Agreement: I Agree Body: Dear Editor The editorial by Mary Daly (BMJ 2026;394:e100629) and article by David Oliver (BMJ 2026;394:e100737) describe clearly what is needed to fund and organise social care. What is also needed is a strategy to reduce the need for social care by increasing healthy longevity, and the new NHS Live Longer Better programme (livelongerbetter.uk) has been introduced to do that. There is now strong evidence that the ageing process is not the major cause of the need for social care which is due to loss of fitness, disease, much of which, including dementia (1), can be prevented or delayed, and social factors--notably, deprivation. The NHS cannot provide all the solutions but it can provide the leadership--namely, a cultural shift in which every debate about social care finds time to highlight the possibility of reducing the need principally by increasing activity, as the House of Commons report on Healthy Ageing made clear. The term social care implies doing things for people but carers should be renamed enablers and even if social care is provided there should continue be an activity programme, stimulating both mental and physical activity, to continue to reduce need by Reconditioning, to use the excellent term introduced by the British Geriatric Society 1. Alessi C et al. Increase your Brainability; reduce the risk and impact of dementia. Offox Press No competing Interests: No competing interests The following competing Interests: I am a coauthor of the book referenced Electronic Publication Date: Friday, September 18, 2026 - 07:35 AI use: No, I have not used AI Highwire Comment Subject: David Oliver: The NHS and adult social care differ so much that talk of a “national care service” is no panacea Workflow State: Released Full Title: Re: David Oliver: The NHS and adult social care differ so much that talk of a “national care service” is no panacea Highwire Comment Response to: David Oliver: The NHS and adult social care differ so much that talk of a “national care service” is no panacea Check this box if you would like your letter to appear anonymously:: Last Name: Gray First name and middle initial: Muir Email: muir.gray@oapltd.com Address: Oxford Occupation: public health professional Affiliation: www.oxfordlongevityproject.org BMJ: Additional Article Info: Rapid response
Re: David Oliver: The NHS and adult social care differ so much that talk of a “national care service” is no panacea
