As a daughter watching my mother slip into Alzheimer’s, I learned the harsh reality of a system that leaves families to fend for themselves. After three years in a care home, the bulk of the funding still comes from our own pockets, a burden that feels both isolating and unjust. This personal pain has shaped my view of Andy Burnham’s recent speech, where he described personal care as a matter of “social insurance” – a concept that promises to spread risk across society rather than concentrate it on individual families.
A mother’s story fuels the call for reform
When Theresa May launched her 2017 election manifesto in Halifax, the spotlight was on care funding. At that moment my mother had not even received a diagnosis, yet the promise of a “dementia tax” already loomed large. Fast forward to today, and my mother has been in residential care for three years, with the financial strain falling overwhelmingly on our family’s resources. The memory of that election night still haunts me, reminding me how political promises can feel distant from the daily grind of caregiving.
Seeing Andy Burnham articulate a vision where personal care is treated like social insurance – sharing the risk across families – brought me to tears. It was a rare moment when a politician seemed to grasp the emotional and financial toll that families like mine endure. Yet, while the sentiment is uplifting, the reality is that most of the cost of residential care is “bed and board”: cooking, cleaning, and upkeep – services that Burnham’s proposed changes will not cover.
Burnham’s address to care workers was equally striking. “I see you. I thank you. And I am sorry that my profession has let down yours for so long,” he said, acknowledging a long history of neglect. The words resonated deeply, especially after a 2024 Labour conference fringe event where I stood beside him, both insisting that carers are not “low‑skilled”. The commitment to place care workers at the centre of any new programme signals a shift in priority, but the journey from promise to delivery remains long for families already navigating the diagnosis maze.
Burnham’s vision: social insurance and a national care service
Burnham’s plan envisages a national care service that would align more closely with the NHS, aiming to standardise standards and improve coordination. He argues that personal care should be a form of “social insurance”, spreading the financial risk across the whole population rather than leaving it to individual families. This approach seeks to address the inequity that has left countless households, including mine, struggling unsupported.
The proposal also pledges to invest political capital in elevating the status of care workers. By foregrounding their role, Burnham hopes to rectify a historic undervaluation of a sector that sustains some of the most vulnerable in society. The emphasis on collective bargaining – a Labour‑backed effort to introduce fair pay agreements and progression pathways – marks a significant departure from the current fragmented landscape.
According to the Institute for Government’s Stuart Hoddinott, the prime minister should “have the courage of his convictions” and push the scheme forward without delay. Even a skeletal framework could begin setting standards, coordinating with the NHS, and engaging in negotiations for a fair pay settlement. Labour has set aside £500 million to support any pay uplift, though critics argue this may be insufficient to tackle the deep‑rooted workforce crisis.
Joe Dromey, general secretary of the Fabian Society, warns that the current funding commitment falls short of what is needed to stabilise the sector. He stresses that the first priority must be fixing the workforce crisis, delivering the pay rise that carers deserve through a more ambitious fair pay agreement. The proposed tweak to the triple lock beyond 2030, while politically astute, will not inject immediate cash into an overstretched system.
Funding the care revolution: options and challenges
Raising the additional money required for a comprehensive social care overhaul is a complex puzzle. The government faces a limited set of options, each with political trade‑offs. One route is a national insurance increase, reminiscent of Boris Johnson’s 2021 plan for a £12 billion‑a‑year “health and care levy”. Johnson’s attempt, though ambitious, collapsed under the weight of scandal and lost political capital.
Another possibility is an estate levy – often dubbed a “death tax” by opponents – which would capture wealth at the point of inheritance. This approach, last championed by Burnham a decade ago, remains contentious but could generate substantial revenue. A third option, perhaps the most honest, is to acknowledge that general taxation will need to rise to meet the growing demands of an ageing population, thereby funding a more generous social care settlement as part of a broader public‑sector reinforcement.
The timeline for implementation adds another layer of difficulty. Labour’s fledgling negotiating body is expected to finalise its agreement, which would come into effect in April 2028. In the meantime, Louise Casey is due to report next summer on how a national care service could be built and financed, followed by a two‑year “national conversation”. For families already enduring the emotional and financial toll of caregiving, such a protracted process feels like an eternity.
Even as the political class seems to have forgotten the urgency of the issue, the stakes remain high. The longer the debate drags on, the more families will be left to navigate an inadequate system without support. Burnham’s ambition to build a political consensus around social care is admirable, but the window for action is narrowing.
Why workers and families cannot wait
The urgency of reform cannot be overstated. As Hoddinott points out, making progress before the next general election would give Burnham a powerful narrative to take to the electorate, reducing the risk that his proposals are swept away if Labour loses power. A concrete plan, even if initially skeletal, could start setting standards, improving NHS integration, and engaging in negotiations for a fair pay deal – all essential steps to stabilise a sector in crisis.
The human cost of delay is already evident. Families like mine continue to shoulder the burden of care costs, often sacrificing savings, careers, and wellbeing. Meanwhile, care workers remain underpaid and undervalued, perpetuating a cycle of staff shortages and poor service quality. The £500 million earmarked by Labour, while a start, will not alone reverse this decline.
Burnham’s call for social insurance is more than a policy slogan; it is a recognition that care is a shared societal responsibility. To turn this vision into reality, decisive action is needed now – from raising the necessary funds through a mix of national insurance, estate levies, or broader taxation, to implementing a robust national care service that puts workers at its heart. The time for debate is over; the time for delivery is now.
Why it Matters
The debate over social care is no longer an abstract policy discussion; it is a lifeline for hundreds of thousands of families and a matter of dignity for the care workforce that holds our most vulnerable citizens together. Burnham’s proposal to treat personal care as social insurance offers a pathway to shared responsibility, but only if political will translates into swift, funded action. The stakes are too high to let another decade of neglect dictate the lives of those who need care the most – and too great a risk to postpone the reforms that could finally give families like mine the support they deserve. The choices made today will shape the future of an ageing nation, determining whether social care becomes a source of security or continues to be a silent crisis.
