Accent on success: Andy Burnham interview

Written by Anoosh Chakelian on 27 February 2014 in Interview
Shadow health secretary Andy Burnham has grand plans for the future of the NHS and, as he tells Anoosh Chakelian, they will work best if Labour rediscovers its identity – and a willingness to listen to some Northern voices

Things are kicking off in the shadow cabinet. Shadow health secretary Andy Burnham was recently so impassioned he came close to elbowing the shadow chancellor in the face. He exclusively reveals the circumstances of this near-violent incident to Total Politics:

“I invited Ed Balls recently to Everton versus Norwich, and I took my daughter, Ed took his son – we had a fantastic day,” he begins. “25 minutes into the game, Gareth Barry unleashes this left-foot drive into the top corner” – Burnham traces the football’s trail wildly with his arm – “so I kind of leapt up, and my left arm just missed Ed’s chin. I soon recovered my composure, and this fella next to me nudged me saying, ‘judging by the scowl on his face then, I think you’ve just lost the NHS £10bn there in the next spending review’. Which made me laugh.”

It seems the only thing kicking off was that football match. Burnham – perhaps giddily free of New Labour’s Blair/Brown tensions – is happily insistent that Ed Miliband has achieved unity within his team, and they spend time together both on and off the pitch.

“The sense of team is often undervalued in politics. I’m a team player. And I think teamwork and people who put the team above themselves are all-important in politics,” he cautions. “There are too many lone rangers at times, and I think a strong team is absolutely essential.

“I’m a football man, as you may have picked up, and [you can] have differences in the dressing room at half-time, but don’t bring them out on the pitch – I’m a big believer in that… The PLP, particularly the shadow cabinet and the frontbench, is more united than at any time I can remember in my now almost 13 years in parliament… I’m talking having lived through the Blair and Brown years. It’s genuinely very united.”

The MP for Leigh and former health secretary is speaking to me in his roomy parliamentary office, which looks over the Thames. A few anti-government leaflets and a suitably expressive Hogarth line the walls. A whiteboard merrily reminds his team ‘Today is not Friday!’ as they tap away at their computers.

Burnham, with his signature lustrous eyelashes – apparently he has a stock answer to questions about this youthful look, so I bite my tongue – leans inquisitively towards me, blue tie offsetting his bright red rubber Hillsborough wristband.

Despite enthusing about apparently chummy shadow cabinet relations, it has not been easy for Burnham in opposition. The coalition has used findings on ill-treatment at Mid-Staffordshire hospital and others to question Labour’s running of the health service, to the extent that health secretary Jeremy Hunt has been threatened with legal action for tweeting a suggestion that Burnham was covering up hospital failings while in government.

Rumours emerged around Labour Party Conference last year that Burnham may not have been safe in the health brief, with a reshuffle around the corner. As Miliband confirmed he was, “four-square behind Andy’s ideas”, media speculation was that this didn’t necessarily extend to being behind Andy. In the end, Burnham was safe, and he asserts there were “no difficult discussions” about his position.

He adds: “We’ve just got a colossal agenda, a huge agenda.” It’s clear he doesn’t want to be cast aside before he can flesh out his health policy ideas: “whole-person care” is his showcase policy.

He spells it out in terms of his leader’s recent unveiling of “people-powered public service” plans:

“What he’s [Miliband’s] talking about is there’s been a sense that organisations have just kind of bulldozed through proposals, and consultations have been a bit of a paper exercise, a bit of a sham, and there’s been a bit of resentment about that. Particularly on health, because people care passionately about health services.

“So the proposal is about putting power genuinely in the hands of the people. And it’s very consistent with what I’ve been saying about whole-person care, which is our emerging policy.”

His idea is to join up healthcare and social care – to stop physical, mental and social care being in separate compartments – in order to provide a holistic approach to each individual. And he’s so evangelical about this plan, he’s happy to criticise the last government’s health service record – as well as reveal he’s prepared to take his leader’s proposals even further.

