Prime Minister Andy Burnham has outlined plans for a new national care service aimed at providing free personal care to older adults, but significant costs would remain for many recipients, particularly those in care homes. The proposed service, inspired by existing models such as Scotland’s, would cover basic personal care tasks like eating, washing, and dressing but would exclude bed and board fees—costs related to accommodation and daily living expenses.
Burnham confirmed that under his plan, care would be provided “free at the point of use” following principles similar to those of the NHS, but individuals would still be responsible for paying hotel fees, which can be substantial. In England, average care home fees run about £1,300 per week, or approximately £67,600 annually, with roughly two-thirds of this amount covering living costs. This means many pensioners could still face significant financial burdens, potentially risking their savings or homes.
The government intends to introduce the national care service gradually over several years. Initial stages would expand free personal care for older people living at home, a policy already partially implemented in some parts of the UK. This early phase is estimated to cost around £7 billion annually. The full service, which would encompass comprehensive nursing and care support, could cost up to £18 billion a year.
Funding these reforms is set to come partly from scrapping the triple lock on the state pension by 2030, a change expected to save the government £15 billion annually by 2040. Burnham has framed this adjustment as part of a “new settlement for the elderly,” although some experts, including Helen Miller of the Institute for Fiscal Studies, argue that ending the triple lock may not generate direct additional cash for social care and that further tax increases or spending cuts could be necessary.
The prime minister has expressed a commitment to improving care quality and preventing hospital admissions by supporting more people to stay in their own homes longer. He also emphasized plans to overhaul pay and conditions for social care workers, promising a fairer system. Legally binding fair pay agreements and the introduction of the first pension scheme for care workers have been announced by Health Secretary Yvette Cooper. Additionally, the government plans to publish a workforce strategy to attract new entrants, while Home Secretary Shabana Mahmood is preparing to ease migration rules that would affect foreign care workers’ access to citizenship.
Experts have highlighted the potential shortcomings of the proposed model. Camille Oung, a fellow at a health policy think tank, noted that free personal care alone would not prevent catastrophic costs for those with higher needs, such as individuals requiring specialist nursing or one-to-one care for conditions like dementia or Parkinson’s disease. Currently, in Scotland, despite free personal care, residents still pay over £60,000 annually toward accommodation and living costs in care homes. Some analysts suggest that to truly protect assets and homes, the government may need to introduce mechanisms to shield individuals from these expenses or move toward a more comprehensive, universal care offering.
While the government emphasizes phased implementation and progressive expansion of the care service, details about its full operation and funding are expected to be clarified following the review led by Baroness Casey of Blackstock, whose findings will be published next summer. Burnham has pledged to build broad consensus on the reforms before presenting them to the public ahead of the next general election in 2029.