Prime Minister Andy Burnham has committed to addressing one of Britain’s most intractable policy challenges: how to fund social care. In his first major interview, Burnham warned that without reform, the NHS faces collapse, and indicated he aims to implement substantial changes during his tenure in office.
Burnham’s stated commitment to solving the social care crisis carries historical weight. As health secretary, he co-authored a 2010 white paper proposing a National Care Service modeled on the NHS, which came close to implementation before Labour’s election defeat. Since 1997, at least 22 major reviews, commissions, and reports have attempted to address the funding question, yet none have succeeded in creating lasting policy. Rising care home fees—increasing by up to 10% annually in recent years—have intensified the urgency, with projections suggesting costs could exceed £1.2 million for a two-year care home stay by 2056 under current trajectories.
The political obstacles to reform remain substantial. Previous governments have encountered severe backlash from proposals framed as potential “death taxes.” Conservative attempts under Theresa May to raise means-test thresholds were rebranded by Labour as a “dementia tax” and contributed to the loss of the government’s parliamentary majority in 2017. A 2014 care cap proposed by economist Andrew Dilnot was delayed repeatedly, ultimately postponed beyond 2025. Most recently, the current Labour government abandoned its predecessor’s care cost cap upon winning the general election, instead commissioning another cross-party review chaired by Louise Casey, expected to report in 2028.
The funding question remains contentious. Care financing currently depends heavily on individual wealth, with people forced to deplete savings and sell homes once they fall below threshold levels. Approximately 10% of care spending goes to administrative costs, profits, and dividends rather than frontline services. International models exist—Australia uses general taxation for lower-income care subsidies, while Japan combines taxation, insurance contributions, and individual fees—yet political consensus on implementation remains elusive. With opposition parties conditioning support on avoiding tax increases or additional borrowing, Burnham faces the same constraints that have stalled predecessors.
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