“When we were in government, we did a lot of good things around four hours for A+E, 18 weeks for an operation. When we were talking about choice, it was good, but we weren’t giving them [patients] the real, fundamental choices that they wanted. We were saying ‘which hospital do you want to go to?’ rather than ‘where and how do you want to be treated?’ So the agenda that Ed is setting out in terms of service design, I’m taking further in saying individual people should have fundamental rights in respect of their care.”

His examples are the right to “a single point of contact,” “care in a place of your choosing,” “give birth at home”, and “end your life at home.”

He continues: “So not just being, you know, what Ed’s talking about, I’m talking about making it very, very real for people, ie an individual saying ‘no, I want to be with my family in my own home at the end of my life’. Obviously that means hospitals will have to change to deliver those kinds of changes.”

The previous Labour government has been criticised by the coalition for its use of targets in the NHS, and Burnham is open about the dangers of that approach too. He talks about using opposition as a “moment of deep reflection on policy, not just patching up and basically repackaging what you were doing in government.

“When you go into government, you have a policy and it gets on the rails and it’s hard to kind of change direction. When you’re in opposition, it’s right to take a proper stand back. So this policy is really forged from my experience of that era, and while targets were right for their time – because they were trying to place some order on a system that was failing the public – like anything, in time, there were negatives that came from an overreliance on targets. It encouraged the system perhaps to function too much as a production line. It could see the immediate problem, but not the whole person.”

Burnham concludes: “So the policy – whole-person care – is born of a deep reflection on our time in government, the 21st century, and the challenges that are coming down the track, and trying to build a system that is ready for it.”

He refers to the aging population, an aspect of the suffering reputation of the health service he believes has not been discussed enough. “Some of the debate [about NHS failings] has been too narrow, to be honest. The underlying factors here that I don’t think have been given enough consideration are the demographic change: the situation that society is aging.

“We have, not just in Stafford, but all over the country, hospitals that have older people in them that really oughtn’t to be there – but can’t go because there isn’t proper care at home. And in that acute hospital environment, many of their needs start to be neglected because hospitals aren’t geared up to deal with their mental and social needs… don’t get me wrong, staff have made some awful judgements around staffing, numbers on the ward, others things – but there is a bigger debate.”

Burnham is vehemently against this government’s NHS reforms, arguing that their reorganisation is “a plan for fragmentation”. He also calls their criticism of the health service “a deliberate attempt to denigrate it. To suggest it’s just not capable; it’s a system that’s unresponsive, uncaring nurses, lazy GPs, wasteful – this narrative was being run I believe to advance a privatisation agenda.”

He has admitted in the past that the last Labour government “let the market in too far” into the NHS, although insists to me “that’s not me doing an emotional argument of the left. There is real evidence to say why it’s the wrong answer to 21st century health challenges… the evidence says market systems cost more.

“For me, [privatisation] is the wrong answer. And there’s almost been at times an unspoken consensus between reformers on both sides of politics that the market should just inexorably be allowed to advance. I suppose I’m making a break with that for the first time in a long time.”

But are there any instances Burnham can see private money helping the NHS?

“Yeah, of course. And it did, didn’t it? The last government worked with the private sector to bring down NHS waiting lists and they came right down. And that’s how I see it. I see a supporting role but not a replacement role.”

Burnham insists his ‘whole-person care’ policy proposal is “the opposite” of something that could be curbed due to the inability to make specific spending commitments. He claims it’s “actually about efficiency” and “spending money we already put into the health and care system much better than we currently do.”

In fact, he sounds fairly gloomy – or at least pragmatic – when discussing his potential future department’s budget: “If I’m assuming that there’s going to be no huge amounts of money for health and social care, how do we get much better results for people from what we’re currently putting in? Whole-person care comes from that quite hard-headed assessment of the future outlook of public spending.”

Still, one of Labour’s main tasks in the build-up to 2015 is to convince the public it’s able to spend responsibly, the perception of a ‘profligate’ previous administration still holding some sway. The current leadership is notably quiet about ‘New Labour’ and they seem to prefer harking back to the days of Clement Attlee than Tony Blair or Gordon Brown.

“I’m proud actually to have been in Gordon Brown’s government, and although it was a difficult time, I think history will be kinder than recent judgements have been,” Burnham comments. “I’m proud of the whole of the last Labour government. I think we did some truly transformative things.

