Andy Burnham has called England's social care system "broken" and urged Baroness Louise Casey to deliver her review of reform options by the end of 2026 — nearly two years ahead of the 2028 deadline set by Keir Starmer. The Greater Manchester mayor, who served as health secretary under Gordon Brown, also suggested sweeping changes to inheritance tax, telling BBC News he was open to abolishing the levy entirely in favour of taxing "the wealthy properly while they are alive".

The remarks came as part of a BBC News assessment of the challenges Burnham would face as a prospective future UK leader, covering defence spending, housing and social care. The article, published on 17 July 2026, features a composite image of Burnham outside No 10 Downing Street.

How social care works in England

Social care in England — help with daily living for older and disabled people, such as washing, dressing and meals — is delivered mainly by private providers rather than the NHS. An estimated two million older people live with some unmet need for care, and around 10% of people aged 65 and over face lifetime care costs above £100,000. Successive governments have attempted reform and each has failed to deliver.

Burnham himself proposed changes when he was health secretary, but his plan was abandoned after Labour lost the 2010 general election. The 2011 Dilnot report, commissioned by the incoming Conservative-Liberal Democrat coalition, proposed a state-funded cap on lifetime care costs of around £35,000. Conservative ministers accepted the principle. It was never implemented.

Theresa May's 2017 manifesto proposed including the value of a person's home in the means test for care received in the home. The policy proved deeply controversial and was blamed for the loss of the Conservative parliamentary majority in that election.

A national care service

Labour's 2024 manifesto pledged a new "national care service". Starmer subsequently commissioned Baroness Casey to produce a review of options for social care reform, with a final report due by 2028. Burnham has now suggested he will ask Casey to bring that timeline forward to the end of 2026.

The funding question

On funding, Burnham initially floated a 10% levy on all estates via inheritance tax to pay for reform. He has since shifted position, saying he is open to scrapping inheritance tax altogether and instead moving to tax "the wealthy properly while they are alive". The shift suggests Burnham is testing distinct funding models in public, rather than settling on a single mechanism.

The broader context here is a policy area that has defeated every health secretary and prime minister who has touched it for the better part of two decades. Burnham occupies an unusual position: he was the last secretary of state to attempt comprehensive reform from inside government, and he is now positioning himself to do so again from outside it. Whether a Casey report delivered by late 2026 rather than 2028 would give a future government more or less political running room is an open question. A faster timeline compresses the window for consultation and white-paper drafting, but it also reduces the risk of a report being overtaken by events or quietly shelved.

The inheritance tax proposals carry their own political weight. A 10% estate levy would affect far more families than the current inheritance tax regime, which applies only to estates above the £325,000 threshold with various exemptions. Burnham's pivot to taxing wealth during life sidesteps that problem but raises entirely different ones about how you value assets, whether people can pay without selling property, and fairness between generations. For policy professionals, the salient point is not which model Burnham ultimately prefers but that both options are now in the public domain, inviting scrutiny from Treasury officials, the Office for Budget Responsibility and the care sector alike.

A devolved matter

Social care is devolved. The proposals under discussion relate to England; Scotland, Wales and Northern Ireland each operate their own systems through Holyrood (the Scottish Parliament), the Senedd (the Welsh Parliament) and Stormont (the Northern Ireland Assembly) respectively. Any "national care service" would, constitutionally, be an English one unless the devolved governments chose to participate or parallel structures were negotiated separately.