Mr Burnham, let's talk about what social care really means

Social care reform, the Assisted Dying Bill, and an economic argument nobody is making.

Andy Burnham gave a big speech yesterday. He talked about 22 failed attempts to reform social care over 30 years. He promised a National Care Service, a fair pay deal for care workers, and a cross-party conversation.

Good. All of it is genuinely good.

But I want to add something to that conversation. Something that didn't make the speech.

There are more than 400,000 people in England currently waiting for a social care assessment. Not waiting for care — waiting to find out whether they qualify to be assessed. And the Assisted Dying Bill returns to Parliament in September.

I'm not saying those two facts are directly connected. I am saying we can't have an honest conversation about one without the other.

When someone reaches the point where they feel their life isn't worth continuing, we need to ask a harder question than "do they really mean it?" We need to ask: what kind of life have we given them to work with? Have they got support at home? Can they get out of bed in the morning? Can they leave the house? If the answer to those questions is no — and for far too many disabled people, it is — then their desperation isn't a free choice. It's a consequence of a system that's failed them.

I've spent years campaigning with Not Dead Yet UK against assisted dying legislation, and I'll keep doing it. But I want to be clear: the strongest argument against the bill isn't a philosophical one. It's a practical one. Fix the care. Then let's talk.

So what does "fix the care" actually mean?

Start here. Disabled people of working age are almost twice as likely to be unemployed as non-disabled people. Earlier this year, our unemployment rate hit 9.2% — the highest in six years. At the same time, 218,000 fewer disabled people are in work than twelve months ago.

Here's what those numbers don't show. For many disabled people, the reason they're not working isn't their impairment. It's that they can't get up in the morning without help. Can't get dressed. Can't travel to work. Can't get home at the end of the day. Social care is the infrastructure of a working life. Without it, employment doesn't happen.

Now here's the part that rarely gets said.

When a disabled person receives the support they need, the economic benefits multiply. The disabled person can work and pay taxes. The family member who's been holding everything together can return to work, too — if that's what they choose.

And in many cases, the disabled person becomes an employer themselves. Around 220,000 people in England use direct payments to employ their own personal assistants. That's a minimum of 220,000 more people in work, employed directly by disabled people.

So we're not talking about one person re-entering the workforce. We're potentially talking about three: the disabled person, their family member, and the care worker they employ.

But right now, more than 600 people a day are giving up their jobs to care for a disabled or older relative — because the care system isn't there. That's over 200,000 people a year leaving the workforce, not because they want to, but because the state has left them no alternative. The cost to the economy? Thirty-seven billion pounds a year, according to DWP's own research.

Mr Burnham talks about growing the economy. Investing in social care is how you do it.

The Casey Commission has until summer 2027 to report. That's a year earlier than planned, and credit where it's due. But let's be honest about what it needs to get right. Not just funding models and pay agreements. Those things are necessary. They're not sufficient.

The Commission needs to understand that social care is the floor on which everything else stands. Work. Independence. Choice. The ability to live a life you've decided to live, rather than one you've been left with.

Twenty-two attempts in thirty years. I don't doubt Andy Burnham's sincerity. But sincerity isn't enough.

The 400,000 people waiting for their assessments aren't waiting for sincerity.

They're waiting for someone to show up.

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References

ADASS Spring Survey 2026. Association of Directors of Adult Social Services. https://www.adass.org.uk/documents/adass-spring-survey-2026/

Disabled people hardest hit by weakening jobs market. Work Foundation, Lancaster University. https://www.lancaster.ac.uk/work-foundation/news/disabled-people-hardest-hit-by-weakening-jobs-market

More than 600 people quit work to look after older and disabled relatives every day. Carers UK. https://www.carersuk.org/press-releases/research-more-than-600-people-quit-work-to-look-after-older-and-disabled-relatives-every-day/

Key facts and figures about unpaid carers. Carers UK (citing DWP research, March 2025). https://www.carersuk.org/policy-and-research/key-facts-and-figures/

Individual employers and personal assistants. Skills for Care. https://www.skillsforcare.org.uk/adult-social-care-workforce-data/Workforce-intelligence/publications/Topics/Individual-employers-and-personal-assistants.aspx

Prime Minister announces major social care reform programme. CMS Law, 29 July 2026. https://cms.law/en/gbr/legal-updates/prime-minister-announces-major-social-care-reform-programme

Assisted Dying Bill falls in the House of Lords. Humanists UK, April 2026. https://humanists.uk/2026/04/24/assisted-dying-bill-falls-in-the-house-of-lords/