Burnham pledges radical overhaul of England’s social care system

Andy Burnham, a prospective MP and potential Labour leader, has signalled he would overhaul England’s social care system if he became prime minister. This pledge represents the strongest indication yet of his main priorities, suggesting a more radical and urgent approach than the current work underway under Prime Minister Keir Starmer. While the Starmer government is introducing updates to the sector, Burnham’s intervention highlights the growing political pressure to address a crisis that has persisted for decades.

The adult social care sector faces severe strain, with total new requests for publicly funded care reaching 2 million in 2024-25. This figure represents a 31% increase in demand from working-age adults compared to the 2015-16 baseline, when requests stood at 1.8 million. Local authorities, which are statutorily required to provide care, are struggling to meet rising costs amid central government funding cuts, leading to a permanent staffing shortage and a two-tier market where self-funders subsidise council-funded care.

In response to the deepening crisis, the current government is introducing a fair pay agreement for care workers, backed by £500m in funding. The initiative aims to address over 100,000 vacancies by establishing minimum pay and working conditions. However, the Local Government Association has stated that this funding is insufficient to cover all costs and may further pressure already stretched council budgets, which currently spend approximately £32bn a year on adult social care.

A cross-bench review led by Louise Casey is underway to determine the best path toward a national care service, a commitment included in Labour’s manifesto. Lady Casey’s initial diagnosis in March 2026 described the system as held together by “add-ons, workarounds, sticking plasters and glue,” warning of a “moment of reckoning.” While the full review is not expected until 2028, critics argue the timeline is too long given the urgency of the situation, with full implementation estimated to take until 2036.

Structural reforms to address the funding model could be financially significant. Analysis by the Institute for Public Policy Research suggests that full structural reform, such as creating an NHS-style model or capping individual costs, could cost up to £36bn a year by 2030. Such measures would likely require increases in national insurance contributions or other taxes, a prospect that could prove politically contentious as the sector seeks stability.