Andy Burnham and the NHS – lose the politics

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January 29, 2015 by Paul Goldsmith

He won’t like the comparison, but Andy Burnham is going to find out over the next few months what it is like to be Iain Duncan-Smith. Duncan-Smith is the former Tory party leader who spent some years afterwards in opposition thinking very hard about the solution to problems faced by our welfare state. Burnham, a former Labour party leader candidate, has spent the last few years in opposition thinking just as hard about the solution to the problems faced by our Health service. Both are good examples of politicians who are in that field for a purpose, and not for themselves. But both are also good examples of people who have struggled and will struggle to get their message across because of the whiff of politics behind their plans.

A great example of this could be seen on Newsnight on Tuesday as Burnham attempted to explain his plans to merge health and social care together to provide an integrated solution in order to save money in the future on both. The idea is that too many hospital beds are being taken up by elderly people who are well enough to leave but cannot be sent home as the care they might need there is not available (partly due to cuts in services that fall outside the NHS by the Coalition) or is being coordinated elsewhere. If health and social care were merged, Burnham argues, we would be able to provide all-around care for everyone, with the overlap that exists between the two being less of a problem.

That on its own seems fine, but it’s election year, and Burnham muddied the waters on Tuesday by giving a speech at the King’s Fund (a health think tank) in which he spent a lot of time using the language of elections. Announcing that the NHS is not safe in Tory hands, Burnham also announced that under Labour, the public sector will be the ‘preferred provider’ of health services.

This was where Kirsty Wark, the Newsnight presenter, had a problem for Burnham. She barely asked about the integration of health and social care – which is, frankly, a lot more important an idea than the politicking beneath it. She presented graphs to Burnham that showed that 4.4% of the health service was provided by private health providers under Labour and only another 1.7% was being added by the Conservatives. Burnham said that he wanted to stop that trend as it was being taken too far by the Conservatives. Wark asked Burnham time and time again what happens if a Doctor feels that the best treatment a patient can get is with a private sector provider, not a public sector one – will they be pressured to commission the less effective service? Burnham, becoming increasingly exasperated that Wark “wasn’t listening” or “didn’t understand”, kept repeating that he is not looking to remove the private sector altogether, but seemed unable to answer that question well.

There will be a lot more of this for Andy Burnham. Partly because the Health Secretary who presided over some of that 4.4% of outsourcing to the private sector was Andy Burnham. But also, behind the considerable, and admirable amount of work he has done on health thinking is a barely concealed ambition to run again for the Labour leadership in the future. Having made little headway in 2010, he has maneuvered himself into the position of being the “darling of the left”, and the way he is going about his work on the NHS isn’t harming that. Pledging to appoint 20,000 more nurses and 8,000 Doctors, banging on about Tory “privatisation” and promising more money every year is going to woo both health sector professionals and the public sector unions.

But, as one senior Labour MP commented to a journalist over the weekend – “It’s all about sucking up to the producers rather than the consumers.” The people that Burnham is wooing are the people he would need for a successful leadership campaign. The Senior MP went onto point out that “The unions love it and the party likes it but he doesn’t ask any hard questions or talk about how things need to change.”

Alan Milburn, a former Health Secretary, added to this on Tuesday by telling Radio 4 that “It would be a fatal mistake, in my view, for Labour to go into this election looking as though it is the party that would better resource the National Health Service, but not necessarily put its foot to the floor when it comes to reforming.”

We shall see about that. But one thing is for sure, Andy Burnham will be a key figure in British Politics over the next few years, whatever happens in May.

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