Burnham Champions NHS-Style Social Care for England, Vows to Take Plan to Voters

Andy Burnham has unveiled an ambitious vision to overhaul adult social care in England by modelling it on the National Health Service, promising universal coverage in which "everyone contributes, everyone is covered." The prime minister said he will present his detailed proposals to the public at the next general election, framing the reform as a defining mission of his leadership.

Speaking to the BBC's Sunday with Laura Kuenssberg programme, Burnham argued that the current system is fundamentally broken and cannot be allowed to continue. "Broken social care will in the end break the NHS," he warned, drawing a direct link between the inadequacies of the care sector and the mounting pressures on the health service.

The prime minister said he wants a system that operates on the same principles as the NHS, where access is based on need rather than the ability to pay. He pointed out that free personal care already exists elsewhere in the UK, notably in Scotland, and said it is unjust that people in England are denied the same entitlement. "I am talking about a system that works on NHS principles because that is the only way you can make it work," he said.

Under the current arrangements in England and Northern Ireland, individuals with savings exceeding £23,250 are not eligible for council-funded help with care costs. Wales and Scotland operate under different eligibility rules. Adult social care provides state support to help people live more independently, including assistance in their own homes, but unlike the NHS it is means-tested and not free at the point of use.

Burnham declined to rule out tax rises to fund the reforms, conceding that such a move could be "difficult or unpopular" with some voters. He said "nothing is off the table at this moment in time" regarding how the proposals would be financed, but insisted the changes must be "done carefully, without putting extra strain on the public purse." When challenged over an estimate that a universal system free at the point of use could cost taxpayers £18bn a year, he responded: "It's not that high."

The prime minister said people already bear a "huge cost" under the present system, which he described as "as unfair as American healthcare, where the most vulnerable in society can lose everything, they can be wiped out." He also highlighted the knock-on cost to the NHS, noting that a "huge number" of hospital patients across England cannot be discharged home "because the social care isn't there."

Burnham said he has asked Whitehall troubleshooter Baroness Casey, who is conducting a government review, to advise on the "best way of doing it." Baroness Casey was originally tasked by former prime minister Sir Keir Starmer to deliver her social care review in 2028, but Burnham has asked her to bring it forward to next summer. He said her detailed findings would be subject to cross-party talks aimed at "building consensus," adding: "I don't think you can reform this system without consensus."

On the timing of any legislative change, Burnham said he intends to stick to the Labour manifesto, acknowledging that existing commitments would make it hard to act within this Parliament. The 2024 Labour manifesto contained explicit pledges not to raise national insurance, income tax or VAT. Burnham said he would develop a "very clear plan" and put it before the electorate, where it would be "tested" and people would be able to decide.

The proposals drew immediate political reaction. Shadow home secretary Chris Philp said the prime minister was signalling that Labour wanted "more tax rises" to pay for the reforms, and confirmed the Conservatives would not support such a move. He described tax increases as a "red line" for his party, telling the BBC: "If more money is needed, for example, for social care or indeed for defence we would find that money through savings elsewhere, particularly in the welfare budget." He added that the country is "already taxed too highly."

Labour MP Darren Jones, who served as a cabinet minister under Sir Keir, praised Burnham for being "very bold and brave" on social care, though he noted that "politics is about prioritisation and these things do cost money." Liberal Democrat leader Sir Ed Davey urged Burnham to demonstrate he is "serious about fixing care" by advancing the cross-party talks that began in July, warning: "This can't just be a series of No 10 headlines with no real action." Reform UK's economic spokesman Robert Jenrick accused the prime minister of refusing to rule out a "universal death tax," claiming: "He's too weak to cut the benefits bill so he's coming for your home instead."

Burnham has made social care reform one of his flagship policies, an ambition shaped in part by personal experience. His father, Roy, who had Alzheimer's, died earlier this month. The prime minister has accused previous generations of politicians of "cowardice" for failing to tackle the issue, though he acknowledged his own push for change is not without political jeopardy.

History illustrates the risks. While serving as health secretary in Gordon Brown's Labour government, Burnham produced a plan for a national care service, funded partly through compulsory contributions that included people's estates after death. Opponents branded it a "death tax," and the proposals were abandoned after Labour lost the 2010 general election. In 2017, then-Conservative prime minister Theresa May faced a similar backlash when she was accused of introducing a "dementia tax" by proposing that people receiving care at home pay full costs if they were worth at least £100,000. That policy provoked a political outcry, and the Conservatives lost their majority in the House of Commons at the ensuing election.

Against that backdrop, Burnham's latest attempt to forge a lasting settlement on social care will test whether a cross-party consensus can finally be built around one of the most intractable domestic policy challenges of recent decades.