure. Investing in care would increase labour market participation, improve NHS efficiency, reduce gender inequality, strengthen local economies and ensure dignity for people drawing on care. The economics are clear: the cost of care is not the burden; the absence of care is. Until care workers are fairly paid, protected and recognised as skilled professionals, the UK will continue to pay far more than it would ever cost to fix the system.
