The state of the social care system in England is a topic that's made Andy Burnham angry for decades. As Gordon Brown's health secretary he proposed a compulsory levy collected from people's estates – an idea the Conservatives dubbed the "death tax". He repeatedly returned to the issue when making interventions as the Mayor of Greater Manchester, and in his first major interview as prime minister back in July, Burnham pledged to put "whatever political capital I have into fixing broken social care".
We now have the first outline about how he hopes to do that. But there are a host of unanswered questions about how the government would fund and deliver what could be an eye-wateringly expensive and politically perilous idea. The prime minister told the BBC's Sunday with Laura Kuenssberg that he will go into the next election proposing a free-to-use, universally funded national care system.
Past governments have looked at how to reform social care and balked at the potential costs. The Health Foundation has previously estimated that a free system could end up costing the taxpayer around £18bn a year. Burnham denied that figure but conceded that tackling the issue could make him "unpopular" with some.
He stressed that the current system comes with hidden costs for individuals and the state, such as people losing their houses to pay for costs and spending time in A&E because their home care isn't adequate. But it's difficult to deny that this idea would come with a staggering up front cost and one the prime minister would have to lay out a far more detailed funding plan for, if he went into an election with this as his flagship proposal. The last prime minister to attempt a substantial overhaul of social care was Theresa May, whose 2017 plans unfurled when they were nicknamed the "dementia tax".
Burnham said the manifesto that Labour was elected on at the last general election would make it "hard" to achieve his goal. That's a clear hint that he could well go into the next election pledging to increase tax in order to fund social care. The manifesto that Burnham is currently bound by pledged not to hike income tax, VAT or National Insurance.
Other funding options are not being taken off the table, including a return to Burnham's old plan to make some people pay out of their inheritance. He could also get some political cover, in the form of an ongoing review by the longtime policy guru Baroness Casey. She's been heading a commission into adult social care since April last year and Burnham said her findings would influence what he proposes.
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