As one of many hundreds of thousands of people in the UK with a parent with Alzheimer’s, the passage in Andy Burnham’s speech about social care moved me to tears.
My mother had not even been diagnosed when I watched Theresa May announce her 2017 general election manifesto in a hall in Halifax – with care funding at its heart.
Almost a decade of political neglect later, and Mum has now been in a care home for three years, with the funding coming overwhelmingly from our family’s own resources.
So it was arresting to hear Burnham speak with clarity about his belief that personal care should be a question of “social insurance” – sharing the risk across families.
In practice, personal care makes up a minority of the total cost of residential social care. Much of it is the “bed and board” that Burnham’s changes won’t pay for: the cooking, cleaning and upkeep.
But a sense that the burden is somewhat shared would be a significant step forward, as would Burnham’s apparent determination to put care workers at the centre of the plan – and to expend political capital in doing so.
Addressing care workers directly, he said: “I see you. I thank you. And I am sorry that my profession has let down yours for so long.”
It’s a long-held view of Burnham’s. I recall speaking alongside him at a fringe event about jobs and skills at Labour’s 2024 party conference, at which we both underscored the fact that we didn’t feel the carers who supported our respective parents were “low-skilled”.
Yet the national care service, with its promised closer alignment with the NHS, will feel a very long time coming, for families making their agonising way down the road to diagnosis and beyond.
The next parliament seems too long to wait. As Stuart Hoddinott of the Institute for Government said after Burnham’s speech, the prime minister should “have the courage of his convictions” and stand it up sooner.
Even as a skeleton body, it could get on with setting standards and coordinating care better with the NHS, and could become involved in the negotiations on a fair pay agreement in the sector.
That’s Labour’s ambitious attempt to introduce collective bargaining, including pay and progression, across a fragmented and poorly paid industry.
Whatever the fledgling negotiating body agrees is set to come into force in April 2028. So far, Labour – under Keir Starmer – has set aside £500m to fund any uplift in pay.
Joe Dromey, the general secretary of the Fabian Society, which has made social care a campaigning issue in recent years, suggests that may not be enough.
“The first priority should be fixing the workforce crisis. We must give care workers the pay rise they deserve, through a more ambitious fair pay agreement,” he says.
Tweaking the triple lock beyond 2030 is a sensible policy, and tying it to social care feels like good politics from Burnham – but it won’t put any money into an overstretched sector now, let alone into the pockets of those care workers.
As Hoddinott says, making progress between now and the next general election “would give Burnham a strong story to tell” – and make it less likely his changes would be swept away if Labour loses.
While it seems to have been memory-holed by the political class, Boris Johnson was prepared to bust a Conservative manifesto promise in 2021 and introduce a £12bn-a-year “health and care levy” to “fix social care”.
That was arguably a greater expenditure of political capital than rewriting the triple lock, and it was set to take effect within months.
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In the event, of course, Johnson torched his entire stock of political capital by partying in lockdown, and took the policy down with him.
But with Louise Casey set to report next summer on how a national care service could be built and paid for, spending perhaps another two years after that in a “national conversation” will seem a very long slog for affected families.
Frankly, having reported on that 2017 campaign, when May’s plans were quickly dubbed a “dementia tax” (there already is one, for goodness sake), Burnham’s hopes of achieving political consensus are high-minded but almost certainly hopeless.
There is also a risk – voiced to me in Liverpool by one Labour MP – that extending the discussion about the right way to fund social care right through to the next election crowds out other arguments they may need to make.
After all, there are only a certain number of ways of raising the additional money that will be needed, over and above the triple-lock tweak, and they are well rehearsed.
There’s a national insurance rise à la Johnson, perhaps applied only to older workers; or a levy on all estates (a “death tax”, as it was called by the Tories when Burnham last advocated it, 15 years ago).
Or there is the politically tougher but perhaps more honest approach that acknowledges general taxation will have to rise because of the growing needs of an ageing society – funding a more generous social care settlement as part of a wider shoring up of the public sector.
It is admirable and refreshing that Burnham wants to build the political case for causes he believes in – and social care is more than ripe for that approach.
But enough families like mine have struggled their way unsupported and forgotten through a system that fails them.
Once he has a plan, he should just crack on with it – and that includes raising the money needed to make it work.
