Prime Minister Andy Burnham has signalled that taxpayers will have to contribute more to fund his ambition for free social care in England, as he prepares to take a national care service to voters at the next general election.
Burnham said the government’s existing manifesto commitments “make it hard” to deliver the reforms during the current parliament, but insisted he would not abandon his plans to overhaul a system in which elderly people can face care bills running into tens of thousands of pounds.
The prime minister said the reforms would cost billions and would be funded through a system in which “everyone contributes”.
He rejected suggestions that a universal free-care system could cost taxpayers £18bn a year.
“It’s not that high,” he told the BBC.
The Health Foundation has estimated that providing free adult social care to everyone currently receiving services in England could require an additional £18.5bn a year by 2035-36, on top of existing spending. The House of Lords Library has cited the same estimate in its assessment of the government’s emerging spending commitments.
Burnham argued that focusing solely on the additional cost of reform overlooked the financial burden already imposed on families by England’s means-tested system.
“People are paying care charges now. They are spending tens of thousands of pounds from their savings, sometimes losing their homes.
“That is what’s happening at the moment.
“So to suggest there isn’t a cost to people at this moment in time, there’s a huge cost.
“Social care in England is as unfair as American healthcare, where the most vulnerable in society can lose everything, they can be wiped out, not just by the condition that they have, but wiped out financially.”
Under the current system, social care is not generally free at the point of use. People with assets above the relevant threshold can be required to fund their own care, while those with lower assets may qualify for local authority support.
Burnham said he would “grasp the nettle” on social care reform, describing the failure of successive governments to resolve the issue as “devastating”.
“For me, obviously, coming in to this journey as Prime Minister as my dad was ending his, has been hard,” he said.
“But it pushes me on, and I’m going to grasp the nettle on social care.”
The financial challenge is significant.
Adult social care already represents a major component of local government spending, while councils across England are under pressure from rising demand and constrained finances. Government figures show that £91mn has recently been allocated to 14 financially distressed councils to modernise expensive services including adult social care.
The proposed expansion of state-funded care would therefore come as the government faces broader pressure on the public finances.
August borrowing reached £18.3bn, above expectations, taking borrowing for the financial year to £77.3bn in the first five months and leaving the government with substantially less fiscal headroom than earlier in the year.
Burnham has said the detailed funding mechanism will form part of a wider political conversation before the next election rather than being imposed immediately.
The prime minister’s approach is based on shifting more of the risk of catastrophic care costs from individuals and families towards the state — and, ultimately, towards taxpayers collectively.
That raises a central question for the government: how much additional taxation voters would accept in exchange for removing or reducing the risk of potentially ruinous care bills.
Burnham has previously argued for a national care service based on an NHS-style principle, while the government has commissioned the Casey Commission to examine the future of adult social care. The commission is due to report by summer 2027.
In the same BBC interview, Burnham declined to commit to supporting a proposed third runway at Heathrow.
Asked whether he backed the expansion, he said: “Principally, it’s a matter for London and Londoners.”
Pressed further, he said: “It’s not right for me to just jump straight in on the back of the consultation.”
He added: “I think it’s right that we hear what people have said through the consultation, and then then consider the way forward from there.”
For Burnham, the social care debate is likely to become one of the defining tests of his government’s approach to public services and taxation.
His promise to make care free at the point of use would remove a major financial uncertainty for families, but the cost would have to be met somewhere — through taxation, spending reductions elsewhere, additional borrowing or a combination of the three.
With the government already facing a tighter fiscal position, the pledge to make “everyone contribute” places the question of how much each taxpayer contributes at the heart of Burnham’s emerging economic agenda.
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