Andy's care plan

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0:37Tim Shipman: Hello and welcome to Coffeehouse Shots. I'm James Heal and delighted to be joined today by Tim Shipman and Isabel Hardman. Now, this morning, the Prime Minister made his big speech on social care. Isabel, what did we find out? Well, firstly, we found out that Andy Burnham is a better communicator than Keir Starmer, which we're all astonished by. He spoke without note and from the heart. and I think probably for some people in Westminster when a politician says I'm going to speak without noticing from the heart there's a slight wave of nausea that sweeps across us but actually I think that the way in which he did that speech was actually quite clever because he did make it emotional but he did actually announce some significant policy proposals which are very ambitious on social media and other details and so he managed to meld emotion and technicality which is difficult he wants as we've known for a long time a national care service which is in some way integrated into the NHS with an emphasis on keeping people in their homes for as long as possible properly funded and staff paid really well which I'm interested in in terms of the sustainability of the sector and sort of higher standard of staffing as well in the same way as and NHS standards of staffing are measured.

1:52And he wants to move forward the work that Baroness Casey is doing. She's just launching this national conversation on care. The reason I started with Burnham's emotions rather than what he actually said was that he is putting a lot of his premiership on the line for this. And he insisted both in the speech and in the sort of social media stuff that he's put out afterwards that this is when the deadlock over social care finishes. This is it. He's going to solve it. And to make that promise so early on, the first really big premiership defining promise, you know, we've had measures on cost of living, we've had some stuff on technical education, but this is the big risky one, is really bold.

2:33I still don't know at the end of this speech, the one thing I haven't learned is what he thinks other than his own incredible emotional power is going to ensure that this reform actually happens. You cannot cry your way to social care reform and neither can you cross party consensus your way to social care reform which is one of the things he's claiming to do with a meeting with the Lib Dems and the Tories. You can't do that because the Tories and Labour disagree with one another fundamentally on the size of the state, the role of the state, the role of private wealth and taxation. Maybe they'll move a little bit closer but then they'll realise that there's still a Grand Canyon between them.

3:10The Lib Dems have that Grand Canyon within their own party so we can sort of discount them because they don't even agree with themselves on the size of the state in the world of tax. But you're not going to get cross-party consensus. What you actually need is consistent leadership and political stability. And political stability follows from consistent leadership. We just don't know if Burnham's capable of that yet, or if the Labour Party is going to allow him to do it. But I think it's fascinating that he has not only chosen to expend political capital on it, but I think make it the defining opening theme of his premiership.

3:39Tim Shipman: Yeah, I think, Tim, we can say that Ernie Burnham has been quite consistent on this, talking for many, many years, back to when he was Health and Social Care Secretary in the Brown government. But I mean, what do you think his aim is here? Because he's going to have difficulty being bound by both the manifesto, the sentiments of the party, and also the fact that, you know, this has been a longstanding 20-year failure of all political parties in the establishment.

3:59James Heale: I think this is liable to upset almost everybody, but there's a bit of Donald Trump about this, isn't there? It's something he's believed for 40, 50 years. It's a bit like Trump's tariffs. I'm going to do it, come what may. I'm going to define my premiership by it. And if people don't like it, I'm just going to sort of crack on. I mean, when he speaks about consensus, you get the distinct impression that that means inviting people into a room to agree with him. And if they don't, then he'll use the power of his office and the weight of Labour numbers in the House of Commons to force it through.

4:29James Heale: I mean, there are think tanks who have looked at the kind of things that he's proposing and said it's going to cost 1.8 % special separate sort of income tax whacked onto presumably the better paid. And I think there's a sort of interesting inconsistency in all of this. On the one hand, this is a Prime Minister who is not terribly comfortable talking about migration and reducing migration. But yet we've basically funded a care service as a form of borrowing, inviting in cheap foreign labour to staff our care service, who are basically net takers from the British economy. and now he's talking out loud about making people in care the best paid people in the country.

5:09James Heale: I mean he literally said that this morning which I think will strike a slightly bum note for some people and I think this is very Burnham. I think that's the other thing we should say. This is about the state dictating how people's lives and retirements go. It's about the state forcing people to pay for it and he doesn't seem that keen on sort of private providers playing any role in it. this is a very kind of sort of statist old Labour solution to the problem. And when Andy Burnham previously started talking like this, he got himself into quite a degree of difficulty and the Tories were not ultimately prepared to go along with it.

