Economist Sir Andrew Dilnot has cautioned that implementing a new NHS-style social care system in England could require decades, based on remarks made to the BBC. Dilnot, who led a commission proposing social care reforms 15 years ago, suggested that Prime Minister Andy Burnham appears to envision a completely free system that would cover residential costs alongside other care services.
Burnham indicated in recent interviews that his proposals would operate on a universal contribution model where “everyone contributes, everyone is covered,” and he declined to rule out tax increases as a funding mechanism. However, he stated that implementation would not occur before the next general election scheduled for August 2029, citing Labour’s 2024 election manifesto commitments regarding national insurance, income tax, and VAT. Burnham promised to provide additional details regarding his vision at a conference speech.
Dilnot noted that the timeline for reform has become more distant, particularly given that any proposals included in Labour’s 2029 election manifesto would arrive approximately 30 years after Tony Blair initiated a royal commission on social care. He estimated that an NHS-style system could cost well in excess of £18 billion annually, while the Health Foundation has provided estimates of around £18.5 billion per year. A Scottish-style model, which does not cover residential accommodation costs, could cost approximately half this amount.
Labour MP Darren Jones identified scrapping the pensions triple lock as a potential funding option, though Helen Miller of the Institute for Fiscal Studies stated this measure alone would be insufficient and tax increases would likely be necessary. The current system in England means-tests support, with people holding assets exceeding £23,250 ineligible for council-funded care assistance. Previous reform efforts, including a proposed lifetime cap of £35,000 from Dilnot’s commission and Theresa May’s failed residential care policy, have encountered implementation delays or political opposition branded as “taxes” by critics.
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