Social care reform could mean big risks and big rewards for Burnham

Andy Burnham has been passionate about reforming the social care system in England for many years. During his tenure as health secretary under Gordon Brown, he proposed a compulsory levy on people’s estates—a plan the Conservatives quickly labeled the “death tax.” He continued to raise the issue frequently while serving as Mayor of Greater Manchester and, in his first major interview as prime minister, committed to dedicating “whatever political capital I have into fixing broken social care.”

Now, the government has begun to reveal its initial vision for how it might achieve those reforms. Burnham has stated that he plans to campaign on a proposal for a national care system that is free at the point of use and universally funded. While this represents a bold ambition, many questions remain about the financial implications and how the government would pay for and implement such a potentially costly scheme. Estimates from the Health Foundation have suggested that providing free care could cost taxpayers around £18 billion annually. Although Burnham disputes this figure, he acknowledges that addressing social care adequately might make him “unpopular” with some voters.

Burnham emphasizes that the current social care system imposes significant hidden costs on individuals and the state. For example, many people have to sell their homes to cover care expenses, and inadequate home care contributes to prolonged stays in A&E. Despite these challenges, the prime minister will need to present a far more detailed funding strategy before going into an election with this as a centerpiece policy. The last major attempt at social care reform came under Theresa May in 2017, whose proposals became famously known as the “dementia tax.” Burnham has also indicated that Labour’s existing manifesto commitments—such as not raising income tax, VAT, or National Insurance—complicate efforts to deliver meaningful reform, hinting that tax increases may be necessary.

Within Labour circles, there is debate about how to approach funding social care. Darren Jones, formerly Sir Keir Starmer’s chief secretary and a known internal critic of Burnham, has cautioned against increasing taxes, spending, and borrowing without corresponding cuts elsewhere. He has suggested that if social care is to be prioritized, there might need to be a revision of existing policies, such as the triple lock on pensions, which Labour has pledged to maintain in its 2024 manifesto. Meanwhile, the Conservative Party and groups like Reform have criticized Burnham’s plans as a new form of the “death tax.” Some Labour MPs might find it difficult to defend potentially unpopular measures like tax hikes or changes to pension protections during the next election campaign. Nevertheless, Burnham appears confident in his ability to make the case. Supporters around him believe that whoever successfully manages to fix social care stands to gain significant public approval, even though history shows prime ministers who fail on this issue often face short tenures. Burning has clearly set his sights on this challenging policy area, ready to make a substantial push

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