Sir Andrew Dilnot warns England's NHS-style care plan could take decades and cost billions

Sir Andrew Dilnot warned that delivering an NHS-style, fully funded social-care system in England could take many decades and would require spending well beyond £18 bn each year. He highlighted that Burnham’s vision of free care, including residential costs, would be "very substantial" and may need tax rises, though the prime minister has not yet outlined a financing plan. The Health Foundation’s estimate of £18.5 bn a year for universal care contrasts with a Scottish-style model that could cost roughly half as much.

Dilnot also recalled that previous reform attempts, such as the lifetime cap proposed by his commission and later dropped, failed to materialise. With the next general election not due until 2029, Burnham is unlikely to implement any new scheme before then, leaving the promised free care further out of reach.