Five big challenges facing Burnham - and how he might tackle them

Burnham faces a series of pressing issues concerning England’s social‑care system, which is delivered mainly by independent providers rather than the NHS and is widely seen as underfunded and inequitable. Public support for care is means‑tested, and estimates indicate that roughly two million older people in England are living with some unmet need for assistance. About ten percent of those aged 65 and over encounter lifetime care costs exceeding £100,000. Burnham himself has labelled the arrangement a "broken" system. He previously attempted to reform it while serving as health secretary in Gordon Brown’s cabinet, but his proposals were dropped after Labour’s defeat in the 2010 election. A 2011 government‑commissioned review led by economist Andrew Dilnot recommended a state‑funded ceiling on lifetime care expenses of about £35,000, a limit that would have prevented anyone from paying more than that amount for their own care. Conservative ministers accepted the principle of a cap, yet the Dilnot plan was never put into practice. Former Prime Minister Theresa May later introduced a separate proposal for a new social‑care framework in the 2017 Conservative manifesto. The plan would have incorporated the value of an individual’s home into the means test for care received at home, without initially specifying a cap on lifetime contributions. Critics argued that this could have compelled homeowners to contribute more based on property values. May was forced to reverse the policy within days, and the controversy was cited as a factor in the Conservatives’ loss of their parliamentary majority in that election. Labour’s 2024 manifesto pledged to create a "national attraction service". After becoming prime minister, however, Starmer delayed further action by commissioning Baroness Louise Casey to review reform options, with instructions to deliver her final report by 2028. Burnham has urged that Casey’s findings be presented sooner, suggesting a deadline of the end of 2026, and indicated he might adopt her recommendations. Any reform is likely to require substantial funding, potentially amounting to billions of pounds annually. In earlier statements Burnham proposed financing changes through adjustments to inheritance tax, including a possible 10 % levy on all estates. Polling consistently shows that inheritance tax is viewed by many as the least fair of taxes. Burnham has also said he would be open to abolishing inheritance tax altogether and shifting toward a system that taxes "the affluent decently portion they are alive".