Every year, thousands of older and disabled people in England face a stark choice: sell their home to pay for care, or go without. Unlike the NHS, social care is not free at the point of use. People with savings over £23,250 must cover the full cost themselves, often running into tens of thousands of pounds a year. This is the reality of a system that successive governments have promised to fix—and failed to reform.
Now Prime Minister Andy Burnham says he will finally tackle the crisis. In his second week in office, he is due to set out plans for a National Care Service, a universal system he wants to make free at the point of use, like the NHS. The proposals are at the centre of a political battle over cost, delivery, and trust.
“The UK social care crisis forces many to sell homes for care. Andy Burnham's proposed National Care Service aims to make it free, but funding questions remain.”
Under the current system in England, only those with assets below £23,250 qualify for state-funded care. Anyone above that threshold pays for their own care—often from savings or the sale of their home. This means many people face unpredictable, catastrophic costs. The system has been described as a "postcode lottery" because eligibility and quality vary by council area. Burnham first proposed reform in 2009 when he was health secretary under Gordon Brown, but the plan was attacked as a "death tax" by the Conservatives and abandoned. In 2019 Boris Johnson promised to "fix the crisis in social care once and for all"—a pledge that never materialised. In 2024, Keir Starmer scrapped Labour's proposed £86,000 cap on care costs, arguing it was not deliverable. Burnham, who became prime minister in July 2026, says he is prepared to spend his political capital on the issue.
For UK readers, this is not an abstract policy debate. The ageing population means more families will face these choices. The current system leaves people exposed to unlimited costs. A National Care Service, as Burnham envisions it, would provide a universal entitlement, not a means-tested safety net. But the plan raises big questions: who pays, and how?
Q: What is the current social care system in England? Social care in England is not free at the point of use. People with savings above £23,250 must pay for their own care, often from savings or by selling their home. The system is means-tested and varies by local council, leading to what critics call a "postcode lottery."
Q: What is Andy Burnham's National Care Service plan? Burnham wants to create a National Care Service that operates on the NHS principle—free at the point of use. Sources say it would cover personal care like bathing, eating and help using the toilet, but likely not daily living costs such as food and accommodation. The plan would be a universal offer, not just for those who cannot afford care.
Q: How would it be funded? In the past, Burnham has proposed a care levy of 10% on assets, savings and homes, with a payment plan possibly beginning at age 65. He calls it a "care levy" rather than an inheritance tax, arguing it buys peace of mind. Conservatives have criticised the plan as unfunded, with claims it would cost £96 billion and add £4,300 a year to family taxes. The government has not yet confirmed funding details.
Burnham is expected to deliver a speech on social care next week, alongside announcements on youth unemployment and devolution. He has said no one will be left to face the care system alone. But with opposition parties demanding to know where the money will come from, the biggest test of his premiership may just be beginning.