Burnham does not rule out tax rises for social care reform, but says current inefficiencies should be tackled first
Q: [From ITV’s Rebecca Barry] Can the government realistically reform social care without raising taxes?
Burnham says existing resources can be used more effectively.
double quotation mark I think more is possible from within existing resources. And the things that I’ve talked about today, particularly around the workforce, will be fully funded.I think it is possible from existing budgets to do much more.
I mentioned that whole thing of people coming into hospital unnecessarily from social care settings, then having a long stay in hospital as a result of that unnecessary admission, and then a long period where they’re medically fit to leave, but can’t, because the care is not available. Now, that very last bit has been [estimated to cost the NHS] £2.5bn a year.
If you add all of it up, you are talking several billion pounds a year is lost from the lack of a preventative front-end social care service that’s well supported.
Burnham says government needs to address these problems “before we talk about tax rises”.
But Burnham goes on to say:
double quotation mark I think Louise [Casey – see 10.18am] indicated some of what we would want to in the fullest sense will require difficult decisions.
He goes on:
double quotation mark But we will be honest with people about those. We will put them before the country at the right time, and we will hopefully proceed with people’s consent.
Key events
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Burnham praises foreign care workers, saying it is important they know they are appreciated
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Tories say social care reform should not happen until ‘best possible use of public funds’ achieved
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Burnham should give other parties a voice but ‘not a veto’ on social care reform, Labour thinktank says
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Ed Davey says he’s ‘hopeful’ after talks with Burnham on social care reform
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Care charities warmly welcome Big Conversation on care, and Casey review being fast-tracked
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Reform UK accuses Burnham of planning ‘universal death tax’ which it says it will ‘fight every step of way’
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Greens say it is ‘deeply disappointing’ they weren’t invited to Burnham’s cross-party talks on social care reform
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Burnham says he wants to ‘lift up’ conditions for care workers, with more career progression and integration with NHS
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No 10 sets out 4 principles for proposed National Care Service
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Burnham declines to commit to getting defence spending to 3% of GDP by 2030
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Care Not Killing welcomes Burnham saying he would not support assisted dying given current state of palliative care
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Burnham urges media to avoid scaremongering in debate on case for NHS-type reform to protect families from huge costs
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Burnham says life has ‘moved on’ from when he proposed care levy in 2010, and ‘more voluntary approach’ may be better now
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Burnham says any move to allow assisted dying should not happen until better palliative care in place
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Burnham says social care in England ‘as unfair as American healthcare’
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Burnham does not rule out tax rises for social care reform, but says current inefficiencies should be tackled first
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Burnham accepts social care reform likely to wear down his political capital
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Burnham says he’s doing social care reform now because he does not want to leave it until close to election
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Burnham says he would ‘never forgive myself’ if he let ‘screaming headlines’ put him off trying social care reform
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Burnham accepts he may need to compromise on social care reform
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Burnham explains what he wants Casey review to address
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Burnham says Casey’s social care review to be fast-tracked, so final recommendations out by summer 2027
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Burnham calls for media to be responsible in way social care crisis is reported
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Burnham says it’s ‘shameful’ politicians have put point-scoring ahead of fixing social care issue
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Burnham says he’s ‘overwhelmed’ by skill of carers helping his dad, saying they should be ‘best paid’ people, not worst paid
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‘We can do difficult in this country,’ Casey says, as she insists social care reform can happen
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Casey says there is ‘room for mixed market’ in provision of social care, but not ‘profiteering out of misery’
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Zack Polanski will not say sorry to Farage for sharing guillotine image
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Burnham to give speech on social care as Louise Casey plays down cost concerns saying many families ‘already paying’
And this is what my colleague Frances Ryan is saying about Andy Burnham’s speech.
double quotation mark It’s worth pausing on the scale of Burnham’s social care pitch. This could be the biggest reform to health in England in a generation. A universal care system – effectively a second NHS – would be revolutionary. Just free personal care would be lifechanging for older and disabled people.
double quotation mark Social care is not a vote winner. Polling shows much of the public don’t even know how the system currently works and assumes it’s available, similar to the NHS. Burnham is spending his political capital because there’s a desperate need for reform. Those who use the system won’t need convincing.
double quotation mark As we wait for Casey’s recommendations, watch out for the right chipping away at the idea the country can afford social care. The Tories are already opposing any tax rises to pay for it. Reform is shouting “death tax”. The Daily Mail will implode, despite the fact its elderly readers would benefit.
