Andy Burnham, the newly appointed prime minister, has identified social care reform as his foremost domestic priority, signaling an ambitious and politically challenging effort to overhaul a system long regarded as fragmented and underfunded. Speaking from a care home in north London, Burnham highlighted the personal impact of inadequate social care through the experience of his father, who suffered from dementia, emphasizing the high costs, variable quality, and prevalent profiteering by private equity firms in the sector.

The current social care system in England is widely regarded as dysfunctional. Despite consuming 78% of local council funds, it remains largely invisible to the public, partly because only a small proportion of the population uses such services at any given time. Surveys indicate significant public misunderstandings about social care funding, with many erroneously believing it is free at the point of use, like the National Health Service (NHS). In reality, individuals with savings above £23,250 are liable for costs, which can exceed £100,000 and sometimes force families to sell their homes.

Burnham’s vision includes creating a national care service integrated with the NHS, addressing both funding and workforce issues. The prime minister stressed the urgent need to prevent further NHS strain, noting that last year delayed discharges due to social care shortages cost the NHS £2.7 billion and resulted in approximately 13,600 hospital beds being occupied unnecessarily. His proposal involves better coordination between health and social care services, including equal pay and career progression for workers across both sectors.

Reform advocates point to systemic issues stemming from policies dating back to Margaret Thatcher’s government in the late 1980s, which privatized care provision by closing local authority facilities and shifting services to private operators. Currently, 85% of England’s 16,500 care homes operate on a for-profit basis, with research indicating that non-profit and publicly run providers often deliver higher quality care.

Public support for reform exists but hinges on increased understanding of the current system’s shortcomings. To this end, Burnham has commissioned Dame Louise Casey to lead a "Big Conversation" public consultation intended to educate and engage citizens on social care challenges. He has also reached out to opposition parties, inviting leaders of the Liberal Democrats and the Conservative Party for talks aimed at achieving cross-party consensus, although neither Reform UK nor the Green Party have been included.

Past attempts at social care reform have failed amid political divisions and concerns over funding mechanisms. Burnham’s predecessor proposals, including a 10% inheritance levy and a capped contribution model, faced significant opposition and were not implemented. Similarly, Boris Johnson’s proposed health and social care levy was abandoned. Burnham has emphasized that any new funding model must avoid placing additional burdens on younger generations, noting pensioners often possess the most wealth and benefit most from existing NHS services.

Critics, particularly in the Conservative and Reform UK parties, have already signaled resistance, opposing new taxes or borrowing to fund reforms. Nonetheless, Burnham’s Labour majority provides a potential path to enact change without opposition support, provided sufficient public backing is secured.

Burnham acknowledges the political risks involved but regards the reform of social care as a necessary gamble. He calls for a new culture in Westminster focused on problem-solving rather than partisan point-scoring. His first steps suggest a commitment to addressing one of the United Kingdom’s most pressing social challenges, with outcomes likely to shape political discourse and public welfare for years to come.