Two weeks in: what Burnham's start tells us about health and care

A fortnight is nowhere near enough time to judge a Prime Minister. But as Andy Burnham discussed with the BBC’s Laura Kuenssberg, it is enough time to get a solid sense of where his government’s priorities lie.

Andy Burnham has spent much of the first two weeks of his premiership talking about difficult issues that have challenged successive governments for years. Social care. Devolution. Productivity. Economic growth. Public service reform. Running through all of the soundbites and press releases, there seems to be a belief that decisions should be made closer to the communities they affect, and that lasting change comes from fixing systems rather than announcing initiatives. The coming months and years will determine whether those ambitions can be delivered (and the tricky point of where the funding will come from is still to be made clear). But for now, they provide a useful indication of the government's direction of travel.

And it’s not just what Andy Burnham has said that’s been interesting, it’s the way he’s been saying it too.

Yes, there has been the big set piece sit-down on Panorama, but he’s also been taking a leaf out of the playbook of pop stars and football pundits with a social media charm-offensive. Even before he took office, Burnham has been focused on this approach with memorable moments including ‘blind-ranking’ pub snacks as part of his announcement on VAT cuts for the hospitality sector, climbing a literal ladder to discuss youth employment, and using the AI-search-friendly Reddit for an Ask Me Anything. These are all tactics and approaches designed to engage younger audiences and give the government shareable social clips that drive modern politics and public opinion.

Latest political polling suggests the content has been compelling for the voting public too. And for those of us working in healthcare, it is pleasing to see a clear signal that health and care sits at the heart of Burnham’s agenda underlined by the appointment of political heavyweight Yvette Cooper MP as the new Secretary of State for Health and Social Care.

Among the headline commitments, the proposal for a National Care Service stands out as an ambitious reform with the potential to reshape the relationship between health and social care for a generation. This is important because (and has been well documented) the NHS can only ever be as effective as the care system that surrounds it. Every winter demonstrates the consequences of social care capacity falling short with thousands of patients remaining in hospital despite being medically fit for discharge. We looked at this issue in some detail a few years ago, highlighting the hospital backdoor as the “battleground for the future of the NHS”. Ultimately this battle is only won if social care is working.

At ZPB we have also seen what happens when social care doesn’t work, not least through our clients in the mental health space. Where high quality community provision is available, people receive the right support in the right setting. Where those services are unavailable, demand inevitably shifts elsewhere, often into expensive acute NHS services. Investment in social care is therefore an investment in the resilience of the whole health system.

While Burnham has backed some quicker initiatives, it’s good to see him investing political capital in long-term projects like this. A National Care Service will not transform this winter, but choosing to focus on long-term reform rather than short-term headlines suggests a government prepared to invest in structural change, even where the political rewards may take years to materialise.

The coming months will reveal whether that ambition can be matched by action. And there are no shortage of other health priorities Andy Burnham must address.

Mental health remains a leading and complex issue for the NHS and government. We see every day how gaps in community provision create pressure elsewhere, from rising demand in primary care to avoidable admissions and delayed discharge. A key criticism of recent governments has been the lack of investment in mental health, and there is an opportunity for Burnham to change this.

Technology also needs attention. The UK has some of the world's most innovative health technology companies, but too often we excel at developing innovation rather than adopting it at scale (as we have seen recently in AVT - Ambient Voice Technology). The challenge for government is to create clearer pathways into routine NHS practice that benefits patients. That means procurement that rewards outcomes, stronger evidence generation, greater confidence in innovation and a willingness to redesign services around digital tools rather than simply layering technology onto existing models.

Alongside this sits the equally important conversation around NHS data. Used responsibly, health data has enormous potential to improve research, accelerate innovation and personalise care. But that opportunity will only be realised if the public trusts how their information is being used. Debates around Palantir illustrate that technology adoption is as much about transparency, governance and public confidence as it is about technical capability. This is a sticky issue for Burnham and team, with opinions charged on both sides.

Greater clarity is also needed around the role of independent sector providers.  Despite high-quality care and delivery at scale, the debate often remains trapped in the age-old debate of public versus private provision. The real question is how every part of the health and care ecosystem can contribute to better outcomes. Whether it is independent hospitals, community services, life sciences companies or health technology businesses, the NHS increasingly relies on partners to deliver innovation, capacity and specialist expertise. If the ambitions set out in the 10 Year Health Plan are to become reality, those partnerships must be embraced.

Two weeks may be too short to measure success, but it is enough time to understand intent.

From what we have seen so far, Andy Burnham is willing to engage with some of the sticky structural challenges that have hampered health and care for decades.  If the government's early signals translate into policies that strengthen the structures around the NHS, build stronger cross-sector partnerships, and focus on long-term change, then these first two weeks may come to be seen as the beginning of a significant chapter for health and care. 

A lot can be achieved through good will, partnership and ambition, but funding will need to be found somewhere. Reality may bite with the autumn budget.