Sep 30, 2026 · 8 min · 5 segments
On this week's Macrodose, James Meadway looks at Andy Burnham’s first speech to Labour party conference as prime minister, his proposals to modify the triple lock on pensions, and how he sets out his…
Andy Burnham's first party conference speech as Prime Minister was pitched at a high emotional level and demonstrated much of what makes him a particularly effective politician.
He came across as warm, empathetic and sincere in a way that few recent Prime Ministers have managed.
And by deliberately leaning into a set of difficult, long-term political problems with social care at the centre, he demonstrated a willingness to break with the safety-first approach that the chronically indecisive Keir Starmer gravitated towards.
The National Care Service is something Andy Burnham wants to stake his and his government's reputation on.
It is a bold move, an offer of a genuinely universal provision of social care, free at the point of need, like the National Health Service, and with, in Burnham's telling, funding not dependent on selling homes or running down savings, whilst also improving paying conditions for care workers, whom Burnham addressed directly in his peroration.
This is, potentially, an even bigger offer on social care than Jeremy Corbyn presented.
Labour's 2017 manifesto promised to raise the minimum asset threshold for free care, cap lifetime care costs and support free end-of-life care, while the 2019 manifesto offered free personal care for the over-65s, backed by £10.8 billion of investment by 2024, along with a new national care service for England and a £100,000 lifetime cap on care costs.
Burnham also wants to avoid the trap Theresa May stumbled into during the 2017 election campaign when making her own pledge on reforming the social care system.
She proposed that those needing care would be expected to fund it from their own assets after a certain level, a policy that contains the cruel result that those requiring more complex and expensive care lose out whilst those who have few needs do much better.
When Burnham as Health Secretary under Gordon Brown proposed a pooling of resources from pensioners, socialising the costs and the risks of late-in-life care, it was immediately and effectively attacked by the Tories as a death tax.
Burnham knows this, and he knows that the last 30 years have seen no fewer than 22 different reviews of the system, all to no avail.
The Prime Minister is taking a significant political risk in staking so much on getting this working.
The Health Foundation estimates that the National Care Service, called for by Andy Burnham, would cost around £18.5 billion a year.
The knock-on benefits, aside from the moral value of ensuring all of our elderly are looked after properly, is that the failing social care system is creating a huge burden on the NHS.
The King's Fund counts around 13,000 delayed discharges a day across England, meaning almost one in 10 hospital beds are occupied by people fit enough to leave at a cost of £2.7 billion a year.
Andy Burnham's first party conference speech as Prime Minister was pitched at a high emotional level and demonstrated much of what makes him a particularly effective politician.
He came across as warm, empathetic and sincere in a way that few recent Prime Ministers have managed.
And by deliberately leaning into a set of difficult, long-term political problems with social care at the centre, he demonstrated a willingness to break with the safety-first approach that the chronically indecisive Keir Starmer gravitated towards.
The National Care Service is something Andy Burnham wants to stake his and his government's reputation on.
It is a bold move, an offer of a genuinely universal provision of social care, free at the point of need, like the National Health Service, and with, in Burnham's telling, funding not dependent on selling homes or running down savings, whilst also improving paying conditions for care workers, whom Burnham addressed directly in his peroration.
This is, potentially, an even bigger offer on social care than Jeremy Corbyn presented.
Labour's 2017 manifesto promised to raise the minimum asset threshold for free care, cap lifetime care costs and support free end-of-life care, while the 2019 manifesto offered free personal care for the over-65s, backed by £10.8 billion of investment by 2024, along with a new national care service for England and a £100,000 lifetime cap on care costs.
Burnham also wants to avoid the trap Theresa May stumbled into during the 2017 election campaign when making her own pledge on reforming the social care system.
She proposed that those needing care would be expected to fund it from their own assets after a certain level, a policy that contains the cruel result that those requiring more complex and expensive care lose out whilst those who have few needs do much better.
When Burnham as Health Secretary under Gordon Brown proposed a pooling of resources from pensioners, socialising the costs and the risks of late-in-life care, it was immediately and effectively attacked by the Tories as a death tax.
Burnham knows this, and he knows that the last 30 years have seen no fewer than 22 different reviews of the system, all to no avail.
The Prime Minister is taking a significant political risk in staking so much on getting this working.
The Health Foundation estimates that the National Care Service, called for by Andy Burnham, would cost around £18.5 billion a year.
The knock-on benefits, aside from the moral value of ensuring all of our elderly are looked after properly, is that the failing social care system is creating a huge burden on the NHS.
The King's Fund counts around 13,000 delayed discharges a day across England, meaning almost one in 10 hospital beds are occupied by people fit enough to leave at a cost of £2.7 billion a year.
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