Andy Burnham, the prime minister, has renewed his longstanding commitment to establishing a national social care system, aiming to deliver free universal care modeled on the NHS. This follows more than 30 years and over 20 unsuccessful attempts by various governments to reform social care in the face of growing demand and funding challenges. Burnham’s proposal intends to address long-standing inequalities in how elderly care is financed and accessed, with many currently having to pay for their own care if their assets exceed a certain threshold.

Burnham plans to present a detailed vision for the reform ahead of the next general election, building on a forthcoming review of the social care system led by Baroness Louise Casey. Social care advocates see his leadership as a potential turning point, especially given the repeated failures of previous initiatives, including Theresa May’s 2017 proposal, which required people with assets above £100,000 to fund their own care and was widely criticized as a “dementia tax.” That plan contributed to significant political backlash and the Conservative Party’s loss of majority in the subsequent election. Similarly, Boris Johnson later suggested a lifetime cap on care costs set at £86,000 but was unable to implement it.

The estimated annual cost of Burnham’s proposed social care system ranges up to around £18 billion. Its funding remains a significant challenge, with discussions focusing on possible tax increases or adjustments to existing entitlements. One notable proposal under consideration is the scrapping or adjustment of the state pension triple lock, which guarantees that pension payments rise by the highest of inflation, average earnings growth, or 2.5%. This mechanism currently costs approximately £20 billion per year, roughly matching the projected annual cost of the new care service. Some policymakers suggest that reducing this guarantee in exchange for universal, free social care could create a revenue-neutral package, benefiting older people overall despite a reduction in pension growth.

Labour strategists hope to “pitch roll” public opinion over the coming years, gradually preparing voters for the idea of contributing more to a system that promises long-term protection in old age. This approach aims to avoid the sudden policy reversals and voter resistance that have previously undermined social care reforms. However, the idea of increased costs to households is sensitive, especially as many face tight budgets amid broader economic pressures. Governments traditionally avoid reforms that affect pension income directly, given the strong political influence of older voters.

Burnham’s ability to build a broad consensus on social care reform, including securing public support for potential funding trade-offs, will be crucial. With a likely fragmented parliament after the next election, cross-party agreement may be essential to implement meaningful change. As the social care system experiences mounting strain due to an ageing population, the political and public debate over how to share the risks and costs of care is expected to intensify in the coming months.