Few in Labour feel the constraints of opposition more than Andy Burnham. “I’m a shadow of my former self,” he jokes when we meet at his Commons office, referring to his current post as Labour’s health spokesman (he held the position in government from 2009 to 2010). More hopefully, he cites the vote in favour of banning parents from smoking in cars where there are children and the government’s decision to accept Syrian refugees as evidence of how the party has changed policy from outside power. The next election, he tells me, is “completely winnable”, and he adds: “That’s a pretty great place to be for a one-term opposition.”
Burnham’s ebullient tone changes when we turn to the National Health Service, around which, he warns, a “perfect storm” is still building. “If you look at the data on A&E, something has fundamentally changed in the last 12 to 18 months and that is that the pressure has both ratcheted up and has been sustained over the year, so it’s not diminishing. It’s normally a winter and then back down again.”
One of the main drivers of the A&E crisis has been the 20 per cent cut in social-care funding since 2010, which has turned some hospitals into de facto warehouses for the elderly. The imaginative solution proposed by Burnham is “whole-person care”: the creation of an integrated service with a single budget for physical, mental and social needs. After securing shadow cabinet support for the principle last year, despite the well-known scepticism of Ed Balls, he is now working on the details. There is the promise of an announcement by the time of Labour’s national policy forum in Milton Keynes in July. The question, he says, is: “How far do you go? Do you go for a very ambitious version of it, or an amalgamation of the existing budget?” Burnham does not disguise his preference. “So great is the challenge that’s coming at the health- and social-care system, both in terms of the financial outlook and the demographic pressures, I would argue that you only rise to that with a solution of equal scale. Tinkering at the edges is not going to do it.”
Complementing the establishment of “whole-person care”, his other main pledge is to repeal the coalition’s NHS reforms and halt the privatisation of services. He is troubled by how the proposed EU-US free trade agreement could give permanent legal backing to the new, market-led regime and reveals that he will soon travel to Brussels to lobby the European Commission over the matter. “It means being absolutely explicit that we carry over the designation for health in the Treaty of Rome, so that we can exempt it from competition law,” he tells me. “The market is not the answer to 21st-century health care. The demands of 21st-century care require integration. Markets deliver fragmentation.”
But it is when I ask for his views on an area outside his policy brief, the High Speed 2 rail link (HS2), that Burnham becomes most animated. “It comes right through my constituency [Leigh] and it’s made me look at it in a very hard-headed way,” he says, complaining of an “absolutely massive depot” on what is “currently green space”.
Recently, after Balls threatened to withdraw backing for the project last year, Labour has moved to a more supportive position, with Ed Miliband recruiting the original architect of HS2, Andrew Adonis, to advise him on the issue. But Burnham goes further in his criticism than any other shadow cabinet minister has done. “I’ve given no guarantees about supporting it. I’m not talking as a frontbencher here, I’m talking as the MP for Leigh. I will not let my constituents carry on paying through their taxes for the rail network when they don’t have reasonable access to it. It’s as simple as that. If the government’s going to lay new rail track in my constituency, it can bloody well give us a station.”
Remarkably, Burnham refuses to rule out breaking collective responsibility and voting against HS2 if changes are not made. “If they don’t look again at the depot, I’d have to say to my own whips: ‘Everyone’s constituency is going to be affected differently and everyone’s going to have to account. You can’t have a blanket position because it doesn’t affect everybody equally, does it?’ ” Whether the Labour whips would take such an emollient view is questionable.
More than almost any other shadow cabinet minister, Burnham has the potential to be a transformative secretary of state. Whole-person care is the most fully developed example of the new approach to public-service reform outlined by Ed Miliband in his Hugo Young memorial lecture on 10 February. In an age of austerity, it is also among the most necessary.
As Burnham points out: “People will often say, ‘Oh, integration – it all sounds quite fluffy, quite nice, but are there are any real savings there?’ Monitor are talking about £6bn as the potential gain from integration. That’s got to be taken before anyone asks anybody for anything else.”
Now he just needs to make sure that Leigh gets that railway station.