5:43James Heale: Maybe that's not necessary this time. But if he wants national consensus, I think he probably needs to proceed with a little bit more listening and a little bit less dictating. But, you know, on the face of it, governments are there to do big things. Everybody agrees this is a problem. But what no one agrees on is the solution, apart from in the most sort of abstract terms. The other thing that I find interesting about this whole care debate is we're not really solving care. All of these sort of solutions are designed to stop people selling their homes, which is a much bigger deal in the south of England, about which Andy Burnham appears much less concerned than it is in the north of England.

6:16James Heale: And I remember talking to Tories in the 2017 general election when Theresa May tried to do things on care. And when working class voters in the north realised that effectively they're being asked to subsidise people not selling their homes in the south of England. That became a sort of something that they were much less keen on. So at the moment, the politics of this are, here's a new prime minister. He's done quite well so far. He's done a few popular things. And now he's saying, this is the thing about which I care the most. But it does seem slightly odd to set up a situation that has been quite so intractable for generations and make that the thing upon which people will judge him in a few years' time.

6:52Tim Shipman: Isabel, as you talked about the National Care Service potentially being launched, which obviously brings comparisons inevitably to the National Health Service. We've had many, many health and social care secretaries over the years. They tended to focus more on the former part of that job than the latter. We've got a new health secretary in the form of Vett Cooper. I suppose the question is whether does she share her prime minister's burning ambition on this? And could we see for the first time in years, I don't know when the last one was, but a health secretary who's more focused on kind of social care, that part of the system, rather than, for instance, junior doctors, waiting times, etc.

7:22Yeah, that last bit of your question is fascinating, isn't it? because will the NHS allow Yvette Cooper to have the bandwidth for social care? It's all very well at this point in time saying these are our priorities. But one of the reasons we haven't had social care reform is that other inconvenient, unplanned things keep getting in the way for prime ministers, even ones who actually want to do serious reform. I don't just mean those prime ministers being removed. I mean big events like Brexit, wars, economic downturns and so on. And within the NHS, it is a health service that is running at crisis point the whole time.

7:56Corridor care has become so normalised that the unions are now involved in monitoring it. And so the health secretary is incredibly busy. The health and social care secretary is now tasked with trying to work on the detailed design and implementation of an absolute mind blowing reform. Does Ibet Cooper share Andy Burnham's burning ambition? I don't think she shares his burning vision in the sense that, and Tim, you might correct me if I'm wrong, but I've never found Yvette Cooper's burning vision.

8:25James Heale: I'm not sure she has any burning visions, does she? She's a very admirable, competent character, but she doesn't make decisions fast. And she's not a heart politician. She's a head politician. Whereas Andy Burnham is clearly a heart blazing away on his sleeve politician. Yeah, but that's potentially a good thing. You probably want somebody like Yvette Cooper who's just going to say, yes, Andy, I agree with you. I'm going to implement this, I believe in doing things properly, which is essentially what she does. That's the kind of politician she is. She likes getting stuff done. She likes doing it properly, rather than sort of going off on one about her own ideas of how this should be set up.

9:00James Heale: I think the danger though, Isabel, isn't it, is that she likes doing things properly, perhaps more than she liked getting things done. And there may come a moment where Burnham's sort of burning passion on this rides into Yvette Cooper's sort of punctilious processology. and you can see the potential there for friction, it seems to me. The other thing that Burnham did this morning, which I think is sensible and I think will be applauded by Spectator readers, is that he's effectively kicked the assisted dying bill into the long grass and said, you know, he wants to see patient care, social care improve before we start working out how people can go around bumping themselves off.

9:36James Heale: And I think there's quite a lot to be said for that. It was a hugely divisive issue under Starmer. and the point that a lot of people made in in support of the right to assisted dying was that care in the health service and and sort of care for people you know in extreme pain or at the end of life is not good enough and i think burnham is effectively saying before we start making it easier to commit suicide we ought to be making it easier for people to have a more dignified death and it seems to me that that is the thing you need to fix first and that that if everything else is

10:05Tim Shipman: complicated and difficult that at least is something that most people will think is is getting your priorities in the right order. Thank you, Tim. Thank you, Isabel. And thank you for listening to Coffeehouse Shots. Thank you.

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