Burnham’s Social Care Ambitions Must Go Further, Letters Say

Following Andy Burnham’s Labour conference speech, media coverage has focused on defining social care and estimating its cost (How will Burnham’s national care service work – and how will it be funded?, 29 September).

Most proposals assume the new system will replicate the existing model: outsourced services, rigid contracts, fixed targets, and poorly compensated, precarious migrant labor.

In reality, many services required by elderly and disabled people—cleaning, meal preparation, medical transport, household repairs, podiatry, hairdressing, physiotherapy, counseling, and massage—are also needed by the general public and already available through local markets.

The issue is that these services are primarily supplied by platforms like Uber, Deliveroo, or Housekeep, which lack commercial incentive to address social needs.

One solution would establish local platforms providing these services to all residents regardless of age or disability. By ensuring staff are properly trained, qualified, and security-checked, and vehicles are appropriately adapted, such platforms could attract commercial users whose spending would subsidize costs. Social care recipients could access services through a voucher system, far cheaper than building new infrastructure or bundling services into large outsourcing contracts.

With proper public oversight, leveraging platform technology for public good would benefit the local economy. Services would improve for everyone. Workers could gain skills and job security. Profits would stay in every postcode rather than flowing to tax havens.
Ursula Huws
London

Andy Burnham’s commitment to a national care service brings welcome clarity to a debate that has too often avoided difficult choices. However, before deciding how to pay for care, we must first answer a fundamental question: what should people be entitled to expect?

Reports that the proposed service may follow Scotland’s model of free personal care raise an important distinction. Eliminating charges for washing, dressing, and eating could make a substantial difference. Yet social care encompasses far more than these tasks. During the coalition government, we placed wellbeing at the heart of the Care Act, extending its purpose to dignity, independence, relationships, participation, and personal control.

There is a risk that defining a national care service primarily through free personal care narrows our understanding of social care’s purpose. The two need not conflict. Free personal care could form part of a wider national guarantee, grounded in the Care Act’s wellbeing principle and applying across adulthood.

The Casey commission has an important opportunity to help establish that wider promise. The question is whether the new service will merely change what people pay, or also strengthen the care and support they can rely on to live their lives.
Paul Burstow
Former minister of state for care services, 2010-12

Andy Burnham’s decision to delay social care reform proposals until after the next election is the latest chapter in an almost two-decade saga of delays.

Since Labour first committed to social care reform in 2007, we have seen a succession of unfulfilled promises: the discarded Personal Care at Home Act 2010, David Cameron’s part-implemented Care Act 2014, Theresa May’s failed 2017 proposals, and Boris Johnson’s 2019 Downing Street pledge—delayed under Rishi Sunak, then scrapped by Rachel Reeves in 2024.

Since this saga of broken promises began, both my parents have been diagnosed with Alzheimer’s disease. One survives, and our family continues to wait for meaningful help.

Families living through the social care crisis do not have the luxury of waiting for another election cycle. Mr Burnham needs to act now.
Dr Ruth Charles
Swavesey, Cambridgeshire

As a 69-year-old receiving a 20-year teacher’s pension and full state pension, I say by all means take money from pensioners. Scrap national insurance—a regressive tax—and increase income tax. Eliminate all age-related tax benefits and exemptions. But please don’t touch the triple lock until the state pension reaches parity with most European states. It is mainly women who rely solely on this inadequate pension, and many live alone in rented accommodation. They are the last people who should be asked to sacrifice.
Sarah James
Monmouth

At 86, I am sure I am not alone in anxiety about paying for a care home if the need arises, and I am delighted that Andy Burnham is determined to fix the system at last. While triple-lock pension increases are welcome, I would happily accept capping them at inflation as a trade-off for never having to worry about paying for social care.
Michael Miller
Sheffield

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