Prime Minister Andy Burnham’s proposed reforms to the social care system could incur costs significantly higher than initially anticipated, with some estimates suggesting an additional £21 billion may be required. Burnham, who took office two weeks ago, has made social care reform a central priority, describing the existing system as “broken” and pledging to invest substantial political capital in developing a National Care Service.

The plan draws on elements of Scotland’s integrated health and social care model, where services are combined at an estimated cost of £18 billion. However, experts have raised concerns about the applicability of the Scottish experience to England and Wales. Notably, the proportion of volunteers providing unpaid care in Scotland declined from 26% to 18%, which, if mirrored across England and Wales—where there are approximately four million volunteer carers—could create a funding shortfall of around £21 billion. Analysts warn that this could lead to significant financial challenges for the proposed system.

Burnham has refrained from detailing how the reforms will be funded, amid increasing scrutiny of his broader policy commitments, which have been collectively valued at £96 billion without clear financing strategies. He has not ruled out raising taxes to support his agenda, previously stating that the United Kingdom is “under taxed” and that he might “ask for a little more” to deliver on his promises.

Critics have questioned the government’s readiness to implement the reforms. Shadow Chancellor Sir Mel Stride commented that Burnham has not adequately developed the necessary details before committing to his plan, emphasizing the need for clarity on funding sources. Maxwell Marlow, from the Adam Smith Institute, suggested that the government's reliance on the Scottish model could lead to a withdrawal of volunteer carers, further exacerbating funding gaps in social care provision.

Advocates for unpaid carers have highlighted the importance of considering their role in any reform package. Emily Holzhausen of charity Carers UK noted that there are 4.7 million unpaid carers in England alone, with about 600 individuals leaving employment daily to provide unpaid care. The charity asserts that 35% of these carers might not need to sacrifice their jobs if there were a dependable social care system in place.

Last week, Burnham outlined his vision for social care reform during a visit to a care home in Golders Green, north London, where he condemned political inaction over previous decades as a “major dereliction of public duty.” He announced plans to expedite an independent review of adult social care in England, led by Baroness Casey, aiming to complete it by next summer—a year earlier than originally scheduled. Additionally, Burnham has initiated cross-party discussions on reform with the Conservative and Liberal Democrat parties, although the absence of Conservative minister Kemi Badenoch from initial talks attracted criticism, with some suggesting the consultations may have been more symbolic than substantive.