Free Social Care, Head On: Britain Tests Whether Care Charges Can Actually Go

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Britain’s prime minister has said he will take on the country’s “broken” social care system “head on”, ending decades of what he called “political drift”. Organizations led by people with disabilities welcomed the pledge, while warning that warm words are not the same as reform.

This is a follow-up to our earlier reporting on the new government’s first moves on disability poverty, and it reports on a developing situation rather than offering advice about anyone’s own care or benefits. The specifics are British. The question underneath them, whether a person should have to pay out of their own pocket to get the support that lets them live an ordinary life, is one Canada answers in its own patchwork of ways, which we come to at the end.

What the prime minister actually said

Andy Burnham set out the pledge in a speech at a care home in north London on Wednesday 29 July. He called it a “major dereliction of public duty” that social care reform had still not been achieved despite 22 reviews over three decades, and he said there were about two million adults in England with unmet care needs. Adults with disabilities, he said, face “very unfair care charges just to live their life”.

He framed the task in personal terms, saying he was making it “a test of myself whether I can bring forward a solution, or I would never forgive myself, ever”, and promising to “stick this out”.

Two things are worth holding apart, because the reporting does. Burnham has previously described care charges as an “abomination”, but he did not promise on 29 July to abolish them. What he committed to was a direction: a national care service that would be “person-centred” but “highly integrated with the NHS”, built on a “principle of home care wherever possible”, with care workers better paid, trained and supported and their pay lifted “closer to NHS standards”.

He also changed the clock. He announced that he had brought forward the final report of Baroness Casey’s Independent Commission on Adult Social Care from 2028 to next summer, and said he would wait for that review’s conclusions before deciding whether there should be a “fully-fledged” national care service and how it should be paid for. Alongside it, Casey launched a public consultation, The Big Conversation on Care, which runs until April 2027 and asks people across England what they want a future care service to be, who it should support, and how it should be funded.

The politics around it moved too. Burnham began cross-party talks with the Conservatives and Liberal Democrats. Liberal Democrat leader Ed Davey joined the first meeting virtually because of his own caring responsibilities, and the Conservatives sent shadow health secretary Stuart Andrew, with party leader Kemi Badenoch undergoing minor surgery. Davey said afterwards that he came out of the call “feeling hopeful” while stressing it was “just the beginning”.

The funding question he has not settled

The hardest part of any care reform is who pays, and Burnham has been here before. Five years ago, at a Labour conference fringe meeting in 2021, he argued that a National Care Service should work on the same principle as the NHS, “free at the point of use, based on need, not ability to pay”, and that it should “start with very personal, individual support in the home”.

At that meeting he floated how to fund it: a care levy of 10 per cent on “everyone’s assets, savings and homes”, with a payment plan that could be agreed when a person reaches 65. He argued that because it is a levy tied to what a person gets rather than an inheritance tax, even someone who never needs care would be buying “peace of mind, the peace of mind the NHS provides for you”.

That was a proposal, not a policy, and he has not repeated the specific 10 per cent figure as prime minister. On his first day in office he told reporters he was “ready to use some of my political capital on this issue” and wanted care to “operate on the NHS principle” of being free at the point of use. The funding mechanism now waits on the Casey review.

What organizations led by people with disabilities replied

The responses from organizations led by people with disabilities, as reported by Disability News Service, were a study in cautious hope.

Greater Manchester Disabled People’s Panel, which worked closely with Burnham when he was Greater Manchester mayor, said it was “very pleased” that he was “beginning to make the changes necessary for a national care service free at the point of need, that supports independent living and the best lives for everybody in the community”. Sara Crookdake, a former co-chair of the panel and from Disability Stockport, said the lesson of the Greater Manchester work was that “the best way to improve adult social care is to design it with people, not for people”.

Inclusion London welcomed the determination but set the bar at outcomes: “Across the country, people are being pushed into poverty to pay for their care, often having to sell their homes or give up the little they receive in benefits. This must change.” Charli Thompson, of the Roadmap to Independent Living Coalition, added that any reform “must do more than end charging” and must let older people and people with disabilities “participate equally in society and live full, independent lives”.

Several groups pressed the point that a pledge is not a plan. Dennis Queen, of Greater Manchester Coalition of Disabled People, said she was “hopeful” but realistic, noting that “successive governments have still worked against us, once our votes were cast”. WinVisible, a grassroots group of women with visible and invisible disabilities, said it wanted “real improvement in support services for us to stay in our own home” and warned against “merging the NHS and social care into one huge institution making decisions over our heads”.

