Prime Minister Andy Burnham delivers his speech at Labour Party Conference.
Photo: Christopher Furlong / Getty
In the new series of Game of Thrones, the King of the North has returned to his birthplace, Liverpool, to conquer the Labour conference. It’s an important moment for Andy Burnham – having successfully swerved a leadership competition, this is the first time he will face party members, unions and his own MPs en masse, including those still viewing him with residual suspicion following an unsavoury, if necessary, coup against his predecessor Sir Keir Starmer. Most importantly, for Burnham’s advisers, it is where the prime minister set out to the public his ambition for the next three years.
To that end, Burnham used his much anticipated leader’s speech to present a vision that was bold and far-reaching, touching on everything from public control of utilities to stewardship of AI to voting reform. In a Kennedy-esque nod, the speech reminded the public that if he was delivering the vision they’d demanded, then they should back it in the spirit of “unity and positivity”.
Most notably, Burnham has set his sights on slaying the monster of a fractured, dysfunctional social care system to prove he’s got what it takes to be prime minister and lead the country from rancour to revival. He has committed to establishing what he calls a “landmark” National Care Service (NCS), free at the point of need for anyone who wishes to use it in England.
Based on our experience, the process that provided essential care to the most vulnerable in society was a Kafkaesque series of bureaucratic tunnels
This is radical stuff that aligns squarely with his anti-neoliberal philosophy. Burnham appears passionate and determined: two qualities he will need in truckloads if this is to be the totemic issue of his premiership. What he will also need, in even bigger quantities, is funding. The Health Foundation has estimated a universal social care system in England, with the government funding all support, could cost around £18.5bn a year. Burnham rejects this figure, though he has not supplied an alternative number. In Scotland, free personal and nursing care is already available, conditional upon appropriate assessment. In Wales, social care is usually paid for by a mix of the person receiving it and the local authority, again dependent upon a financial assessment.
At this point, I could chuck in a load of statistics to prove just how ruinous the decrepitude of the English social care system is to our public finances and NHS waiting times. Instead, I want to tell you that – like Burnham, who recently lost his father to dementia – I too have lived through the ravages of the speciously named “care system” with my own parents in the years preceding their deaths in 2015. Based on our experience in London, the process that provided essential care to the most vulnerable in society was, in fact, a Kafkaesque series of bureaucratic tunnels that led to a deeply dehumanising experience for all those involved, be it the elderly and disabled, their families or care workers.
It seemed to me the dangerous nature of what we were experiencing was the dirty secret of politics. No one in power was prepared to deal with it because those in need were often hidden behind the closed doors of nursing and care homes or their own residences: out of public sight, out of political mind.
It led me, back in 2015, to investigate the state of domiciliary care in England for BBC Radio 4. My programmes, with the help of brave whistleblowers, exposed the wholesale privatisation of essential services, the abuse of vulnerable people, and the pay-per-minute exploitation of low-paid workers doing important skilled work helping our loved ones. It also suggested solutions: best practice that cost little more with disproportionately positive effects.
The ideological driver of the current crisis can be traced back to the Hannibal Lecter of public spending, George Osborne
Over a decade on, I’m sorry to report that little, if anything, has changed. Instead, an ageing population, starved budgets, an exodus of foreign care workers caused by Brexit and the pandemic, and ever-tightening immigration rules has left social care in a calamitous state.
The ideological driver of the current crisis can be traced back to the Hannibal Lecter of public spending, George Osborne. It was the Tory chancellor’s 2010 spending review that introduced the era of “austerity” which cannibalised local authority budgets – including that of adult social care. According to the magazine LocalGov, consecutive funding cuts “resulted in an over 60% cumulative fall in funding between 2010 and 2019. Taking into account other sources of funding like council tax, overall spending power fell by 25% on average over the same period.”
I am pleased that Burnham has the guts to describe what has happened as “devastating”, and conclude that parliament has ignored this issue because it is “just too difficult”. In a recent BBC interview, he rightly pointed out that this postcode lottery of care has diminished trust in government. “Is it any wonder that politics is in such low esteem with the public when it can't fix something as basic as the care that we give to each other? So, it can't carry on. Somebody needs to grasp the nettle.”
Of course, one of those to be potentially stung is the new chancellor, John Healey, who will have to find the pot of gold that will fund the NCS. In his party conference speech, delivered from behind a lectern with Labour’s latest logo, “Hope Again”, stamped on it, he told the audience: “The money we had in the 1990s is simply not there; it’s not progressive to allow a bigger benefits bill in the system which offers an income but doesn’t offer a future. We must act; it’s not just an economic must, it’s a moral duty”. Was this a hint that welfare reform might be on the cards to help pay for the NCS? The truth is, we don’t know. With less than a month to go until Healey’s first budget, he cannot be specific; however, what we do know is that the government already faces huge challenges. To name but a few, UK taxes are at their highest since 1945, our debt interest payments are running to billions of pounds a month and growth remains sluggish.
A clue may, however, lie in an overlooked indication Burnham gave in a BBC interview In it, he said that while setting up an NCS was his ambition – the how to do it (and presumably some indication of cost) would be revealed via a piece of work being undertaken by every government’s go-to grown-up in the room: the formidable Dame Louise Casey. It was after that, he said, that he would take his plan to the public to be voted on at the next general election in 2029.
If Burnham really is serious about a much-needed revolution in social care, then what we need is for him to stick to his guns, spend the personal political capital he says he’ll sacrifice and, most importantly, face down the enemy – including the rightwing media, opposition parties and internal critics – and avoid kicking the issue into the long grass in the hope it’ll be someone else’s problem. It's only then that the public can genuinely “hope again” that the King of the North can conquer the UK’s biggest problems.
Sangita Myska is an award-winning journalist and presenter best known for her political and social commentary. She writes a twice-monthly column for the Nerve.