PM Warns of NHS “Collapse” Without Social Care Overhaul, but Stops Short of Setting a Timetable
New Prime Minister Andy Burnham has warned that the NHS could ultimately “collapse” unless adult social care in England is fundamentally reformed, while declining to commit to a firm date for change.
Speaking to the BBC in his first substantial broadcast interview since entering Downing Street, Mr Burnham said hospitals would continue to struggle with long waiting times for as long as the underlying pressures in social care remain unresolved. He argued that the two systems are so closely linked that progress on one is impossible without progress on the other.
Pressed on when reforms might actually arrive, the Prime Minister was candid about the scale of the challenge, acknowledging that he was not yet in a position to give a specific timescale. He was, however, direct about the stakes involved, suggesting that without intervention, the health service risks being overwhelmed by demand from people who end up in hospital beds largely because appropriate social care isn’t available to them.
According to a source close to Number 10, Mr Burnham intends to use an upcoming speech to address what he regards as one of the most persistently overlooked areas of domestic policy. He has previously spoken about wanting his government to tackle long-standing, difficult issues head-on rather than allow them to be pushed further down the road, and social care funding is understood to be high on that list.
A system many say has been left behind
Social care in England operates on a fundamentally different basis to the NHS. Where NHS treatment is free at the point of use, social care support is means-tested, and the costs involved can be substantial enough that some people are forced to sell their homes to pay for the care they need.
Under current rules, anyone with savings and assets above £23,250 is not eligible for local authority financial support towards their care costs. Northern Ireland follows broadly similar thresholds, while Scotland and Wales apply their own distinct eligibility criteria.
Social care itself covers a wide range of support designed to help people remain independent, from help with everyday personal tasks such as washing and dressing, to broader home-care arrangements for those with more complex needs.
Mr Burnham noted that work on social care reform had originally been on a longer-term track before he brought it forward as an immediate priority, saying he had accelerated the timetable rather than starting the process from scratch.
He has already signalled that he is prepared to spend political capital on reforming a system that successive governments have pledged to fix without ultimately delivering lasting change.
Sarah Woolnough, Chief Executive at The King’s Fund, said: ‘For decades social care reform has been passed from one government to the next, consigned to the politically ‘too difficult’ box. The Prime Minister’s willingness to confront the issue within his first weeks in office signals clear determination and that ambition should be welcomed.
‘It’s true that an underfunded social care system places significant strain on the NHS, with many people stuck in hospital longer than they need to be waiting for care. And too many people end up using NHS services when they would be better served at home or in residential care if the support was available. However, social care is about far more than relieving pressure on the NHS or reducing delayed discharges. At its heart, it is about helping people live independently and with dignity.
‘There is a lot at stake. Debates about social care are too often haunted by ‘death tax’ rhetoric and the costs of improving the system rather than focused on the tangible benefits reform could bring for people and families. If the prime minister wants to succeed where previous governments have failed, he must make a positive case for reform and build a shared understanding of why change matters.’
‘Since the Casey Commission was established, we’ve urged the government to accelerate its timetable, so bringing forward its findings is welcome. But the commission was just about to begin engaging with the public and that should not be lost in the drive for speed. Even if the timetable is shortened, the commission must involve the public and use this opportunity to build understanding of social care and what reform could mean for people and their families.’
‘A fairer more universal state system would mean the risk of huge individual care bills would be shared across the population as a whole rather than falling on individuals and families. Under the current system, around a quarter of a million people with high care needs do not qualify for any state-funded support and must front the bill themselves. Moving towards a model based on the NHS principle will therefore be welcomed by many, but important questions remain about how far it would go in practice and the fairest way of funding it.’