The research that landed the same week

Burnham’s pledge arrived alongside new research that gave it evidence to point at. A Centre for Care working paper, “Social Care Charging: is it worth it?”, co-produced with two researchers who have disabilities, Anne Pridmore and Eleni Chambers, concluded that the charging system is “highly complex, inconsistent, burdensome and punitive” and contributes to “increased hardship” for people with disabilities.

Participants described the system as “stressful, exhausting and humiliating”, said it imposed “significant administrative, emotional and financial burdens”, and told researchers that charges pushed them further into poverty and removed their ability to save. The researchers found “substantial variation” between the charging systems run by different local councils. As one participant put it, “You could be the same person and present yourself to five different local authorities, and be charged anything from nil charges in one to £200 a week in another.” Nearly every participant said care charges should be abolished. The study spoke to a small number of people and does not claim to be a national survey; its authors present it as lived-experience evidence, funded by the Economic and Social Research Council with a contribution from the National Institute for Health and Care Research.

Where Canada fits

Canada does not have a single national care-charging rule to reform, because long-term and home care sit with the provinces, and the result is a patchwork. That is the honest comparison to draw, not a ranking.

Ontario is a clear illustration. Every long-term care resident pays a co-payment toward accommodation and meals, at rates the Ministry of Long-Term Care sets each year and applies across all homes. As of 1 July 2026 the maximum monthly co-payment runs from $2,129.17 for basic accommodation to $2,567.17 for semi-private and $3,041.97 for private, and the province notes that all residents receive the same care regardless of room type. A Long-Term Care Rate Reduction Program can lower the basic-accommodation charge for low-income residents, though it applies only to basic rooms, has to be re-applied for every year, and is calculated on income rather than assets.

Home care is funded differently again, and the mix of what is publicly covered and what a person pays out of pocket varies by province. The takeaway for readers here is not a policy to copy but a lens to read your own province with. When a government talks about care being “free at the point of use”, the useful question is the same one campaigners are asking in Britain: free of what, exactly, and does the charge that remains fall hardest on the people with the least room to absorb it? Britain has set itself a public test with a timetable attached. In Canada, the question is a standing one, answered a little differently in each province.

We have written before about why disability costs more in the first place, about the poverty that care and living costs can push people into, and about what happens when another country rebuilds a disability support system in public. This is the next chapter of that same story.

By the Living Unlimited Team

Frequently asked questions

What did Andy Burnham promise on social care on 29 July?

In a speech at a care home in north London, the British prime minister said he would take on the country’s “broken” social care system “head on” and called it a “major dereliction of public duty” that reform had still not been achieved despite 22 reviews over three decades. What he committed to was a direction: a national care service that would be “person-centred” but “highly integrated with the NHS”, built on a “principle of home care wherever possible”, with care workers better paid, trained and supported.

Has Britain promised to abolish care charges?

Not yet. The article notes that Burnham has previously described care charges as an “abomination”, but he did not promise on 29 July to abolish them. He said he would wait for the conclusions of Baroness Casey’s Independent Commission on Adult Social Care, whose final report he brought forward from 2028 to next summer, before deciding whether there should be a “fully-fledged” national care service and how it should be paid for.

What do the new Centre for Care findings say about care charging?

A Centre for Care working paper, “Social Care Charging: is it worth it?”, co-produced with two researchers who have disabilities, Anne Pridmore and Eleni Chambers, concluded that the charging system is “highly complex, inconsistent, burdensome and punitive” and contributes to “increased hardship” for people with disabilities. Researchers found “substantial variation” between the charging systems run by different local councils. The article says the study spoke to a small number of people and does not claim to be a national survey.

How did organizations led by people with disabilities respond to the pledge?

As reported by Disability News Service, the responses were cautiously hopeful. Greater Manchester Disabled People’s Panel said it was “very pleased”, Inclusion London said people are being pushed into poverty to pay for their care and “This must change”, and Charli Thompson of the Roadmap to Independent Living Coalition said reform “must do more than end charging”. Several groups pressed the point that a pledge is not a plan, and WinVisible warned against “merging the NHS and social care into one huge institution making decisions over our heads”.

How does Britain’s care-charging debate compare with care costs in Canada?

The article says Canada has no single national care-charging rule to reform, because long-term and home care sit with the provinces, and the result is a patchwork. In Ontario, as of 1 July 2026, the maximum monthly long-term care co-payment runs from $2,129.17 for basic accommodation to $2,567.17 for semi-private and $3,041.97 for private, and the province notes that all residents receive the same care regardless of room type. Home care is funded differently again, and what a person pays out of pocket varies by province, so confirm current rates with your province’s ministry, since the Ministry of Long-Term Care sets Ontario’s rates each year.

Sources

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