Burnham sets out ambition for NHS-style social care in England
Constantvpn.com – Andy Burnham has outlined plans for a social care system in England built around principles similar to those of the NHS, with the aim of making care available free when people need it.
The proposal would represent a major change from the current model, in which many adults must use savings and assets to pay for support. Burnham has said he intends to present a detailed plan to voters at the next general election, arguing that reform cannot be delayed indefinitely.
“Broken social care will in the end break the NHS.”
Adult social care covers practical support that helps people remain independent, including assistance in their own homes. It can involve help with everyday activities and personal tasks, but it is not generally provided without charge at the point of use in the way NHS treatment is.
In England and Northern Ireland, people with savings above £23,250 are normally unable to receive council help with their care costs. Scotland and Wales operate under different eligibility arrangements. Burnham has argued that England should move towards the model of free personal care already available elsewhere in the UK.
A system in which people contribute and are protected
Burnham said the proposed approach would mean that everybody makes a contribution while everyone receives cover. He stressed, however, that the precise mechanism would not necessarily mirror the current way the NHS is financed.
“It will be a system of that kind – so everyone contributes, everyone is covered but not precisely necessarily in the same way that we currently pay for the NHS.”
He has not ruled out any funding options, while acknowledging that the reforms must be designed carefully to avoid putting further pressure on public finances. When asked about an estimate that a universal, free-at-use system in England could cost taxpayers £18bn each year, Burnham said the true figure would be lower.
His argument is that the present arrangement already imposes heavy costs on families, particularly when a person’s care needs are prolonged. He described the system as deeply unfair, saying vulnerable people can lose their accumulated wealth while facing high care bills.
Burnham’s personal experience has also shaped his focus on the issue. His father, Roy, had Alzheimer’s disease and died earlier this month. Social care has become one of Burnham’s central policy priorities as he presses for a long-term settlement rather than piecemeal adjustments.
Pressure on hospitals
One of the strongest practical cases for reform concerns the effect on the NHS. Hospitals can struggle to discharge patients who are medically ready to leave because appropriate support is unavailable at home or in the community. Those delays can leave beds occupied and add to wider pressure across hospital services.
Burnham said the lack of available social care means a large number of people in hospitals across England cannot return home when they otherwise could. A stronger care system, supporters argue, could help people receive suitable support in the right setting while reducing avoidable strain on acute services.
Scotland’s system offers one reference point. Free personal care there is available to adults assessed as needing help with tasks such as eating and bathing. Burnham has said he does not believe people in England should be denied comparable support.
“I am talking about a system that works on NHS principles because that is the only way you can make it work.”
He also emphasised that any overhaul would not be rushed. The scale of change required means decisions on eligibility, funding and delivery would need to be worked through in detail, alongside the effect on councils, care providers, families and the public finances.
Casey review to shape proposals
Whitehall troubleshooter Baroness Casey is conducting a review into social care and is expected to advise on how the changes could be delivered. She had originally been asked by former prime minister Sir Keir Starmer to complete the review in 2028, but Burnham has requested that it be brought forward to next summer.
Burnham has said the eventual plan should be discussed across party lines in an effort to build agreement. He believes durable reform will require consensus because social care policy has long presented difficult choices about tax, spending and the balance between individual responsibility and collective support.
“I don’t think you can reform this system without consensus. I will develop a very clear plan and I will put that plan to the public at a general election and that will be where the plan gets tested and people will then be able to decide.”
He said he would keep to the commitments made in the Labour manifesto, noting that promises on tax would make it difficult to introduce such a reform during the current Parliament. Labour’s 2024 manifesto pledged not to raise national insurance, income tax or VAT.
Political disagreement over funding
Shadow home secretary Chris Philp said the proposals pointed towards further tax rises and made clear that the Conservatives would oppose them. He described tax increases as a red line, arguing that the country is already taxed too heavily.
Philp said that if additional spending were needed for social care or defence, the Conservatives would seek savings elsewhere, particularly from the welfare budget.
Labour MP Darren Jones, who served as a cabinet minister in Sir Keir’s government, said Burnham was taking a bold approach to a difficult issue. He said the eventual policy detail would matter because social care reform carries substantial financial consequences.
The debate now turns on whether a funding model can be developed that offers greater protection to people needing care, supports a pressured NHS and commands public support. Burnham’s intention is to place that choice before the electorate, with Baroness Casey’s work expected to help determine the shape of the plan.
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