Keep Andy at Health

Labour Party

Just about everyone who has met Andy Burnham would agree that he is thoughtful, pleasant and engaging; a conviction politician.  He is also obviously passionate about the NHS and the whole of care and his knowledge and experience give him command of his subject.  The few that suggest he was somehow in some way involved in hiding or deflecting criticisms of aspects of his time as a Minister are simply wrong; his determination to confront opposition from all sides to the revelation of the facts about Hillsborough show his true nature.

Despite that there is no doubt that somewhere in the Coalition strategy was the tactic to smear Andy as part of an assault on Labour’s record on the NHS.  If anything the aim was to say that nobody can be trusted with the NHS.  The predictable and indeed anticipated attacks based on the Frances Inquiry and then the Keogh Report both failed; Andy’ reputation was not damaged and Labour’s poll lead on the NHS remained as high as ever.  Nothing in either report substantiated the puerile claims made before they came out.  It was nasty enough that some politicians and the right wing media supinely cooperated with the nonsense but sadly a few ill informed others joined in.

Of far greater importance is policy development where Andy has been one of the more active amongst Shadow Ministers setting out in his Kings Fund speech this year and at Party Conference the main policy themes.

The SHA has advocated for some time a shift in policy which would see a greater focus on prevention and dealing with the social determinants of poor health.  We wish to see the NHS firmly established as a public service but integrated with other services, not an island on its own.  We support the ideas around whole person care and the removal of barriers which separate social, mental and physical care both at the level of individual care and at strategic and policy level.  We have long argued for the greater involvement of local authorities in healthcare, welcoming (in principle) the return of public health.  We strongly support the need for the Secretary of State to be unambiguously both politically and legally responsible for a comprehensive and universal service.  We support moves to make social care free at the point of need as with health and with a more rational system for needs assessment.  We argue that the era of markets and competition within public services is over. There is no evidence that private is better than public and in health especially the idea of market competition as the basis for the system is wrong both ideologically and economically. Repeal of the disastrous H&SC Act will send a powerful message about our view on markets.

In all these key areas we see support from Andy and his team.  So we would like Andy to be there to deliver.

On other aspects the debate is less clear, although we see signs of support in general.

Any incoming government in 2015 will be constrained by the economic situation and changes in care policy will need to be planned over a long period, depending on how strongly the economy recovers from enforced austerity.

Other constraints are for some more difficult to accept but it is simply not possible to have yet another top down whole system reorganisation of the NHS; policy aims have to be met using so far as possible the structures and organisations that will be there in 2015.  Change is necessary but it will come through evolution and different places may take different approaches.

A commitment to public value can see an end to the trend for competition law to intrude into healthcare and the imposition of competitive tendering for everything.  That failed Coalition policy can be reversed with the return to the idea that non public providers are used only when it is demonstrated that public providers are unable to deliver what is required.  But there will still be a role for both the voluntary and private sectors within a managed system.

So on most of the key aspects of policy the SHA sees a large measure of agreement with what the Shadow Team are putting forward.  Obviously many questions remain and issues have still to be debated and the SHA will contribute but moving Andy from his post might mean starting over again.

For the SHA we want to see these policy themes converted into manifesto commitments and then implemented by an incoming Labour government and we are content that Andy Burnham could be a key player in delivering that.