Women mainly provide family care, but as women’s economic opportunities increase they will not continue to bear the costs of providing care unaided. To create a sustainable care system, care and carers must be better supported and more highly valued to involve more men in caring and reduce gender inequalities.Key pointsMost care is still provided through family obligations, unpaid but not free, since it is ‘paid for’ by reduced opportunities for carers. Family carers are mostly women, because of gender norms and also the gender pay gap, which makes it more costly for men to reduce employment hours.As women move increasingly into employment, family carers’ demand for employment will continue to rise, as will the need for paid care. The UK’s long working hours make it difficult to combine caring with full-time employment, but part-time pay rates are often considerably lower.Four in five paid carers are women, in a sector having increasing difficulties with recruitment and retention. The care sector’s poor pay is a large contributor to the gender pay gap.Privatisation of residential and domiciliary care has produced a labour market with insufficient opportunities for training and career development. This is unlikely to attract men, and women will increasingly leave as their employment opportunities improve.This situation will be unsustainable for meeting society’s care needs unless:- pay and conditions improve to retain more women and encourage men to enter the care sector;- unpaid carers receive financial and other support, and working hours are reduced for all, so that more people can combine family care with employment;- cash payments to individuals are not allowed to drive out funding for vital community services; and- policies are judged by the quality of care they support and how much they encourage a stable, less gender-divided workforce, as well as value for moneyAny other solution would be unworkable, unfair and inconsistent with government commitments to reduce gender inequalities.Costs will continue to rise as the paid care sector grows, since to recruit and retain care workers, wages will have to keep up with those elsewhere. Because rising care costs are an effect of rising productivity elsewhere in the economy, paying for them will still let disposable incomes increase. Spending more on social care can be afforded.</br