Could this be a turning point for social care?
Today Prime Minister Andy Burnham pledged to make tackling the social care crisis a top priority of his government. After years of patients suffering in a broken, underfunded and heavily privatised system, we welcome this commitment. Now we must see these words matched with tangible policy changes - including greater investment funded through wealth taxation, not through additional cuts.
What’s wrong with the current model?
All of us deserve to be looked after when we can no longer look after ourselves. Social care is an essential part of the fabric of our society yet, under the current model, it is not free at the point of use. It is funded through a mixture of local council budgets, central government grants and personal contributions, with access to state-funded care heavily means- and needs-tested.
Under this outsourced system, the vast majority of care home beds are run by profit-making companies, meaning huge chunks of public money are being siphoned away into the pockets of private equity firms and corporate shareholders.
In these privately-run facilities, abuse and neglect is rife - particularly amongst disabled residents - and the companies are not being properly held to account for substandard care. On top of this, patients face exorbitant fees, forcing many families to make huge financial sacrifices in order to ensure their loved ones are cared for.
With an aging population and years of deep cuts to local councils, the system is also not able to meet patients’ needs and keep up with demand. As a result, there are thousands of discharge-ready patients in NHS hospitals who need social care provision, but have nowhere to go. This in turn is driving deadly bottlenecks in urgent care - ambulance delays, A&E waits and corridor care - which are costing patients’ lives.
This heavily disjointed model also means that patients in care homes face huge barriers accessing other types of healthcare. For example, referrals into secondary care can take months to even be booked, meaning many patients’ health steadily declines until they reach a crisis point, where the only option is urgent A&E care - a service that is also completely overwhelmed.
What is Andy Burnham proposing?
Further policy details are still yet to come, but the Prime Minister has signalled a few key changes so far.
Firstly, he is expediting the timeline of the Casey Commission - an independent review into the problems in social care and how they can be addressed in the medium and long term.
In January 2025, when the review was first announced by Wes Streeting, it was scheduled to conclude in 2028. We warned at the time that this was far too late, and risked kicking urgently needed social care reforms into the long grass while patients continued to die. So we are glad that Andy Burnham has listened to these concerns and brought the review conclusion forward to summer 2027.
In the immediate term, the Prime Minister said he wants to focus on “lifting up the social care workforce, integrating it with the NHS workforce, creating routes for progression, better pay, training and job security.”
Carers are horrifically underpaid and undervalued. As a patient-led organisation we have always made the case that improving pay and conditions of health and care workers is vital for patients, so we are pleased to see this commitment, but await further concrete details on how the government will stand by these words.
In the longer term, Burnham has affirmed the government’s commitment to creating a ‘National Care Service’, centred on the same universal principles as the NHS.
If it happens, this would be transformative, and is exactly what is needed to counter years of underfunding and neglect in social care. In our letter to Burnham only a few weeks ago, we called for him to “set out a clear timetable to take NHS services and care back into the public sector”. So the promise of a National Care Service is very significant but, again, will need to be backed up by clear timescales and funding.
What’s missing?
There is no doubt that longer term reform of social care is vital. But we also need short term investment that can ease the deadly pressures we are seeing in social care and - in turn - NHS hospitals.
For example, an extra ~£0.5bn a year could free up 8000 extra beds in social care, which would be enough to end the crisis of corridor care in hospitals. If Burnham waits until summer 2027 to start implementing changes, many more patients will needlessly die.
But beyond this, the Prime Minister needs to get serious about the scale of investment required to fix social care, and where this funding will come from.
It is deeply concerning to read reports that he wants “NHS savings” to pay for social care reform. Our struggling NHS has endured over a decade of chronic underinvestment, leaving services in a permanent state of crisis. It cannot survive yet more cuts.
Instead, Burnham must look to those who are amassing ever-greater levels of wealth whilst tens of millions of people struggle to get by. He must pursue taxes on corporations and the super rich to fund the critical public services that we all rely on every day.
Andy Burnham is absolutely right to make fixing social care a top political priority. Next, we need to see meaningful action and investment. Our movement will continue holding the government to account and fighting for the fully-funded and truly public care service we desperately need.