In 2019, Tory PM Boris Johnson stood on the steps of Downing Street and promised to “fix the crisis in social care once and for all.”

That promise never materialised, with a service still now described as “threadbare”.

Seven years later, Labour Prime Minister Andy Burnham has promised to introduce a new National Care Service, comparable to the NHS, in the next election manifesto.

Speaking with , Simon Bottery, senior fellow for social care for the King’s Fund, said Mr Burnham’s Labour Conference speech was a “big moment” and "very big promise" for adult social care, and a bigger promise than Johnson’s in 2019.

However, Mr Bottery said: “This is still a promise rather than a plan”.

Alongside other experts, Mr Bottery has pointed out that at the moment there is little clarity on what this new care service would offer, how it would be funded, who would benefit.

“At the moment we really don’t know very much about that at all, so there’s an immense amount of work to be done in the next three years to get the point where there is a credible place to enter a general election…So understanding whether a national care service would work for working-age adults as well as older people, I think, is one really basic factor.”

The PM’s speech focused on the experience of pensioners. However, a King’s Fund analysis from April this year shows roughly the same is spent on working-age adult social care compared to over-65s.

According to a King’s Fund analysis data shows in 2024-25, local authorities spent similar proportions of money on long-term support for working-age adults (£11.5 billion) and older people (£12.0 billion) in 2024/25, compared with 2023/24.

The PM addressed the social care workforce directly in his speech; however, there was no specific detail on improvements to their pay and working conditions.

A fair pay agreement for workers in the sector is due to be introduced in 2028, and so there will be some improvements.

Simon Bottery said it is a significant investment of £ 0.5 billion, but it is not enough to bring in parity between the social care and NHS workforce.

Patrick Hurley, MP for Southport, told that he was “blown away” by his party leader’s speech.

He said: “It's fantastic to see a bit of optimism, a bit of hope.“You know, it's not just the big things, although there were a lot of big things in there: the reform of social care, the electoral reform that he's looking to promise, the changes to pensions, and the changes to social care.

“But also the little things. He's saying that, you know, as of this Thursday, in two days' time, take VAT off some energy bills and make sure that people feel the benefits in their pockets.

“There's that mix of big things, little things, and things that are benefiting the country, and really it's put a bit of hope back in my heart and I am very, very pleased to see it.”

Mr Hurley said he found Mr Burnham’s mentions of the experiences of his father, who lived in a care home while suffering from Alzheimer’s, very moving.

He believes it gets to the core of the prime minister’s motivations in politics.

He said: “It's one of the reasons so many of us come into politics is we've got our personal stories, we've got our things that we want to get across.

“And it just shines through with Andy that, for him, improving the country, it's not some sort of technocratic managerial process. He means it, he feels it in his bones, and I think the public can see that.”

It was emotional, it was passionate, it was radical and – most of all – it was revolutionary.

We were promised a dramatic speech with big announcements unlike anything we had heard before. And that is what we got from Andy Burnham.

The prime minister currently has no electoral mandate beyond winning a by-election in Makerfield but he has just laid out an agenda more radical and revolutionary than anything seen since Margaret Thatcher tore up the post-war consensus in the 80s.

Whether it’s nationalisation of housing, water and energy, electoral reform, ending the triple lock on pensions, or a national social care service, Mr Burnham has torn up the playbook of the consensus of 40 years. And he has bet his future on the next election manifesto – which will be completely different to the one Keir Starmer put to the nation in 2024.

The cost-of-living crisis and Brexit has brought about a desire in him to be bold and different to what has happened before.

Andy Burnham’s conference speech was “just an ode to the past”, Kemi Badnoch said, as she claimed “more tax rises are inevitable” under the Labour Party.

The Tory leader accused the prime minister of wanting to take the UK back to the 1970s, saying he “delivered a speech for the Labour Party, not the country.”

“Nothing Burnham announced today will do anything to fix Britain’s long-term problems. He had no plan to fix our stagnant economy. No plan to fund defence. No plan to sort out the spiralling welfare bill, beyond more government schemes.

“Burnham wants to take Britain back to the 1970s, a time of more government control, more trade union control and no economic growth. There is a reason our country took a different course after that decade.

“His proposal to change the triple lock is already falling apart under scrutiny, and it won’t generate enough savings to fund a nationalised care system for another two decades, which means more tax rises are inevitable.

“Britain does not need to recreate the politics of the 1970s. It needs a government prepared to take the difficult decisions, back those who work and build businesses, and look confidently to the future.”

Nigel Farage has accused Andy Burnham of “launching an offensive against our elderly” after the prime minister revealed plans to scrap the state pension triple lock to pay for social care.

