Andy Burnham has promised to end decades of government inaction by fixing adult social care in England, and did not rule out tax rises to help pay for it. The prime minister said it was a "major dereliction of public duty" that successive governments had failed to address the crisis, adding there would be "difficult decisions" on funding but he was determined to "get it right."
His plans include a new national care service, with more pay and better training for care workers, and closer integration with the NHS. He announced that a review of social care by veteran Whitehall troubleshooter Baroness Casey would now be published next summer instead of 2028.
Burnham, speaking at a care home in north London, said there was a feeling in Westminster that the issue is "too big a political risk" to deal with, adding he wants to take on the challenge as the "risks of failing to act are too great."
He highlighted the financial impact of care costs on people and spoke of how fixing issues in social care could ease the pressure on the NHS and make savings. The PM said Baroness Casey's review should consider how to pay for a national care service, adding there needs to a system that becomes "highly integrated" with the NHS.
What did Burnham say about his personal motivation?
In an emotional speech he praised those caring for his father, who has Alzheimer's, and said he wanted to deliver changes to help "my dad and the millions like him". Burnham spoke to residents at a Jewish Care facility in North London before delivering his speech.
How is he trying to build political support?
He is attempting to get cross-party consensus on any changes and has held initial talks with the Liberal Democrats and Conservatives in an attempt to get them on board. Liberal Democrat leader Sir Ed Davey took part in the talks but Conservative Party leader Kemi Badenoch could not be there and sent shadow health secretary Stuart Andrew instead.
Andrew said any changes must be "backed by a clear, credible and fully costed plan that delivers better care for the public and value for taxpayers." Burnham did not invite the leaders of Reform UK or the Green Party of England and Wales to the talks. Both parties have expressed disappointment at this.
Reform Treasury spokesman Robert Jenrick said:
"Make no mistake, today Andy Burnham fired the starting gun on his scheme to raid the little money that hundreds of thousands of regular people have struggled to save over their lifetimes.
That's why he can't rule out the new universal death tax."
Green Party social care spokesperson Ellie Chowns said:
"If Andy Burnham is serious about doing things differently and tackling the crisis in care, he must work collaboratively with the Greens and other parties to do so."
What did Burnham say about funding and tax rises?
Answering questions about his social care ambitions, Burnham was pressed on the prospect of tax rises. He said the first thing is "to do more with what you've got" and issues he raised on Wednesday, including for the workforce, "will be fully funded."
Burnham added:
"Some of what we would want to do in the fuller sense will require difficult decisions but we will be honest with people about those, we will put them before the country at the right time, and we will hopefully proceed with people's consent."
The PM said Baroness Casey's review should consider how to pay for a national care service. Burnham said he wants to "immediately" focus on the social care workforce, noting a fair pay agreement is due to come into force from 2028/29 and described it as a "massive building block of a national care service."
Why is social care reform being pushed now?
Burnham said in Westminster there has long been a sense that social care is "too big a political risk" to fix, but he believes the costs of inaction are greater. He said he is determined to address the issue because failing to do so has major consequences for people, families and the NHS.
Adult social care provides state support to help people live more independently, including assistance at home. Unlike the NHS, social care is not free at the point of use. In England and Northern Ireland, people with savings worth more than £23,250 are not entitled to help with care costs from their council.
In Wales and Scotland, different rules apply in terms of eligibility. Asked about the threshold, Burnham said:
"I think social care in England is as unfair as American healthcare. The vulnerable pay with everything and it can completely leave them with nothing.
"That floor has been in place for a long, long time and common sense says it cannot be fair."
Burnham said in "an ideal world" he would not want anyone to have to sell their home to pay for care, describing it as a "really awful process." He added proposals he previously put forward were intended to stop that, saying:
"If everybody on the NHS principle contributed a little, it would mean everybody could protect the majority of what they'd worked for."
Burnham said he did not know if people support that approach, adding this was for something for the consultation to consider.
What previous proposals has Burnham made?
Burnham first proposed a universal system of social care in England in 2009, when he was health secretary under former Prime Minister Gordon Brown. He suggested a compulsory levy to fund the system and Brown's government also floated the idea of allowing people to defer the payment until after they died, leading to the Tories branding it a "death tax."
What did he say about the wider political process?
On the cross-party talks, Burnham said there has been 22 failed attempts to make progress in almost 30 years. The PM said:
"We're going to have to find common ground here if this is to be a lasting solution."
Burnham is seeking cross-party agreement on any eventual changes, and his meetings with the Liberal Democrats and Conservatives are intended to test whether there is support for a long-term settlement. The discussion comes as Baroness Casey's review is brought forward and the government prepares to consider both workforce reform and future funding.
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Key Facts
- Andy Burnham said he would not rule out tax rises to help fund social care reform in England.
- Baroness Casey's review will now be published next summer instead of 2028.
- The plans include a new national care service, better pay and training for care workers, and closer NHS integration.
- People in England and Northern Ireland with savings above £23,250 are not entitled to council help with care costs.
- Burnham held initial talks with the Liberal Democrats and Conservatives, but not Reform UK or the Green Party.
