Social care, with its high costs and overstretched and underpaid staff, has long been seen as one of the UK’s most intractable issues. Demand is increasing all the time and far outstrips capacity.
Given its treatment by previous governments (see panel), social care might be considered a poisoned chalice. But prime minister Andy Burnham – who was health secretary under Gordon Brown and advocated hard for a national care service in 2010 – has wasted no time in returning to the subject since he took office this summer.
The LTCF is funded by a 1.5% income tax levy, along with government grants
A national care service forms a key element of Burnham’s plans, along with better pay and training for care workers, and integration with the NHS. In September 2026, he declared: ‘There is only one real answer: a person-centred, high-quality care service that starts in the home … free at the point of use, and no care charges paid out of your basic state pension.’
Big conversation
The prime minister has launched a ‘big conversation’ about social care, commissioning a review whose final recommendations are expected by summer 2027. Part of this process is to learn lessons from other systems around the world and to look how to implement best practice in a reimagined UK care system.
In fact the review may not need to look too far afield for instruction and inspiration. Jersey’s Long-Term Care Fund (LTCF) has been in place since 2014 and is explicitly funded by a 1.5% income tax levy, along with central government grants. It means those using it pay for their care until they hit the lifetime cap – £80,700 for a single person and £121,050 for a couple – at which point, the universal public scheme steps in and covers care costs for the rest of the person’s life, regardless of income or assets.
‘It was always recognised the charge would need to be increased’
Andrew Hacquoil FCCA is Jersey’s chief officer of employment, social security and housing and oversees the administration of the LTCF, which currently provides care for just over 2,000 people on an island with an overall population of around 104,000.
‘The LTCF supports adults who have long-term care needs and is built around a mixed model,’ he explains. ‘It eventually becomes a universal benefit that everyone can access, but there is a waiting period. People with sufficient income or assets will pay for their own care for a period before they’re entitled to the universal benefit.’
The length of the waiting period depends on care level – an assessment of the degree of care required, running from level 1 (the least intense) to level 4 (round-the-clock care). ‘If you’re at care level 1, you might be waiting for three years, but if you’re at care level 4, you might only wait for one year,’ Hacquoil says.
Future funding
The Jersey scheme paid out £93m for care last year, which is expected to rise to £136m by 2030, and Hacquoil says the model will soon need updating. ‘We’re seeing the costs increase, partly with the ageing demographic coming through. We’re expecting care costs to increase higher than inflation.’
The scheme receives around £50m from the 1.5% income tax levy and roughly £40m from general taxation. ‘The fund is, in effect, running out of money, and that’s why it’s a big debate for us at the moment,’ Hacquoil says. ‘We have projections that the fund will run out of cash in the next couple of years unless something is done to make the scheme sustainable.
‘This isn’t news. We always knew that with an ageing population, care costs will continue to increase. The charge was put in at a level that kept it going for a period of time, but it was always recognised that it would need to be increased once, probably twice.’
Three options
The Jersey government has been weighing up the relative merits of three options for securing the LTCF’s future: raising the income tax levy, making the scheme less generous or finding efficiencies within the system. Raising the levy from 1.5% to 2.5% would guarantee the scheme for the next two decades, while improving the way care is delivered (to manage the growth in costs) might involve supporting people to retain their independence for longer so they need less care or helping care providers to work more efficiently.
‘If you cut benefits too far, the scheme no longer serves its purpose’
‘Increasing income is a very straightforward way of raising money,’ Hacquoil says, ‘but if you cut benefits too far, then the scheme no longer serves its purpose. If you do things like adjust waiting times, the analysis showed you had to make quite big changes to get relatively small savings. However, there is never a good time to raise taxes, and the current challenges around the cost of living exacerbate it.’
Jersey’s proposed Budget 2027–30 includes phased increases in the long-term care contribution from 2028 (to 2.5% in 2030) and will be debated in December.
Failure to reform
In 2010, under Gordon Brown’s premiership, Labour proposed a national care service, which was quickly branded a ‘death tax’ by Conservatives as some people would have had to retrospectively contribute to their care out of their estate after they died. The following year, the Dilnot review, commissioned by David Cameron’s coalition government, proposed a £35,000 lifetime contribution cap. Later interventions on social care under prime ministers Theresa May and Boris Johnson were equally unsuccessful.