“This is the simplest answer that I can give to these attacks we’ve seen on our health policy: in 2010, we left office with the lowest ever waiting lists, and the highest ever public satisfaction. And that, whatever the Tories try and do, cannot be eroded.”

If so, why is Miliband reticent about discussing New Labour, Blair and Brown?

“Well, it’s a new era isn’t it? We’re not living in the past,” Burnham replies. “I think all of us as leadership contenders [Burnham ran for the Labour leadership in 2010] came to our own reckoning. That’s what you’ve got to do in opposition. It’s not an easy process actually, you have to come to an honest reckoning with the government that you were a part of… You have to say ‘we didn’t get everything right. Who will?’ You have to come to a reckoning about that.

“One of the reasons I stood in the leadership contest was because I wanted to give vent to some of those feelings. I think we had lost our sense of who we were, lost a bit of identity. I kept saying it was as if we were closest to big business, the establishment, vested interests…

“Given my involvement in the Hillsborough campaign, I’ve always illustrated it through that – perhaps people were too busy listening to media vested interests and the establishment down here rather than an entire city that was crying injustice, and I don’t feel proud of that. So there were things where we’d lost touch… We can be proud of what Tony and Gordon did, but it doesn’t mean we have to be stuck. I think the Tories have had this with Margaret Thatcher haven’t they? New era demands new thinking demands new ideas.”

Burnham’s Labour leadership campaign drew on his Northern roots, building an ‘outsider’ type of appeal. Would he like to see more Northerners on the frontbench?

“Definitely! Absolutely. I do have a lot of sympathy with that. I’ve spoken to a lot of colleagues, who perhaps have a different accent to most – a lot of people say they come down here and… in the House, people who speak in a certain way tend to get called a bit more, and people who speak in a certain way get calls off Radio 4 more often than others.

“I always remember I shared this office with [former Labour politician] James Purnell when I first came into parliament. Whenever something happened, the media would always ring us both to ask us for a comment. And we used to laugh about it because whenever something would break, our phones would both ring, but his would be Radio 4 and mine would be 5 Live,” Burnham chuckles in recollection. (Purnell is a Londoner).

“There is a sense to a lot of people that the kind of ‘London set’ slightly pushes people with Northern voices out a little bit. That’s probably always been the way, but it’s still a bit of a shame. If you look at the House of Lords, oh God, it’s so London-dominated, it’s unbelievable. I think it’s quite frightening to be honest. It’s still quite rare isn’t it to hear Northern accents on frontbenches?”

Burnham has been very animated on this topic, and suddenly slows himself down: “I’d better not propose a new positive discrimination policy! Also people often maybe accuse me of overplaying the Northern card, the chip on the shoulder card, so I’m also well aware of that.”

But then he carries on regardless: “I think the Westminster club kind of warms more to certain kinds of cut-glass, Home Counties accents. It probably ‘twas ever thus, but it’s sad that it still feels like that today.”

Perhaps a more pressing concern now for Labour is how the next election will play out. There may be a chance to form a Lib/Lab coalition, although Labour is adamant  it’s only looking to a majority.

Burnham reveals he attempted to approach the Lib Dems and bring them round to his side of the argument on the Health and Social Care Bill, now an Act, while it was being made. He wasn’t impressed by their response.

“I’ve tried to talk to them,” he remarks, frankly. “When the Health and Social Care Bill was going through, we made so many efforts to speak to them and to say, ‘Look, you can stop this, come on, why? It’s not in the coalition agreement, it’s not in anyone’s manifesto, you don’t have to support it’. We worked really hard at that, and it was literally like talking to the wall. They just went blank behind the eyes. And it’s quite hard to even think about having let’s say the current leadership of the Lib Dems…” he trails off. “I’m working for a Labour majority, absolutely.”

But when the final whistle eventually sounds, will Andy Burnham be picked again for Labour’s team? He has developed a policy, and clearly believes fervently in the benefits its cultural and structural shift would bring to the health service. He’s a man who sees the heartache of opposition as a necessary prelude to a Whitehall-based result. However he fares in this game of two halves, he’ll be worth watching.

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