It will use up vast amounts of political capital to get a national care service off the ground. But he has already fought on the battleground that is social care reform. Burnham rightly described the UK’s social care system as equally unfair as the US health system: it bankrupts some. Crafting a new national care service out of all this would be the hardest of all in-sourcing tasks. It has never been the right time to brave social care reform.