Health Foundation response to the Prime Minister's comments on social care

Responding to Prime Minister Andy Burnham’s plans for social care, Hugh Alderwick, Director of Policy and Research at the Health Foundation, said:

'We welcome the Prime Minister’s commitment to tackle social care reform and use his political capital to do it. Our threadbare safety-net system is inadequate and unfair, leaving too many people without the care they need or facing high costs. This has knock on effects on family carers, the NHS and our economy. The lack of state protection against social care costs is a glaring gap in our welfare state and makes England an outlier internationally.

'It’s right to engage the public on the options for reform and build momentum for change. Our research with the public tells us that awareness of how social care currently works is limited – around a third of people incorrectly think care services are free at the point of need, like the NHS. When the reform options are explained to the public, most think the current means-tested system is unfair and favour a system where the state takes more responsibility for care costs – either through some universal entitlement with additional means-tested services or an NHS-style system where social care is free at the point of use. Attitudes to reform do not map simply along party political lines – for instance, with people intending to vote Green or Reform UK more likely to think the state should be entirely responsible for paying for the social care people need [1].

'It’s hard not to have déjà vu: successive governments have promised reform, then failed to deliver. What’s needed now is the sustained political will and investment to make it happen. Media debate will likely focus on the costs of reform to the public purse and where government will find the money. But many of us are already shouldering these costs without state support, with around 1 in 7 older people facing care costs over £100,000 [2]. The cost of inaction to people and their families is substantial and investing in a more generous system could improve the lives of millions. The Prime Minister’s leadership will be crucial in painting a positive vision for the future and demonstrating why this is an investment worth making. The commitment to taking a cross-party approach to reform is the right one – and the other parties will need to step up to support the change needed. After decades of political failure, this is a test of our political system as well as Burnham’s leadership.'

Notes to editors

1. Public perceptions of health and social care polling (Wave 8: May 2025)
2. Operational guidance to implement a lifetime cap on care costs (Department of Health and Social Care)

The Health Foundation has an ongoing programme of work on public perceptions with Ipsos. Key findings on the views of the public in England on social care include that:

• 33% incorrectly think social care services are generally free at the point of need and a further 18% don’t know if they are or not
• In-depth research finds public support for funding reform, once people understand the current system
• 77% of people prefer a system where the state has a bigger role in paying for care than under the current system
• 21% of the public believe the state should pay for all the care an individual needs – people who intend to vote Green (30%) or Reform UK (28%) are more likely than average to think this.

Media contact

Billie Morgan
Billie.Morgan@health.org.uk
020 7257 8001 / mobile: 0790 8637 666