Andy Burnham will fight the next election with a pledge to finally fix the broken social care system, acknowledging he is willing to expend political capital by asking taxpayers to cover the cost.
As Labour's party conference began in Liverpool, he pledged to "rip the plaster off" to radically transform care, setting out a vision for a universal service that would be free at the point of use for everyone in England.
The prime minister said the new NHS-style service would be funded by "everybody" but did not give further details on how his long-term plan would be paid for, indicating that a tax rise may be on the cards.
He said Labour would put the proposals into its next general election manifesto so voters could give their endorsement, in the hope of reducing the risk that political attacks over "death taxes" would sink the policy.
Burnham acknowledged there were risks in a nationwide reform, likely to be costly and complicated to implement, although he rejected suggestions it could cost £18bn a year. "It's not that high," he told the BBC.
"Somebody needs to grasp the nettle. I will be the one to do that," he said. "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]."
But he said he would take his time to work out how it could be fairly funded. "The challenge in the public finances is real. So it has to be done carefully, without putting extra strain on the public purse. But I will bring forward proposals."
Labour's annual gathering is intended to be an upbeat affair, with the prime minister wanting to restore hope that some of the country's most intractable political problems can be solved despite severe economic headwinds.
With political courage a theme of the conference, he said in an interview with the Guardian at the weekend: "There's always things you can do, it's just whether you're prepared to do them."
Burnham acknowledged the public finances were "challenging" ahead of next month's budget but he said delivering fiscal stability would be "crucial", because only then would the government be able to focus on fixing bigger problems.
A series of global economic shocks, including the Iran conflict, has put the UK economy under intense inflationary pressure and pushed up borrowing costs, leaving the government with limited room for manoeuvre.
On Sunday, Burnham said he did not want to focus on a "narrative of doom" about the UK's economy but that he would show in his leader's speech that he was prepared to take tough decisions.
He acknowledged there was "real concern" in the financial markets about the state of the British economy, pointing to the "febrile" global backdrop. He said he was willing to cut government spending to balance the books, and he believed money could be saved by taking a more "productive" long-term approach to issues such as rough sleeping and youth unemployment.
Amid concerns that the government could be hemmed in at the budget by the parlous state of the public finances, he said the chancellor, John Healey, would be "highly prudent" in running the economy. "I won't do what the previous Tory government did and take risks with the economy that are actually still hurting us right now," he said.
Burnham suggested to the Guardian that a significant fiscal buffer would be necessary, with speculation that the Treasury could now consider £15bn acceptable.
"I do think it is crucial to have stability and to show that there's a willingness to face up to the reality of some of these difficult things," he said. "But actually from that stability, the permission can come to make bigger change that, in the end, could put the country in a stronger position in relation to the public finances."
Sadiq Khan, the mayor of London, said the "heavy lifting" on making the case for rejoining the EU needed to be done by the government now, after Burnham signalled that the move could be in the next manifesto.
"The pitch rolling must be done now, explaining to the country the dis-benefits of being outside the European Union and the benefits of being part of this family," Khan said.
However, the business secretary, Jonathan Reynolds, appeared to criticise Khan – and Burnham – telling Politico that the speculation "frankly cause[s] a lot of uncertainty for business".
Meanwhile, plans for a third runway at Heathrow are once again up in the air after Burnham refused to say whether he backed the "contested" project, which is delayed by up to four years, saying it was "principally" a matter for London.