Andy Burnham has taken office as Prime Minister carrying more social care baggage, and more social care expertise, than any predecessor in living memory. What has changed since he last wrote a National Care Service blueprint, back in 2010, is the consensus now lined up behind him. I spoke with two MPs from opposite sides of the House, one from government, one from opposition, for their verdict on what a Burnham premiership actually means for the sector. For a closer look at the funding model he has spent fifteen years arguing for, see our separate analysis of whether Burnham can actually deliver free personal care.
That consensus starts with the industry itself. A report published this month by the Care Association Alliance (CAA), Adult Social Care Funding Reform, found council spending on care, once adjusted for age, ranges from £392 to £960 per person, a gap of more than two to one between councils under identical rules — see our breakdown of what's really driving that postcode lottery. Its fix: ring-fenced national funding, a national tariff, and an independent body to enforce both. Melanie Weatherley MBE, the CAA's Co-Chair, put it bluntly: "Andy Burnham wrote the last serious blueprint for a National Care Service in 2010, and watched it scrapped within weeks. He now has the mandate to finish what he started."
Alison Bennett MP, Liberal Democrat spokesperson for social care
Andy Burnham inherits the social care crisis he has spent fifteen years diagnosing. For the sector, the question is whether he'll finally treat it.
As the architect of the original National Care Service white paper and a long-standing champion of free personal care in Greater Manchester, our new Prime Minister understands adult social care better than most who have held his office. His conference pledge to find "the courage to fix the big things that politics has neglected" was the right instinct. But the sector has heard fine words before, from leaders of every party, while providers absorb rising costs, commissioners juggle impossible budgets and workforce gaps widen across care homes and home care alike. What matters now is delivery.
That starts with catastrophic costs: no one should have to sell their home or exhaust their savings because of the level of care they need, and the sector should not be left managing the fallout of an unreformed charging system. It means a genuinely funded settlement for personal care, delivered along the lines Scotland has shown is possible, rather than further means-testing by stealth.
It also means the workforce, unpaid as well as paid. Two years of tighter immigration rules have left providers struggling to recruit, while pay and career progression for care staff remain an afterthought and unpaid carers are left propping up the system with too little support. Liberal Democrats have called for care providers to be exempted from the Immigration Skills Charge, for a proper career structure to match the NHS, and for Carer's Allowance to be overhauled – practical steps a new government could take quickly, ahead of any wider settlement.
Mr Burnham has floated funding models from social insurance to inheritance tax reform. If he is serious, he should establish the cross-party funding commission Liberal Democrats have long argued for – one built to survive his premiership, so the sector can finally plan for the long term.
Sojan Joseph MP, Chair of the APPG on Adult Social Care
Read our full interview with Sojan Joseph MP on what the APPG on Adult Social Care is fighting for.
It is no secret that adult social care has been under severe pressure for decades and is in desperate need of reform. There are shortages in the workforce, resources are stretched, and the problems spill over into the NHS, causing delays in discharges and overcrowding in wards. In my regular meetings with my Integrated Care Board and other local healthcare trusts, leadership often report that they are unable to discharge hundreds of patients because of an inadequate adult social care service.
This is why implementing a National Care Service must be treated as a priority, and I welcome what Andy Burnham has outlined over the previous months and years. As Chair of the APPG on Adult Social Care, I have seen first hand the challenges facing the sector and the urgent need for meaningful reform. I am particularly encouraged by his devolution programme, which will put healthcare decision making, including adult social care, in the hands of local people, and I look forward to seeing how the Burnham premiership implements this from Westminster.
The National Care Service must raise standards and deliver a social care service built on greater choice and control, joined-up health and care services, and higher quality of care. That confidence will be vital, because the success of the National Care Service will ultimately depend on whether the people who use it believe in its fairness, its relevance, and its ability to meet their needs.
However, as we look towards a new Prime Minister in Andy Burnham, I believe it is important to also recognise the progress made under Keir Starmer's premiership: the Casey Commission going ahead, and the Fair Pay Agreement for care workers due in 2028, backed by £500 million of investment. The Fair Pay Agreement will see a new body formed to negotiate pay and terms and conditions, on which both employers and trade unions will sit, strengthening the voice of the workforce and helping to secure fair pay and conditions that reflect the value of the work care staff do. It should also help tackle recruitment and retention problems by helping people see social care not as a temporary job, but as a career. But I know from speaking to people with lived experience that we must go further and faster to deliver these reforms, and a functioning National Care Service, more quickly.
Where the sector, and now the Prime Minister, agree
Strip away the party lines and the overlap is striking. Both MPs, and the CAA's own numbers, point to the same bottleneck: a workforce too thin and too poorly rewarded to hold the system together, and a funding model that lets councils commission care below the cost of delivering it safely. All three land on the same fix: ring-fenced national funding, honestly priced, backed by a body with the authority to enforce it.
Burnham appears to agree. Hours into his premiership, he called the state of social care "not defensible," telling reporters: "How many people have lost their homes and their savings in that time? We need to face it and fix it." He has already asked Baroness Casey to bring her commission's recommendations forward from 2028 to the end of this year, and he has long championed exactly the model Alison Bennett, Sojan Joseph and the CAA are now converging on: a National Care Service, free at the point of use, sitting alongside the NHS — the same principle we examine in full in Free Personal Care: Could Burnham Actually Deliver It?
That is the real test facing Andy Burnham. For the first time in years, industry, opposition and government backbenchers are all making the same argument, and the Prime Minister is nodding along. Providers, commissioners and the families relying on care now need him to spend his premiership delivering it, faster than the pace anyone believes the system is currently moving at.
