Andy Burnham said he is prepared to take unpopular choices and hike taxes to fund an NHS-style social care system.

The Prime Minister blamed the “cowardice” of previous generations of politicians for failing to “grasp the nettle” of reforming the system in England.

He said nothing was off the table to pay for the reforms, which would be put to the public at the next general election.

The Prime Minister is constrained by Labour’s current manifesto commitments not to hike income tax, VAT or national insurance for workers.

His previous attempts to reform the system as health secretary which could have been funded by a levy on estates was condemned as a “death tax” by opponents.

But Mr Burnham indicated he was prepared to have another attempt at a taxpayer-funded national care service, despite the potential unpopularity it would cause.

He told the BBC’s Sunday With Laura Kuenssberg: “People are paying care charges now. They are spending tens of thousands of pounds from their savings, sometimes losing their homes.

“That is what’s happening at the moment.

“So to suggest there isn’t a cost to people at this moment in time, there’s a huge cost.

“Social care in England is as unfair as American healthcare, where the most vulnerable in society can lose everything, they can be wiped out, not just by the condition that they have, but wiped out financially.”

Mr Burnham will set out the “broad direction” of his social care plans in his Labour Party conference speech in Liverpool on Tuesday.

Baroness Louise Casey is leading a review of social care and Mr Burnham is committed to cross-party talks to try to find a consensus.

Mr Burnham said: “We have dementia taxes right now and people can lose everything they’ve worked for paying those taxes.

“So the idea that there isn’t already a cost is just wrong. It’s just making that cost fairer and spreading it across across the population.”

Asked if a levy on estates was one option he was considering, he said: “Nothing is off the table at this moment in time. Now that doesn’t mean that I’m going straight back to the proposal that I had in 2010.”

In a sign that some tax rises would be required, Mr Burnham said Labour’s manifesto promises made it “hard to do in this Parliament” so he would put his proposals to the public in the next election expected in 2029.

“I am prepared to put myself in that position, recognising that it might be difficult or unpopular with some,” he said.

A care service which, like the NHS, is free at the point of use could cost up to £18.5 billion a year in 2035/6, the Health Foundation think tank has estimated.

Mr Burnham rejected that assessment and pointed out there would be savings to the NHS from people who no longer needed emergency treatment or a hospital bed because they had better social care provision.

The Prime Minister, whose father died earlier this month, said: “When I was in Parliament first time round, in fact, when I was a new MP, my gran was going through the care system.

“As health secretary I remember saying ‘we shouldn’t let what happened to my grandparents’ generation happen to my parents’ generation’, and it’s devastating actually to be here, and it has happened.

“Parliament just ignoring this issue because they consider it too difficult.

“Is there 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. I will be the one to do that and I realise it might require me to spend some political capital. That it might make me unpopular with some, but that isn’t going to stop me.”

Reform’s Treasury spokesman Robert Jenrick said: “Andy Burnham refuses to rule out his universal death tax.

“He’s too weak to cut the benefits bill so he’s coming for your home instead.”

Shadow home secretary Chris Philp told the BBC that welfare should be cut to fund social care.

He said: “It looks like Andy Burnham is not prepared to make those difficult decisions, is not prepared to reduce the welfare budget that is totally out of control.

“Instead, he’s going to reach for tax increases that will simply cause even more damage to our economy.”

Liberal Democrat leader Sir Ed Davey said: “I really hope the PM is serious about fixing care, and he can show it by getting on with the cross-party talks we started in July.

“This can’t just be a series of No10 headlines with no real action.

“I’ll do everything I can to put family carers at the heart of any solution.”