The NHS will collapse if social care is not reformed, Prime Minister Andy Burnham warned, and he said he would not want to leave office without delivering "substantial change" to the system.
In his first major interview since taking office, Burnham told the BBC "the NHS will collapse" if government does not address the pressure caused by inadequate social care. He declined to give a timeline for a new system, saying he "couldn't put a timeline on it right here, right now", but pledged to invest "whatever political capital I have into fixing broken social care".
Burnham has long advocated a universal social care model. The source notes he first proposed such a system in 2009 while serving as health secretary under Gordon Brown and pushed the idea of a compulsory levy. At the time the government considered letting people defer care payments until after their death, an approach Conservatives called a "death tax".
The prime minister is due to make a speech on adult social care on Wednesday. The BBC understands he will stop short of unveiling a new framework and instead announce he intends to speed up the Casey Commission, an independent review led by Baroness Louise Casey. Baroness Casey is not expected to issue final recommendations until 2028, but Burnham wants her timetable moved forward.
Adult social care offers state support to help people live independently, including home assistance. Unlike the NHS, it is not free at point of use. In England and Northern Ireland people with savings above £23,250 are not eligible for council-funded care; Wales and Scotland operate different eligibility rules. Sarah Woolnough, chief executive of the King’s Fund, said the current system is "punitive", leaving many without needed support and with around one in seven paying in excess of £100,000 for care. She told the BBC reform options range from free-at-point-of-need provision to introducing a cap, and noted that while the NHS costs around £200bn, some social care options would be only low billions per year.
The response from opposition and other parties was immediate. Conservative leader Kemi Badenoch wrote to Burnham urging him to rule out tax rises or higher borrowing to fund reform and saying any solution must be fair to those who saved. Liberal Democrat figures pushed for cross-party consensus. Layla Moran said politicians must commit their political capital to the issue, and Sir Ed Davey said he would do "whatever I can to find a real and lasting consensus on social care", adding family carers must be central and no one should lose their home. Reform Treasury spokesman Robert Jenrick warned his party would oppose a "universal death tax", saying: "It's not fair to raid people's life savings and drags hundreds of thousands more families into paying tax when their loved ones pass away."
Burnham also signalled possible tightening of benefit rules, saying he might "increase the conditions on people required to receive benefits" and arguing some people could work with the right support. He emphasised he would not "straight to blaming" claimants and highlighted young people who had been let down. He flagged "big decisions ahead" on council tax but No 10 said reports that he is actively considering scrapping council tax or stamp duty are "not true".
For now the immediate next steps are the Wednesday speech and an effort to accelerate the Casey review. A new statutory system is not on the table this week and Baroness Casey's final recommendations are expected in 2028, leaving policymakers with months of detailed choices before any legislative change.
