Burnham Pledges Free Social Care for All in England, but Funding Questions Loom

Andy Burnham has set out an ambitious vision to overhaul adult social care in England, promising a system modelled on the founding principles of the NHS in which "everyone contributes, everyone is covered". The prime minister said he would put his proposals directly to voters at the next general election, framing the reform as one of his flagship policies and a personal mission shaped by his father's experience of Alzheimer's disease.

In an interview with the BBC's Sunday with Laura Kuenssberg, Burnham argued that the current system is fundamentally unjust and unsustainable. He said social care in England is "as unfair as American healthcare", warning that the most vulnerable people in society can "lose everything" and be "wiped out" by care costs. He also linked the issue directly to the health service, saying: "Broken social care will in the end break the NHS."

The prime minister said he wants to offer access to free social care services to everyone in England, drawing a direct comparison with the NHS. "I am talking about a system that works on NHS principles because that is the only way you can make it work," he said. While he acknowledged that free personal care already exists elsewhere in the UK, he said it is not right that people in England are denied the same support, but stressed that the reform would not be rushed.

Adult social care provides state support to help people live more independently, including assistance in their own homes. Unlike the NHS, however, it is not free at the point of use. In England and Northern Ireland, people with savings above £23,250 are not entitled to council help with care costs, while Wales and Scotland operate under different eligibility rules. In Scotland, personal care is available to all adults assessed as needing help with tasks such as eating and bathing, a universal model that Burnham appears keen to emulate south of the border.

Burnham said he would outline his "vision" on Tuesday, with Whitehall troubleshooter Baroness Casey, who is conducting a review of social care, advising on the "best way of doing it". Baroness Casey was originally asked by former prime minister Sir Keir Starmer to deliver her review in 2028, but Burnham has asked her to bring it forward to next summer. He said her detailed proposals would be subject to cross-party talks in an effort to "build consensus" around a lasting settlement.

The funding question remains the central political challenge. Burnham declined to rule out tax rises, conceding they may be "difficult or unpopular" with some voters, and said "nothing is off the table at this moment in time" when it comes to paying for the reforms. When told that a universal, free-at-the-point-of-use system for England could cost taxpayers an estimated £18bn a year, he replied: "It's not that high." He argued that families already bear a "huge cost" under the present arrangements.

The prime minister also pointed to the wider financial burden on the NHS, noting that a "huge number" of people across England remain stuck in hospital because they cannot be discharged home while adequate social care is unavailable. This so-called bed-blocking problem has long been cited by health leaders as a drain on resources and a cause of delayed treatment for others. Burnham suggested that investing in care outside hospitals would ultimately relieve pressure on the health service.

Asked whether everyone would have to contribute to his proposed system, Burnham said: "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 was careful to say that the changes would have to be "done carefully, without putting extra strain on the public purse", and he emphasised that he intended to stick to the manifesto on which Labour was elected.

That manifesto, published in 2024, contained clear commitments on tax, including a pledge not to increase national insurance, income tax or VAT. Burnham said those commitments would make it hard to enact the reform within the current Parliament, adding: "I don't think you can reform this system without consensus. I will develop a very clear plan and I will put that plan to the public at a general election and that will be where the plan gets tested."

The proposals drew immediate criticism from opposition parties. Shadow home secretary Chris Philp said the prime minister was signalling that Labour wanted "more tax rises" to pay for the reforms, and confirmed that the Conservatives would not support them. Philp described tax increases as a "red line" for his party, saying they would "not under any circumstances" back more of them and that the country is "already taxed too highly". He said any extra money needed for social care or defence should be found through savings elsewhere, particularly in the welfare budget.

Reform UK's economic spokesman, Robert Jenrick, accused Burnham of refusing to rule out a "universal death tax", adding: "He's too weak to cut the benefits bill so he's coming for your home instead." The phrase echoes the political battles of previous decades. Burnham himself produced a plan for a national care service while serving as health secretary in Gordon Brown's government, funded partly through compulsory contributions including from people's estates after death. Opponents branded it a "death tax", and the proposals were abandoned after Labour lost the 2010 general election. A similar outcry in 2017 saw then-prime minister Theresa May accused of pursuing a "dementia tax", a controversy that contributed to the Conservatives losing their Commons majority.

Not all reactions were hostile. Labour MP Darren Jones, a former cabinet minister in Sir Keir's government, said Burnham was being "very bold and brave" on social care, though he cautioned that "politics is about prioritisation and these things do cost money", adding that the detail of the policy would need scrutiny. Liberal Democrat leader Sir Ed Davey said Burnham could prove he is "serious about fixing care" by pressing ahead with cross-party talks that began in July, warning: "This can't just be a series of No 10 headlines with no real action."

Burnham has accused previous generations of politicians of "cowardice" for failing to confront social care reform, a charge that underscores both the political risk and the personal stakes involved. His father, Roy, who had Alzheimer's, died earlier this month, an experience the prime minister has frequently cited in making the case for change. Whether his vision can survive the funding dilemma, opposition attacks and the inevitable election battleground remains the defining question of his premiership.