Andy Burnham Sets Out National Care Service Plan With Free Personal Care

Prime Minister Andy Burnham has set out plans for a new National Care Service in England, promising free personal care for older people based on need rather than their ability to pay.

The proposal, announced on 29 September at the Labour Party conference, would represent a major change to the way adult social care is funded.

The government says the new service would be introduced during the next Parliament and developed in phases rather than launched nationwide in a single step.

Under the plans, personal care such as help with eating, washing, bathing and using the toilet would eventually be provided without individual care charges for eligible older people.

However, the commitment does not mean every cost associated with residential care would become free.

The government has confirmed that accommodation, food and other “bed and board” costs would remain outside the free personal-care offer. Existing means-tested council support for those costs would continue.

Burnham’s announcement is also closely tied to a planned change to the State Pension Triple Lock after April 2030, setting up a wider debate about how Britain should divide public spending between pensions and care for an ageing population.

How Would Andy Burnham’s National Care Service Work?

The National Care Service is intended to operate on principles closer to those associated with the NHS, with eligibility for personal care determined by a person’s needs rather than simply by their financial resources.

It would be introduced gradually as funding, workforce numbers and care-provider capacity increased.

Baroness Louise Casey’s independent Commission on Adult Social Care has been tasked with developing recommendations on precisely how the system should work. Its report is expected in summer 2027.

That means important questions remain unresolved, including how eligibility assessments would work, how local councils and private care providers would fit into the system, the workforce required to deliver it and how quickly free personal care could be extended.

The government’s current commitment covers personal care. It says existing arrangements would continue for accommodation costs.

For people entering residential care, this distinction could remain financially significant because care-home bills generally include both personal care and living costs.

Deferred payment agreements would also remain available for eligible people who need help meeting care costs without selling their home during their lifetime.

Where a partner or dependent relative continues to live in a property, councils would continue to exclude the home’s value from relevant financial assessments under existing rules.

The government estimates that around three-quarters of people aged over 65 will require some form of care and support during later life, while around one in seven could face lifetime care costs exceeding £100,000.

The proposed National Care Service is designed to reduce that financial uncertainty.

It could also have implications for the NHS, particularly in London and other large urban areas where hospitals can experience difficulties discharging medically fit patients when suitable community or home-care support is unavailable.

Burnham has argued that weaknesses in social care place additional pressure on hospital beds, accident and emergency departments and families providing unpaid care.

State Pension Triple Lock to Change From April 2030

One of the most politically significant parts of the announcement concerns the State Pension.

The existing Triple Lock guarantees that the State Pension rises each year according to the highest of average earnings growth, inflation or 2.5%.

The government says the existing arrangement will remain in place throughout the current Parliament and until April 2030.

After that point, the proposed system would guarantee annual State Pension increases of at least inflation or 2.5%, whichever is higher.

There would also be a longer-term earnings safeguard intended to prevent the value of the pension falling behind average wages over time.

The government estimates the change could reduce State Pension expenditure by approximately £15 billion a year by the end of the 2030s, rising to around £50 billion annually by 2050 compared with retaining the current formula.

It says those savings would contribute towards building the National Care Service.

The precise cost of the care system and the pace at which it could expand have not yet been settled.

The government says the service would not be funded through borrowing and that Baroness Casey’s commission will help establish a workable implementation and funding model.

That leaves the eventual financial package as one of the biggest issues still to be resolved.

Experts Welcome Reform but Warn About Funding and Delivery

Health and social care organisations broadly welcomed renewed political attention on the sector while stressing that delivering a genuinely universal service would require substantial additional investment.

Dr Jennifer Dixon, Chief Executive of the Health Foundation, described the proposal as a “generational opportunity to create a fairer, more generous system” for people requiring care, their families and carers.

She said England’s existing system leaves some people without sufficient support while others spend significant amounts of their savings or become dependent on unpaid relatives.

However, Dixon also warned that major decisions remained about how the reforms would be financed and how responsibility for costs would be shared between individuals and the state.

The Health Foundation said additional public investment would be required if the government is to create a more generous and universal social-care system.

Caroline Abrahams, Charity Director at Age UK, also welcomed the direction of the proposal, describing the commitment to social-care reform as “hugely welcome, after decades of dither and delay”.

Age UK said a modern system free at the point of use could significantly change the experience of older and disabled people and their families, while stressing that the eventual design of the scheme will matter.

The response from the workforce side has also focused heavily on pay and staffing.

Andrea Egan, General Secretary of UNISON, said social-care reform was a “national emergency” and argued that improving pay and conditions must form part of any overhaul.

UNISON welcomed the ambition to create a National Care Service but disagreed with relying on changes to pensions as a major funding mechanism.

The union has instead called for ministers to examine measures including taxes on wealth and higher banking-sector contributions.

That disagreement illustrates one of the central political questions surrounding Burnham’s plan: there is substantial support for social-care reform, but much less agreement about who should ultimately pay for it.

What Does the Latest Public Polling Show?

A YouGov survey carried out on 29 September 2026, covering 4,503 adults across Great Britain, found broad support for the principle of a National Care Service.

According to the poll, 74% said they supported establishing a national care service where adult social care is free at the point of use, compared with 11% who opposed the idea.

Public opinion was more divided when the proposed pension change was included.

YouGov found that 48% supported changing the Triple Lock to help fund the care service, while 28% opposed it.

The figures provide a snapshot of opinion immediately after Andy Burnham’s announcement rather than a prediction of how attitudes could develop once more detailed costs and eligibility rules are published.

The debate over pensions is therefore likely to remain central as the policy develops.

The government’s position is that pensioners would continue receiving annual increases and would gain greater protection from potentially very high personal care bills.

Critics and some trade unions argue that the government should find alternative sources of revenue rather than reduce future pension expenditure.

When Could the National Care Service Begin?

People needing care today will not immediately move onto the proposed new system.

The National Care Service is planned for the next Parliament, while the redesigned pension uprating system would take effect from April 2030.

Before then, Baroness Casey’s commission is expected to provide detailed recommendations in summer 2027 covering the structure and implementation of the service.

Further legislation and detailed spending decisions would also be required.

The government has already said the scheme would be phased, meaning different parts of the new system could be introduced at different times as funding and care capacity become available.

For London’s older residents and their families, the announcement therefore represents a proposed long-term change rather than an immediate alteration to current care bills.

Existing means-testing rules and council-funded social-care arrangements remain in place for now.

What has changed is the government’s stated long-term objective: to move personal care away from a system in which substantial costs can fall directly on individuals and towards a National Care Service where qualifying personal care is available according to need.

The crucial details exactly who qualifies, how quickly free care becomes available, how the workforce will be expanded and whether the proposed pension savings provide sufficient funding will become clearer as the Casey Commission completes its work.

With its report due in 2027 and the proposed pension changes scheduled from 2030, the argument over how England funds care in later life is now likely to remain a major national policy issue for several years.