Adult social care can be divided into two parts.

FIRST, involving people of working age. According to The Times (30.07.26) between 2024-25 and 2031 the number of people claiming incapacity benefit is forecast to rise from 3.4 million to 4 million and those on disability benefit from 6.5 to 8.8 million, costing billions of £’s. Mr Burnham isapparently prepared to make claiming benefits harder and said that the country had to “get really serious” about bringing down the bill.

SECOND, involving the care of the elderly and vulnerable, often in the closing stages of their lives. This aspect of adult social care was the main object of his announcement. It is a problem well-known to many of us: an elderly relative deteriorates, and does not qualify for free NHS clinical care, or for local authority funding for nursing or residential care.  His or her assets, and often the family’s assets, have to be sold to pay for private care.

OVER the last 30 years, there have been 22 reviews of adult social care, usually concentrating on the second part, and each one has ended in failure. Will this one succeed? The new Secretary of State for Health and Social Care, Yvette Cooper MP, and Baroness Louise Casey, have been tasked with holding a “Big Conversation on Care”, and Baroness Casey to lead the 23rd review to an interim report later this year and to produce full recommendations during 2028. Perhaps Mr Burnham will still be Prime Minister and will manage to pass a Social Care Bill into law.

HOW might free social care for the elderly, costing perhaps £18.5 billion a year, be paid for? (a) Replace inheritance tax (paid by about 4.5% of people) by a “national care levy” on all estates after a person dies. (b) A national insurance scheme in which working-age people make contributions and the “big pot” is ring-fenced for social care. (c) An extra 1.8% income tax for workers aged over 34 earning over £6,240, which would go into a national Later Life Care Fund. (d) From “existing budgets” and without raising taxes, but this would require cutbacks elsewhere, but from where? Defence, education, hospitals?

Would anyone like to be in Mr Burnham’s shoes? Kemi or Ed or Jac or Nigel?  Or will they prefer to gainsay his offer of consensus and cooperation in favour of criticism?

From your intrepid health correspondent, seated quietly at his desk.