John Crace has filed on Andy Burnham’s speech this morning. He was impressed.
Here is his sketch.
And this is how it starts.
double quotation mark It feels like the UK has a prime minister again. Not the Maybot paralysed with indecision. Not the clown-like Boris Johnson who crumbled under the weight of his own narcissism. Not the ridiculous Liz Truss. Not the steamrollered Rishi Sunak for whom everything was impossible. Not the automaton-like Keir Starmer who was never entirely sure what he wanted to do.But a prime minister who is emotionally intelligent. Who understands the country and can connect with it. Who is prepared to expend political capital to get the things done that other politicians were too weak to go near. You can almost feel the sense of relief in a UK that has become almost accepting of decline and failure. It’s the return of hope over grievance. Where once more we have an adult prime minister prepared to speak to voters as fellow adults. It could catch on.
Burnham praises foreign care workers, saying it is important they know they are appreciated
Unison, Britain’s largest public sector union, has welcomed Andy Burnham’s speech. In a statement, Andrea Egan, its general secretary, said she was glad that the Casey review was being fast-tracked and that Burnham “gets the magnitude of the problem and what it’ll take to fix things”.
She also called for better treatment for foreign care workers.
double quotation mark There must be an urgent rethink on how international staff are being treated. Plans to push migrant care workers out of the UK need to be scrapped.They’re looking after people with complex needs and some of society’s most vulnerable people. They should be better rewarded, not vilified. Without them, the system would collapse.
Egan seemed to be referring in particular to the Home Office planto make foreign care workers wait up to 15 years before they can be eligible for indefinite leave to remain.
But in fact Burnham made a specific point of praising foreign care workers in his speech. Referring to the workers looking after his father, who has dementia and is in a care home, he said:
double quotation mark I’ve just been really overwhelmed by their care, their skill in what they do, their professionalism.It really is incredible, and it’s humbling to watch them caring for someone else’s dad or someone else’s mum.
If you think about that, you know, bringing all of that to the care of someone else’s relative, it’s just an incredible thing, isn’t it?
To me, they should be the best paid people in society, not the worst.
And I just start with that feeling.
And I am talking because many people from other countries have been caring for my dad.
I want those carers to know we appreciate you.
We appreciate what you are doing to support people here.
And it really matters that I say that as well.
This could be seen as a further hint that Burnham is going to revise the Home Office plan. The Guardian reported this last week, and in his BBC interview broadcast on Monday Burnham strongly suggested that care workers will get some sort of exemption from the new, tougher settlement rules proposed by Shabana Mahmood, the home secretary.
Social care reform would be particularly beneficial for women, the Women’s Budget Group says.
In a statement, Daniella Jenkins, executive director of the WBG, a feminist economic thinktank, says:
double quotation mark Women have borne the brunt of the fallout from the failure of successive governments to fix social care. They continue to provide the majority of unpaid care, often at significant personal cost: reduced working hours, lower earnings, poorer health and lower pensions. When care systems fail, women are expected to fill in the gaps.It is particularly encouraging to see the prime minister recognise the importance of the social care workforce, the majority of whom are women.
Tories say social care reform should not happen until ‘best possible use of public funds’ achieved
Stuart Andrew, the shadow health secretary, has issued a statement after the cross-party talks on social care with Andy Burnham. (See 3.08pm.) He says that the Tories are ready to work with the government on this issue, but he has also restated Kemi Badenoch’s conditions, which strongly imply that ultimately the Conservatives will come out against what Burnham is trying to achieve.
Andrew says:
double quotation mark We welcome cross-party recognition of the problems in the social care sector. But fixing the system requires a credible, funded plan. So far, we have only had very broad-brush information from the government.The Conservatives are ready to work with Labour on serious proposals to reform social care. But Burnham needs to produce the detail, and pledge not to raise taxes or increase borrowing to pay for change.
At today’s talks I emphasised the need to ensure we make the best possible use of public funds. Only then can we find a sustainable future for social care.
“Best possible use of public funds” sounds like code for welfare cuts, and Andrew seems to be hinting that the Tories will insist on those being implemented before social care reform happens.
