What feels different this time is a sense of political will. For Andy Burnham, reforming adult social care in England is personal. During his speech at Jewish Care in London in July, and again when Parliament returned in September, he spoke movingly about his own family’s experience of care and his determination to reform the system.
He also told The House that he ‘will not leave this role until we have introduced a social care system that we can be proud of’ – a striking commitment to give social care the priority it has lacked for far too long.
But here is that phrase again: cautious optimism. The real test is whether Andy Burnham’s commitment survives contact with the Treasury, whether providers and people who draw on care are genuinely involved in decision making and whether a properly funded plan follows on a clear timetable.
A lot to welcome
There is a great deal to welcome so far. The PM’s decision to bring forward Baroness Casey’s review of adult social care from 2028 to summer 2027 is particularly meaningful. Allowing fundamental recommendations to drift towards an election would invite the same political paralysis we have seen before.
The Big Conversation on Care also has potential, provided it is a genuine exercise in public consent rather than a communications exercise. We need an honest national conversation about what social care is, what people should be entitled to expect and how responsibility should be shared between individuals, families and the state.
I support the ambition for a National Care Service, but the phrase needs definition. It should embody a clear national promise – consistent rights and standards, fair access wherever someone lives and a properly supported workforce – as opposed to representing a single state-run provider.
Government’s workforce commitments are also welcome, particularly the Fair Pay Agreement and the expansion of a national career pathway. However, negotiations will not begin until April 2027, with the first settlement due by April 2028. Care workers and providers need nearer-term action, and every pay commitment must be fully funded through commissioning rates rather than passed down as an unfunded expectation.
Call to action
To that end, there are several priorities I hope the PM will now champion. First, Government needs to publish a firm route from consultation to legislation and implementation, with named milestones and transparent accountability.
Second, reform must put home-based support and prevention first; too often the system waits for crisis before offering meaningful help. We need to invest earlier in quality homecare that helps people stay well, maintain routines and remain connected to their community.
Third, we need a national minimum entitlement with simpler access and less postcode variation, while retaining local flexibility. Health and care funding, assessment and planning must be built around the person, with genuine choice as to whether care is publicly funded, privately paid or a mix of both.
Fourth, workforce reform must be fully costed. That means fair pay, paid travel time, training, career progression and professional recognition, backed by commissioning rates that allow good employers to deliver them.
Fifth, a healthy care market needs reliable multi-year funding, realistic fees and proportionate regulation. I support a sustainable minimum price for homecare – one that reflects the true cost of delivery. This should be seen as a quality floor rather than a ceiling, ensuring providers can deliver consistent high-quality care.
Finally, the PM must answer the question that has eluded his predecessors – how do we ensure the social care system is properly funded, whilst protecting people’s savings and wealth? Government and opposition MPs should resist the temptation to weaponise funding options before cross-party discussions develop.
Can the new PM shift the dial?
Andy Burnham has made a brave opening move by choosing social care as an early test of his premiership and admitting that reform may require difficult decisions. But bravery in social care is not measured by the strength of a speech. It means settling the funding question, standing by a fair solution when it attracts criticism and ensuring that the promise to care workers is matched by money in the system.
It also means resisting the temptation to design social care mainly around the needs of the NHS. A fair system starts with the person: their independence, relationships, choices and outcomes. So, can the new PM finally achieve lasting social care reform? I genuinely hope so. The early signs justify cautious optimism. Lasting reform will depend on what happens next.
Will this be the Government to deliver lasting social care reform? Comment on this Straight Talk or join the conversation to share your thoughts.
Lucy Campbell is Chief Executive Officer at Right at Home UK.
Email: [email protected]
Linkedin: @Right-at-Home-UK