Prime Minister Andy Burnham has made tackling England’s social care crisis a central priority, signalling a willingness to consider tax increases to fund comprehensive reforms aimed at establishing a national care service. Speaking at a care home in north London on July 29, Burnham described the current system as “broken” and “unfair,” with many older people forced to sell their homes to cover care costs. He emphasised the need for “difficult decisions” on funding to create a system akin to the NHS, offering protection from catastrophic expenses and ensuring better pay for care workers.
Burnham, whose father has Alzheimer’s disease and resides in a care home, framed the issue as deeply personal. He highlighted that about 1.9 million people in England currently have unmet care needs and pointed to the toll this puts on the NHS, where pressure from inadequate social care affects hospital capacity and treatment targets. According to government estimates, the proposed national care service is expected to cost around £18 billion annually.
Various funding mechanisms are under consideration. Burnham has previously advocated a “social care levy,” which would involve a 10 percent tax on all inheritances, replacing the current inheritance tax that applies to a small minority. Another proposal includes a 1.8 percent levy on earnings above a threshold for workers aged 34 and over, following models used in countries such as Japan and Germany. Burnham has stated he is open to different options and intends to initiate a broad public consultation, led by Baroness Louise Casey, who has been tasked with accelerating a review on the future of social care. The review, initially due in 2028, is now expected by summer 2027.
Burnham rejected characterisations of the social care levy as a “death tax,” dismissing such labels as attempts to scare the public. He acknowledged, however, that any meaningful reform would likely require an increased tax burden, adding that the government would be “honest” and seek public consent before implementing changes. While he remains committed to Labour’s manifesto pledges to avoid rises in income tax, National Insurance, and VAT, Burnham did not rule out other forms of taxation for this purpose.
The Prime Minister also stressed the need to improve conditions for social care workers, who have long faced low pay and staffing shortages. He called for carers to be “the best-paid people in society,” pointing to the reliance on migrant workers in the sector amid post-Brexit visa restrictions.
The response from opposition figures has been mixed. Conservative leader Kemi Badenoch has agreed to participate in cross-party talks but firmly opposed tax increases, suggesting funding should come from cuts elsewhere, including welfare. Similarly, shadow health secretary Stuart Andrew called for detailed proposals without tax hikes or increased borrowing. Some experts have expressed cautious optimism about Burnham’s commitment but remain skeptical about the political feasibility of delivering sweeping reforms, citing 22 failed attempts in the past 30 years.
Critics on the right warn against excluding private care providers, which make up the majority of care homes in England, from any national system. They argue that private operators often deliver high-quality services and should not be sidelined by a government approach that emphasizes public-sector control. Advocates for social care reforms, meanwhile, emphasize the need to eliminate the current patchwork of services and regional disparities.
As the government begins a wide-ranging “big conversation” on social care funding and delivery, Burnham’s approach marks a notable departure from his predecessor’s, signalling a readiness to deploy political capital to address a longstanding and complex challenge. The coming months will test the Prime Minister’s ability to build consensus both within Parliament and among the public for reforms that could reshape how social care is provided and financed in England.