The Reform UK leader, who was previously ambivalent about whether his party would keep the policy, said: “By potentially scrapping the triple lock, Andy Burnham will abdicate his responsibility to British pensioners.

“Instead of cutting our bloated benefits bill, stopping migrants from accessing benefits, or slashing foreign aid, he’s considering launching an offensive against our elderly.

“If he is so desperate to pick a fight with pensioners, he should get on with it, call a general election now, and let the public decide.

“Reform UK will always protect our pensioners and maintain the triple lock.”

In a post on X, he said: “I will cut foreign aid, migrant welfare, welfare fraud, and mad net zero spending. Andy Burnham will cut your pension.”

I will cut foreign aid, migrant welfare, welfare fraud, and mad net zero spending.

Andy Burnham will cut your pension.

— Nigel Farage (@Nigel_Farage) September 29, 2026

Sector experts have welcomed Andy Burnham’s focus on social care. However, they say his speech leaves unanswered questions over what a National Care Service, free at the point of use and akin to the NHS would look like in reality.

Health think tank the Nuffield Trust pointed out that even in Denmark, which has a very generous social care system, people are charged for accommodation costs.

Natasha Curry, Nuffield Trust Deputy Director of Policy, added: “Burnham needs to be crystal clear about who stands to gain from the changes he’s proposing. Today’s speech leaves us with important questions unanswered over exactly how the system he envisages would compare to what we have now, who can expect to receive ‘free’ care, and what types of support are included. With the focus on pensioners, working-age adults who rely on care services will be wondering whether they will benefit.”

She warned the PM would need to “tread carefully” and not plough ahead with changes that would undermine the upcoming commission by Baroness Casey.

However, she said not taking any action at all to begin reforms risks leaving the sector to languish further.

Responding to the PM’s speech Nadra Ahmed, co-chair of the National Care Association, which represents care providers, toldt: “The prime minister’s speech today reinforced his commitment to social care but appeared to take the urgency out of it.

“His timescale has moved to the next decade, which means he has to win the next general election to enable him to do anything.He has alluded to ‘laying the grounds’; those will have to be very solid foundations which strengthen the ever increasingly fragile sectors to give us hope again.”

Industry professionals have praised Andy Burnham for “facing reality” after he took the decision to scrap the triple lock on pensions.

The prime minister confirmed on Tuesday that from April 2030, pensions would rise either by CPI inflation, or a minimum of 2.5 per cent which would generate “significant savings” and remove the link to average earnings.

The move will be divisive, but Tony Dalwood, CEO of investment management firm Gresham House, said the triple lock was “an elephant in the room”.

“The only sustainable way to pay for pensions, care and defence is a growing economy,” he said.

“The triple lock was an elephant in the room. Everyone knows it is unaffordable, and nobody wanted to say so. If Andy Burnham is prepared to reform it without abandoning pensioners, he deserves credit for facing reality.

“However, every area of spending has to be on the table, to free up money for the incentives that drive growth, including lower taxes and a system that rewards success rather than punishes it.”

Andy Burnham’s former economic advisor has praised the prime minister for committing to scrapping the triple lock in his major conference speech.

Jim O’Neill, who advised the former Greater Manchester mayor on economic affairs as he prepared to enter Downing Street, told he was “very impressed” by Mr Burnham’s decision.

The prime minister confirmed on Tuesday that from April 2030, pensions would rise either by CPI inflation, or a minimum of 2.5 per cent which would generate “significant savings” and remove the link to average earnings.

Lord O’Neill, who turned down a tole in Burnham’s government, said the decision shows “we have a prime minister who wants to lead”.

“I don’t think it will be political pain, it’s a leader,” he said.

Earlier this month, Lord O’Neill urged the prime minister to reduce spending on the pensions triple lock or welfare as the fallout from the Iran war hit the economy.

Peter Reid, former Everton and England midfielder – and close friend of Andy Burnham – described his speech as “honest” and “uplifting”, saying that it showed his human side.

Mr Reid, who won two league titles with Mr Burnham’s beloved Everton, told : “I thought it was very uplifting, I thought it was very positive, honest, and certainly what I wanted to hear. A lot more positive, and he mentioned the word hope. I thought it was good.”

About Mr Burnham’s emotional tributes to his late father Roy and how his values will determine how he governs, Mr Reid said he “got the moment right”.

“As you know I'm a mate of his”, he said.“I met his father and I knew how close his dad was, and knew the difficulty he went through.

“So, I think the biggest thing is, it proves we're all human beings.“I've lost my own father, I knew what it was like. I just thought he got the moment right.”