Figures abound about the increasing age of Britain’s population; and, as baby boomers reach retirement and people live longer, the changing demographics are placing ever greater strains on our social care system. Since the post-war creation of the welfare state, the percentage of the population aged over 65 has increased, from 10.5% to 15.7% in 2001, and is set to rise to 24.2% by 2051. There is already evidence of unmet need in the social care system, and the pressure on services is immense. The pressure is not only one of numbers, however. There is an expectation of high-quality support and care, from a population increasingly used to high-quality services (both public and private) tailored to their needs. Making social care fit for the 21st century will not be easy. With a diminishing workforce (in percentage terms) and a reluctance to raise general taxation, various reports have begun to highlight the need for radical change, and to point to the consequences of not responding to this need. As Neil Churchill’s introduction states, those consequences will be severe. Building on that emerging consensus, the essays in this monograph seek to articulate more fully how and where policy change and intervention are required. The authors examine the trade-offs to be made between quality and coverage; the case for more targeted support; the concept of co-payment; and the role of the private market for care insurance. Most importantly, the essays aim to set out some positive and achievable options, which can lead to the action that is necessary to ensure the dignity and meet the aspirations of Britain’s older citizens.