Burnham Unveils Plan for NHS-Style Social Care in England, Leaving Funding Question Open

Andy Burnham has set out an ambition to extend free social care to every adult in England, framing the proposal as a remedy for a system he describes as profoundly unjust and a growing burden on the health service. The prime minister said he would present his vision on Tuesday, with the explicit intention of putting the plan before the electorate at the next general election.

Speaking to the BBC, Burnham said the model he envisages would operate on the principles that underpin the National Health Service, with costs shared across the population and coverage available to all. He acknowledged that delivering such a system may require tax increases, conceding that the prospect could prove "difficult or unpopular" with some voters. Nevertheless, he declined to rule out higher taxes as a means of financing the reforms.

The plan would be informed by a review being conducted by Baroness Casey, the Whitehall troubleshooter who has been asked to advise on the most effective route to implementation. Burnham said he wanted Casey's work to inform what he called the "best way of doing it," signalling that the practical mechanics of the policy remain under development.

Adult social care in England currently differs sharply from the NHS in one fundamental respect: it is not free at the point of use. Under the existing means-tested regime in England and Northern Ireland, individuals with savings above £23,250 are not entitled to council support with care costs. Wales and Scotland operate under different eligibility rules, with Scotland offering free personal care to all adults assessed as needing help with tasks such as eating and bathing.

Burnham argued that the disparity between England and the rest of the UK is untenable. "There is free personal care elsewhere in the UK," he told the BBC's Sunday with Laura Kuenssberg programme. "I don't think it's right that people in England don't get the same and it's not something we're going to rush." He stressed that any changes would need to be introduced carefully so as not to place additional strain on public finances.

The prime minister has made social care reform one of his flagship policy areas, a commitment he has linked publicly to the experience of his father, Roy, who had Alzheimer's disease and died earlier this month. While Burnham has been unambiguous about his desire to overhaul the system, he has yet to explain in detail how the changes would be paid for.

Pressed on the cost, Burnham disputed an estimate that a universal system free at the point of use could cost taxpayers £18bn a year. "It's not that high," he said. He argued that families already bear enormous costs under the current arrangements, describing social care in England as "as unfair as American healthcare, where the most vulnerable in society can lose everything, they can be wiped out."

Burnham also highlighted the knock-on effect on the NHS, pointing to the substantial number of patients in hospitals across England who are unable to return home because adequate social care is not available. This bottleneck, he suggested, represents an additional cost to the health service and underscores the urgency of reform. "Broken social care will in the end break the NHS," he said.

Asked whether everyone would be required to contribute to his proposed system, Burnham replied: "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 indicated that the finer points would be shaped by Casey's review and then subjected to cross-party discussions aimed at building consensus.

Casey had originally been commissioned by former prime minister Sir Keir Starmer to deliver her social care review in 2028, but Burnham asked her to accelerate the timetable to next summer. On the broader timeline, Burnham said his government would adhere to its manifesto commitments, acknowledging that some pledges would make reform difficult to achieve within the current Parliament. The 2024 Labour manifesto included firm commitments not to raise national insurance, income tax or VAT.

The political response was swift and divided. Shadow home secretary Chris Philp said the prime minister's remarks amounted to a signal that Labour wanted "more tax rises" to finance the reforms, adding that the Conservatives would not support such a course. Philp described tax increases as a "red line" for his party and said the country is "already taxed too highly."

Philp suggested that any additional funding required for social care or defence should be found through savings elsewhere, particularly in the welfare budget. Labour MP Darren Jones, a former cabinet minister in Sir Keir's government, characterised Burnham's approach as "very bold and brave," while cautioning that "politics is about prioritisation and these things do cost money." He said the details of the policy would need to be examined closely.

Liberal Democrat leader Sir Ed Davey said Burnham could demonstrate that he is "serious about fixing care" by advancing the cross-party talks that began in July. He warned that the proposal "can't just be a series of No 10 headlines with no real action." Robert Jenrick, Reform UK's economic spokesman, accused Burnham of refusing to rule out a "universal death tax" and claimed the prime minister was "too weak to cut the benefits bill" and was "coming for your home instead."

Burnham accused previous generations of politicians of "cowardice" for failing to confront social care reform, though his own attempt carries political risk. As health secretary in Gordon Brown's Labour government, he produced a plan for a national care service funded partly through compulsory contributions, including from people's estates after death. Opponents branded the idea a "death tax," and the proposals were abandoned after Labour lost the 2010 general election. A later attempt at reform, by Conservative prime minister Theresa May in 2017, was similarly derailed when her proposal that people receiving care at home pay full costs if worth at least £100,000 was labelled a "dementia tax." The backlash contributed to the Conservatives losing their majority in the House of Commons.