Andy Burnham has said he will use his political authority as prime minister to pursue major reform of social care in England, warning that NHS performance cannot recover properly unless the care system is repaired.
In his first full interview since entering No 10 last week, Burnham told the BBC that he could not yet set a timetable for a new social care model. He said, however, that he wanted to move quickly on changes before the next general election and did not want to leave office without substantial reform in place.
The issue matters for households because adult social care affects older people, disabled adults and families arranging support at home or in residential care. Unlike NHS treatment, social care in England is largely means tested and often involves council assessments, personal contributions and difficult financial decisions for families.
Burnham linked reform directly to NHS waiting times, saying the health service was carrying significant costs because social care was not functioning properly. He argued that people were ending up in hospital when better support outside the NHS might have prevented their condition from escalating or helped them return home sooner.
“This costs the NHS billions of pounds,” he told the BBC, adding that waiting time standards would not return to acceptable levels without action on care. He said that if reform did not happen, the NHS risked being overwhelmed by the burden of caring for people whose needs should have been met earlier elsewhere.
Successive governments have promised to address social care funding and organisation, but attempts have repeatedly stalled because of disagreements over costs, tax, personal contributions and protection for people’s savings. Burnham has previously spoken about his family’s experience, including his father’s Alzheimer’s disease and need for care, as a reason for prioritising the policy area.
Asked whether he would create a completely new system before the next election, Burnham said he would proceed as quickly as possible but acknowledged that a full replacement would take time. His comments suggest the government may look first at changes that can be delivered within the current parliament, while leaving more complex funding questions for a longer process.
For care users and relatives, the practical impact will depend on details that have not yet been set out. Key questions include who would qualify for support, how much people would be expected to contribute, what role councils would play, and whether any new system would affect home care, care homes or support for unpaid carers.
The Conservative leader, Kemi Badenoch, has written to Burnham repeating an offer for her party to work with the government on social care reform. The offer came with conditions, including that any plan must be fair to people with savings and must not involve higher taxes or borrowing. Those conditions would rule out several possible funding approaches and are unlikely to be acceptable to the government in full.
Burnham also used the interview to discuss welfare spending, saying the UK needed to take a more serious approach to reducing the benefits bill. He said he did not want to blame people claiming support, particularly young adults who, in his view, had often been failed by services that should have helped them earlier.
The prime minister said changes could involve altering the nature of support and making some benefits conditional on people taking up opportunities offered to them. He referred to government guarantees of opportunities for young people and said mental health support should be available in work where needed. The comments point to a continued focus on employment and training as part of wider welfare reform.
Burnham gave limited detail on how social care or welfare changes would be paid for. He said he would stick to existing fiscal rules and take a cautious approach to public finances, arguing that he was bound by Labour’s 2024 election manifesto after taking over without a general election.
Pressed on possible tax changes, including a wealth tax, he said it was too early to make commitments and noted that he had been in office for only a few days. He said he was interested in looking at parts of the tax system, including council tax thresholds and bands, but said any proposals would have to be judged against the manifesto on which Labour was elected.
Burnham also declined to set a date for when the UK would reach defence spending of at least 3% of GDP. He argued that his appointment of John Healey as chancellor showed his commitment to defence, after Healey had previously resigned from Keir Starmer’s government over concerns about the pace of progress towards that target.
The central question for households remains whether the government can turn long standing promises on social care into a workable plan. Burnham has made clear that he sees reform as essential to the future of the NHS, but families, councils and care providers will have to wait for decisions on funding, eligibility and timing before the real impact becomes clear.