Phillip Inman
Phillip Inman is a senior economics writer at the Guardian.
Andy Burnham was warned yesterday about “difficult trade-offs” by the National Institute of Economic and Social Research, which said Donald Trump’s attacks on Iran and rising oil and gas prices would harm economic growth this year and next.
Today it is the turn of the consultancy Capital Economics.
In a note to clients, deputy chief UK economist Ruth Gregory said she calculates Burnham has spent as much as £46bn to £63bn in his first days at No 10.
But the scepticism of financial markets – which will be reluctant to lend the UK government much more money – and his commitment to preserve the big three taxes (income tax, national insurance and VAT) means “his ambitions will soon collide with the fiscal reality”.
“This will limit the size of any increase in spending and borrowing,” she said.
Burnham has said his policies will be paid for by higher borrowing using the “flexibility in the fiscal rules” and “asking for a bit more in tax”.
Gregory said this will not be enough to close the gap. To emphasise how tough the outlook has become, she said:
double quotation mark The bond market is already close to the limits of how much extra borrowing it will tolerate.What’s more, there is no “flexibility in the fiscal rules” to fund day-to-day spending or tax cuts. If anything, the headroom against the fiscal mandate may have shrunk from £23.6bn to £10-15bn, meaning Burnham is caught in the same headroom trap as Reeves and will need to cut spending and/or raise taxes to restore headroom and maintain fiscal credibility.
So far the new prime minister’s revenue raising efforts amount to £2.5bn.
All in all, and with manifesto pledges considered sacrosanct, “it will be difficult to generate enough revenue eing very unpopular for voters,” Gregory said.
Gregory said everyone should expect a much-reduced menu of policies from Burnham as budget realities bite.
double quotation mark A more plausible outcome is that there is a big increase in the size of the state, with higher spending on defence, council house building and social care (perhaps of no more than £30bn-40bn), higher taxes (perhaps up to £20-25bn) and higher borrowing.
Burnham should give other parties a voice but ‘not a veto’ on social care reform, Labour thinktank says
Andy Burnham should not let other parties have a “veto” on social care reform, the Fabian Society, a Labour thinktank, has said.
In a statement, Ben Cooper, its research manager, said:
double quotation mark The prime minister is right to ask the Casey Commission to speed up its review. People cannot wait until 2028 to improve the affordability, accessibility and quality of care.Cross-party consensus is desirable, but other political parties must not be allowed to prevent change. They should have a voice, not a veto: Labour has a mandate to deliver a National Care Service. The government should use its powers to start fixing social care – ensuring everyone has access to the care and support needed to live a good life.
Ed Davey says he’s ‘hopeful’ after talks with Burnham on social care reform
Andy Burnham has held talks on social care with Stuart Andrew, the shadow health secretary, and Ed Davey, the Lib Dem leader. (See 9.36am.) Davey is in France and participated
double quotation mark We had a constructive call, and I come out of it feeling hopeful. Clearly this is just the beginning and we will need many more cross-party meetings to find consensus. Everyone will have to accept things we might not like in order to work together – but I think that’s what the public want and expect us to do.
Care charities warmly welcome Big Conversation on care, and Casey review being fast-tracked
Charities and organisations in the care sector have welcomed Andy Burnham’s speech, and particularly the launch of the Big Conversation on Care and Louise Casey being asked to produce her final recommendations by next summer, a year earlier than planned.
Here are some comments.
From Emily Holzhausen, director of policy and public affairs at Carers UK, a charity representing carers
double quotation mark It’s fantastic to hear the prime minister’s clear, personal commitment to make government action on the social care crisis a real, urgent priority and bring forward the conclusion of the Casey Commission. This is really what we needed to hear.The Big Conversation on Care is a huge opportunity to shape our individual and collective futures whilst helping to strengthen families and communities, improve wellbeing and support paid employment.
From James White, head of campaigns at Dementia UK
double quotation mark Every day, Dementia UK hears from people navigating a fragmented system, often without specialist support, pushing them to crisis point. Bringing forward the Commission’s timetable is a positive step in recognising the urgent need for reform.
From Jon Spakes, chief executive at Mencap
double quotation mark Putting social care at the top of the prime minister’s agenda is a significant and welcome step …Accelerating Baroness Louise Casey’s work is the right decision. This is too important to risk kicking into the long grass.
