Andy Burnham on the NHS, school freedom and working with Lib Dems

The new Shadow Health Secretary has spoken exclusively to the New Statesman

For this week's magazine I have interviewed Shadow Health Secretary Andy Burnham. We know, of course, that he opposes the government's health reforms. But I was intrigued to hear how far he would commit Labour to reversing the plans if they are enacted. The answer, it turns out, is quite far. PCT's he said, would "definitely" be reinstated.

I have been mystified by Labour's stance on public service reform since the election. Indeed, ever since Gordon Brown took over from Tony Blair in Number 10 it hasn't been clear whether the party is for or against the use of market mechanisms and competition to drive change. (Ed Miliband, I gather, has not yet finalised his own thinking on this question.) But as far as the NHS is concerned Burnham made it pretty clear that the march of Blairism is halted.

The most efficient healthcare systems in the world are the ones that are planned and managed ... the argument that the market is cheaper just doesn't wash.

It was a long conversation and not all of it made it into the magazine - constraints of space rather than interest. So, for example, Burnham was revealing on the difference between his current job and his last one. He was reshuffled away from the education portfolio last month. Comparing Michael Gove's education reforms and Andrew Lansley's health plans he said:

They're both highly ideological, free market, damaging reforms and they will dismantle in both cases the infrasttructuire and state healthcare and state education. They're designed to do that, they're born of an innate distrust of planned and managed systems. Both reforms are almost identical in that.

But he noted that having shadowed both jobs:

Gove has been cleverer in both the momentum he set and the way in which he created a vision and went for it. Lansley has just created a mess. He's 18 months into the job and people are less about what he is trying to do.

I noted my impression that Labour seemed ready to accept Gove's plans as a fait accompli (they build on Blair reforms, after all). Having signalled that the health plans would be reversed, would he accept that the school reforms would not?

There is a differnece between health and education. A degree of school autonomy is a good thing the identity of the school, its independence - PISA [the Organisation for Economic Cooperation and Development's Programme for International School Assessment] backs autonomous schools within a strong system ... You wouldn't want to go completely back to the old days when the local authority replaced every window and all of that stuff ... But you need a strong system. In Education you would have to balance strong independent schools wth reassertion of the local authority role on fairer admissions.

We had a long conversation about public health. Burnham accepted that his party had sometimes crossed the line in terms of meddling in people's lives.

The tendency for Labour is sometimes to go straight to regulation, straight for the sledgehammer. I don't thnk we should do that.

But he sought to draw a distinction between interventions to protect children and the need for a lighter touch where adults are concerned:

And if people say 'nanny state' we'll just say 'Yeah, so what! We are working to give every child the healthiest possible start in life'

Naturally we talked about social care - the main theme in Burnham's campaign for the Labour leadership. He has been invited to cross-party talks on advancing the ideas contained in the Dilnot report on long-term funding. Not surprisingly, Burnham is wary. When he was Health Secretary and Lansley was his shadow equivalent talks collapsed in rancour. The Tories attacked Labour's proposals in a public campaign as a "Death Tax".

The irony of it was unbelievable. I got a letter from Lansley inviting me to take part in cross-pary talks on social care about a week into this job. Bear in mind, he initiated the talks last time, so it was about as alluring as an invitation from Liam Fox to talk about defence procurement with his friened Mr Werrity.

Burnham says he is prepared to participate but as long as certain conditions are met. They include confidentiality, guarantees on funding and access to the Department of Health Secretariat for figures and demographic modelling.

Given that Burnham has this week launched what he calls "the last push" to kill off Lansley's NHS reforms, I'd be surprised if collegiate negotiations on social care got under way any time soon.

As a parting shot I asked him he could imagine ever working with Liberal Democrats - given that they too have opposed aspects of Lansley's reform. He belittled their contribution. ("The Liberal Democrats haven't done anything to the Health Bill.") And could he ever imagine serving in a coalition with Lib Dems?

"People like Norman Lamb, I've got lots of common ground with. I'd work with people like that."

And Nick Clegg?

"Clegg's basically a Tory. It's like asking me if I could serve in a cabinet with Tories. I find it hard to imagine."

Read the rest in the magazine.

Rafael Behr is political columnist at the Guardian and former political editor of the New Statesman

Photo: Getty Images
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There are risks as well as opportunities ahead for George Osborne

The Chancellor is in a tight spot, but expect his political wiles to be on full display, says Spencer Thompson.

The most significant fiscal event of this parliament will take place in late November, when the Chancellor presents the spending review setting out his plans for funding government departments over the next four years. This week, across Whitehall and up and down the country, ministers, lobbyists, advocacy groups and town halls are busily finalising their pitches ahead of Friday’s deadline for submissions to the review

It is difficult to overstate the challenge faced by the Chancellor. Under his current spending forecast and planned protections for the NHS, schools, defence and international aid spending, other areas of government will need to be cut by 16.4 per cent in real terms between 2015/16 and 2019/20. Focusing on services spending outside of protected areas, the cumulative cut will reach 26.5 per cent. Despite this, the Chancellor nonetheless has significant room for manoeuvre.

Firstly, under plans unveiled at the budget, the government intends to expand capital investment significantly in both 2018-19 and 2019-20. Over the last parliament capital spending was cut by around a quarter, but between now and 2019-20 it will grow by almost 20 per cent. How this growth in spending should be distributed across departments and between investment projects should be at the heart of the spending review.

In a paper published on Monday, we highlighted three urgent priorities for any additional capital spending: re-balancing transport investment away from London and the greater South East towards the North of England, a £2bn per year boost in public spending on housebuilding, and £1bn of extra investment per year in energy efficiency improvements for fuel-poor households.

Secondly, despite the tough fiscal environment, the Chancellor has the scope to fund a range of areas of policy in dire need of extra resources. These include social care, where rising costs at a time of falling resources are set to generate a severe funding squeeze for local government, 16-19 education, where many 6th-form and FE colleges are at risk of great financial difficulty, and funding a guaranteed paid job for young people in long-term unemployment. Our paper suggests a range of options for how to put these and other areas of policy on a sustainable funding footing.

There is a political angle to this as well. The Conservatives are keen to be seen as a party representing all working people, as shown by the "blue-collar Conservatism" agenda. In addition, the spending review offers the Conservative party the opportunity to return to ‘Compassionate Conservatism’ as a going concern.  If they are truly serious about being seen in this light, this should be reflected in a social investment agenda pursued through the spending review that promotes employment and secures a future for public services outside the NHS and schools.

This will come at a cost, however. In our paper, we show how the Chancellor could fund our package of proposed policies without increasing the pain on other areas of government, while remaining consistent with the government’s fiscal rules that require him to reach a surplus on overall government borrowing by 2019-20. We do not agree that the Government needs to reach a surplus in that year. But given this target wont be scrapped ahead of the spending review, we suggest that he should target a slightly lower surplus in 2019/20 of £7bn, with the deficit the year before being £2bn higher. In addition, we propose several revenue-raising measures in line with recent government tax policy that together would unlock an additional £5bn of resource for government departments.

Make no mistake, this will be a tough settlement for government departments and for public services. But the Chancellor does have a range of options open as he plans the upcoming spending review. Expect his reputation as a highly political Chancellor to be on full display.

Spencer Thompson is economic analyst at IPPR