Prime Minister Andy Burnham has warned that the NHS risks being overwhelmed unless the social care system is reformed, in his first major broadcast interview since taking office.
Speaking to the BBC, Mr Burnham said he could not put a firm date on when changes would be delivered, but insisted he did not want to leave office without securing “substantial change” to social care.
Without reform, he warned, the health service would end up struggling to cope with people who should never have needed hospital treatment in the first place.
The prime minister is due to set out his thinking on adult social care in a speech on Wednesday. According to the BBC, he is not expected to unveil a fully formed new system at that stage. Instead, he will reportedly announce that he is accelerating the timetable for the Casey Commission, the independent review examining long-term options for care funding, chaired by Baroness Louise Casey. Her final recommendations had not been expected until 2028, but Mr Burnham wants that work brought forward.
He noted that he has form on this issue: as health secretary under Gordon Brown in 2009, he first floated the idea of a universal social care system, later pursuing a compulsory levy to pay for it. One option considered at the time, letting people defer payment until after death, was branded a “death tax” by the Conservatives.
Social care, unlike NHS treatment, is not free at the point of use. In England and Northern Ireland, anyone with savings above £23,250 is not entitled to help with care costs from their local council, though the rules differ in Scotland and Wales.
Sarah Woolnough, chief executive of the King’s Fund, described the current arrangement as a “punitive system” under which many people go without the care they need, with one in seven paying more than £100,000 towards their care. She said possible reforms range from free care at the point of need to a cap on how much individuals have to spend, and suggested the costs, while significant, would be modest set against the roughly £200bn spent annually on the NHS.
The issue has tripped up governments before. Two years ago Sir Keir Starmer faced criticism after Labour dropped a planned £86,000 lifetime cap on social care costs in England.
Reaction from other parties was swift. Conservative leader Kemi Badenoch wrote to Mr Burnham arguing that any reform must be fair to those who have already saved for their own care and should not rely on tax rises or extra borrowing. Reform UK’s Treasury spokesman, Robert Jenrick, said the system needed fixing but cautioned against any “universal death tax”, arguing it would be wrong to raid savings or draw more families into inheritance-related tax when a loved one dies.
Liberal Democrat leader Sir Ed Davey struck a more conciliatory note, saying he was willing to do “whatever I can to find a real and lasting consensus on social care,” while insisting family carers “must be at the heart of any new system” and that no one should lose their home to pay for care. Layla Moran, who chairs the Health and Social Care Committee, urged politicians not to turn the issue into a “political football,” while acknowledging that funding questions cannot be ducked.
Benefits system to get tougher conditions
In the same interview, Mr Burnham signalled a tougher approach to welfare, saying the government needs to “get serious” about bringing down the benefits bill.
He suggested he might “increase the conditions on people required to receive benefits,” telling the BBC: “there are people out there who, with the right support, can go into work.” Support itself would change in nature, he said, becoming “conditional upon people taking opportunities that are presented in front of them.”
However, he was careful not to place blame solely on claimants, pointing to “young people in their 20s who have been quite seriously let down because the support wasn’t there for them when it should have been there.”
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