From Michelle Dyson, chief executive of Alzheimer’s Society, said:
double quotation mark We warmly welcome and support the prime minister’s commitment to tackling social care …Urgency is key – so it is great to see that Baroness Casey’s review will be brought forward by a year. We are also pleased to see a commitment to addressing the workforce as a matter of priority, which is a real opportunity to make sure that care workers get the dementia-specific training they need to deliver high-quality care.
Andy Burnham gave his speech at the Jewish Care care home in Golders Green today. He also spoke to residents and there is a nice clip here of his exchange with a resident who did not realise he was the prime minister. “What, a new one?” the man asks. “They keep changing every five minutes.”
Reform UK accuses Burnham of planning ‘universal death tax’ which it says it will ‘fight every step of way’
During his speech and press conference this morning, Andy Burnham said he hoped other political parties, and the media, would allow the country to have a sensible debate about options for social care reform. (See 10.32am and 11.41am.)
Whether the media will oblige remains to be seen. But Reform UK is not going into the debate with an open mind. After Burnham’s speech, Robert Jenrick, its Treasury spokesperson, released this statement.
double quotation mark Make no mistake, today Andy Burnham fired the starting gun on his scheme to raid the little money that hundreds of thousands of regular people have struggled to save over their lifetimes.That’s why he can’t rule out the new universal death tax. He won’t cut the money we hand out to migrants who have just come to our country, or cut the cash we hand out to rich foreign states in aid or reduce the benefit payments to people who are choosing not to work – instead he’s eying up another slice from hard-earned savings of Brits as their lives end.
It’s typical that the Tories and Lib Dems are conspiring with Labour to foist this tax on a country that has rejected it four times. Reform will fight a universal death tax every step of the way. Yes, we’ll make social care work properly – but not with a mammoth tax assault. Instead we’ll cut the ridiculous spending the failed political establishment has imposed on our country for 30 years.
Jenrick seems not to have noticed that only last week Burnham did cut the money going to foreign countries in aid.
It is not hard to work out why Reform UK wants to revive the “death tax” argument, which successfully scuppered social care reform when Burnham last tried it in 2010.
But what was interesting about Burnham’s press conference today was the extent to which he seemed to be willing to back away from the plans he was advocating 16 years ago. He repeatedly stressed that he needed to find a proposal acceptable to the public and that this might involve compromise. He also said a “more voluntary approach initially” might be better than a levy.(See 10.41am and 11.23am.)
Dignity in Dying, which campaigns for assisted dying, has said Andy Burnham’s concerns about palliative care (see 11.15am) should not stop parliament passing legislation to allow terminally ill people to choose to die.
In a statement it said:
double quotation mark The prime minister is right to highlight that too many people are being let down by our health and care systems. So too are dying people, under a ban on assisted dying that both the public and MPs agree is forcing people to endure unimaginable suffering as they die, or take drastic actions at home and abroad with no upfront safeguards. Improving health and social care is essential, but will not remove the need for choice at the end of life.The terminally ill adults (end of life) bill is the opportunity to change that. Parliament began the process of reforming this cruel, outdated law but was scuppered by a handful of unelected Lords intent on blocking change by any means necessary. Their action was an insult to our democracy. As the bill returns in September, there is the chance to finish what we started and Parliament must grip it with both hands.
This debate is no longer hypothetical and law change is not a distant prospect. Assisted dying laws are already coming to Jersey and the Isle of Man; to our neighbours in France. Experience the world-over proves that improving access to care as well as choice at the end of life is not only possible but complementary, improving protections for everyone no matter what they choose.
Greens say it is ‘deeply disappointing’ they weren’t invited to Burnham’s cross-party talks on social care reform
Ellie Chowns, the Green party MP, has said that it is “deeply disappointing” that her party was not invited to the cross-party talks on social care reform that Andy Burnham is holding with the Tories and Lib Dems this afternoon. (See 9.36am.)
In a statement, she said:
double quotation mark I have repeatedly called for greater action to fix adult social care, and for increased work across party lines to achieve this aim, because I know that the scale of the challenge before us demands commitment from MPs across the political spectrum if we are to make real progress.It is therefore deeply disappointing that the Green party was not invited to take part in the cross-party talks on adult social care today, despite Burnham’s stated commitment to working cooperatively on this issue.
