Andy Burnham’s proposal for a National Care Service that would offer free personal care to older adults could result in only marginal savings for families, according to recent analysis. Despite the promise of a system free at the point of use and designed to protect people’s homes and savings, the actual financial relief for those requiring residential care may be minimal.
Burnham, the Prime Minister, has highlighted Scotland’s model as a framework. There, the government provides a weekly payment of £260 for personal care costs such as washing and dressing for individuals in care homes, while residents continue to pay for accommodation and other expenses. However, investigation reveals that the overall costs for someone with dementia entering residential care are nearly the same in Scotland and England—approximately £70,000 annually.
The analysis shows that while Scottish care homes charge about £257 more per week than those in England, the state’s personal care payment nearly offsets this increase, leaving state-supported residents just £3 a week better off. Experts attribute the higher Scottish fees to care homes inflating accommodation charges because the £260 personal care payment is insufficient to cover actual costs, effectively passing these expenses onto families. As a result, many remain vulnerable to substantial out-of-pocket bills and the risk of having to sell their homes to pay for care.
For example, an elderly woman with dementia and savings above the means-testing thresholds would face a weekly bill of £1,603 in Scotland, reduced to £1,343 after applying the personal care payment, compared to an average of £1,346 in England. The annual difference between the two totals just £172.
Critics warn that unless charges such as bed and board are addressed, the reform risks being a “care con” that fails to meaningfully protect families from heavy financial burdens. Damian Hinds, the shadow health secretary, cautioned that Burnham’s free care pledge might fall short of delivering genuine relief and called for detailed, credible plans to substantiate how pensioners would be safeguarded from crippling costs without triggering additional tax increases.
Burnham has publicly shared that his motivation for reform stems from personal experience, having witnessed his grandmother’s home sold to cover her care costs. He aims for the National Care Service to provide both free personal care and security over finances in later life. His funding proposal involves modifying the state pension triple lock to a double lock to finance these changes.
Representatives from the social care sector echoed concerns about the plan’s current formulation. Dennis Reed, director of the advocacy group Silver Voices, expressed worry that the initiative is “full of holes” and risks unraveling, pointing out that families might expect care costs to be lower in Scotland due to additional state support and lower property prices, yet the data shows otherwise. William Laing of care data firm LaingBuisson described the proposals as lacking detail.
A government spokesman responded by affirming the commitment to deliver a fully funded National Care Service offering free personal care based on need rather than financial ability. The spokesman highlighted that existing protections, including deferred payments to prevent premature sale of homes for care costs, would remain during the phased implementation of the service, aiming to enable more individuals to remain at home longer.