Cowper’s Cut 429: “Honesty is the best thing”
“Honesty is the best thing”, new Health But Social Care Secretary James Murray told Department For Health But Social Care staff in an introductory Q&A session.
Ah well: he’ll learn.
The Times Diary, which reported this remark, also relays the compelling news that Mr Murray does not have a favourite biscuit. This is not because Murray believes that all biscuits are equal in a socialist paradise, but rather because he does not eat biscuits. Or certainly, claims not to.
The biscuit question is apparently a Mumsnet interview ‘staple’: The Times reveals that when it was asked of ex-Health Secretary, Mascara Kid and aspiring Makerfield Labour MP and then party leader Andy Burnham, his reply was that he preferred “beer and chips and gravy any day”. Mmmmmmm.
In another telling titbit of Whitehall gossip, The Times reported that Labour’s former deputy leader and former Housing Secretary Angela Rayner was offered the Health But Social Care brief in the wake of Young Master Wesley Streeting’s resignation, and refused it. Intriguingly, the piece reports that “Rayner and Starmer did not speak directly at any point” in this negotiation.
Feel the Burn
The Mascara Kid’s desire to return to a Westminster politics that apparently made him so unwelcome that in 2019 he told GQ magazine it had become “a living nightmare” is giving rise to the inevitable wave of ‘will the real Andy Burnham please stand up?’ articles.
The best I’ve yet seen is from Manchester journalist Jennifer Williams of the Financial Times. Williams will write about The Mascara Kid’s aspiring return every Friday during his campaign for the Makerfield seat for the real pink paper. That’ll be worth following: she is one of a few impressive national journalists, with a real desire to understand the roots of public policy issues, as shown by her work for the Manchester Evening News during the pandemic. Joshi Herrmann’s piece for the Manchester Mill is also detailed on Burnham’s actual record as Manchester mayor.
Only social care tax funding reform can save us now
Many of the nationals focus on Burnham’s non-disavowal of his old plan for abolish inheritance tax, and replace it with a 10% ‘Care Tax’ levy on all estates to fund social care. The Times summarises it quite well.
The fates of Andy Burnham’s plan for social care tax funding in becoming ‘Labour’s death tax’ (2010 general election campaign, courtesy of the Conservatives), and then of Theresa May’s version of the same becoming ‘the Tories’ dementia tax’ (2017 general election campaign, courtesy of Labour) remind us that symmetry is a wonderful thing.
They also remind us that no brave political move on funding social care universally and without means-testing goes unpunished.
Burnham’s plan is more a rebranding of inheritance tax than an abolition. That is less important than the practical problems: even for those who must self-pay, there is a current shortage of social care provision. This is why prices are high and quality is, to put it charitably, variable.
If self-payment goes at the cost of a 10% tax rate on estates, then how in practical terms will provision be expanded to provide universal free-at-the-point-of-use coverage?
Department of Health and Social Care
Quality regulation in health and social care is already bad. Once social care meaningfully becomes the Secretary Of State’s responsibility, on a basis of being tax-funded (a levy being a tax) and universal, how will it cope?
How will the reputational fallout be managed, given the powerful track record of social care as (alongside mental health and maternity) one of the sector’s biggest fields for quality and safety scandals?
If The Mascara Kid wants to become Labour leader and so Prime Minister, he will need to have answers to these and many other detail questions about such a key policy. At present, it is not clear that he has even been asked these questions by anybody (himself included).
Wes Streeting: the Schrödinger’s Cat Health Secretary
Longstanding readers know of my fondness for Schrödinger’s Cat: the thought experiment which aims to explain quantum superposition mechanics. This unfortunate feline in a closed box may be considered to be simultaneously both alive and dead while it is unobserved, as a result of its fate being linked to a random sub-atomic event that may or may not occur.
It’s a handy analogy. So you get Schrödinger’s Immigrant, who simultaneously comes over here to laze around on benefits doing nothing all day, while at the same time stealing your job.
Now we have Young Master Wesley Streeting acting as the Schrödinger’s Cat Health Secretary: simultaneously having resigned very publicly, while at the same time trying to push through parts of his agenda in his life in exile after abdication.
Let’s consider whose distinctively unsubtle fingerprints are all over this briefing and draft plan leak to the Financial Times attempting to push the Milburn-Streeting agenda of AI replacing NHS workforce growth.
See if you can guess who might be behind paragraphs three and four: “the reforms were drawn up while Wes Streeting was health secretary before he resigned with an attack on Sir Keir Starmer and announced he wanted to succeed him as the next prime minister.
“James Murray, appointed as Streeting’s successor, will quickly have to decide whether to press ahead with the proposals, which are due to be published within weeks. Murray, who was previously chancellor Rachel Reeves’ deputy at the Treasury, is yet to formally review the proposals but is thought likely to be sympathetic.”
It’s a real head-scratcher, isn’t it?
There’s nothing like a subtle briefing from Young Master Wesley, and this is nothing like a subtle briefing from Young Master Wesley.
It’s not a bad rule of thumb to be highly sceptical about all such AI overclaims as the one behind this Milburn-Streeting workforce plan. Those interested in the area would do well to look into the much more reliable final report of the Health Data Research Service (HDRS) Digital Ecosystem Analysis, funded by the Wellcome Trust, published this week. Its authors are actually knowledgable about the possibilities and technicalities of AI.
As for the Milburn-Streeting workforce plan as reported, neither the problem nor the proposed AI solution are accurately drawn. The assumptions are unsafe, and the evidence is mostly absent.
Indeed, if a doctor proposed to deploy a healthcare intervention like that and did some harm, they’d be lucky not to go to prison. And yet this is an intervention that affects all of healthcare, everywhere as far into the future as we can see. Surely the sector deserves better? Or at least, far more careful consideration.
March 2026: Streeting on Starmer - “I don’t want to see Keir challenged in May”
Doubtless you, like me, have been wondering how this parish can possibly cope without Young Master Wesley Streeting’s vigorous brand of briefing national journalists?
Pippa Crerar and Kiran Stacey
Clearly, The Young Master is not likely to disappear below the radar.
Even if by some tragic chance he were to do so, we still have his greatest hits to mine, such as his claim from all the way back in March 26th 2006 to The Guardian that “I don’t want to see Keir (Starmer, the PM) challenged in May. I don’t think that that will happen … He’s only been prime minister for 20 months. Give the guy and the government a chance.”
Mmmmmmmm.
Young Master Wesley added, “I think there is a risk for the Labour party if people look at us and think, hang on a minute, we voted for change. We thought you were going to draw a line under chaos and now it looks like you’re going to chop and change”.
There are likely to be more such ‘important interventions’ from The Young Master as Labour lurches onwards in government.
Yet we should remember that recent YouGov polling of Labour Party members shows that Young Master Wesley would badly lose a Labour leadership contest to Sir Keir Starmer, and indeed to any of the other likely candidates.
Recommended and required reading
The final report of the Health Data Research Service (HDRS) Digital Ecosystem Analysis, funded by the Wellcome Trust, has been published.
The one consistently impressive Health Minister, Karin Smyth, told the Commons that the Government will fully accept the DDRB pay recommendations for NHS mangers, both ESMs and VSMs.
Henry Anderson
Times comment piece by Covid Vaccines Taskforce leader Dame Kate Bingham on why Britain is failing to capture the value of its medical scientific success.
Accountancy firm EY have settled for £100 million with the administrators of private provider NMC Health (owners of Aspen Healthcare) over allegations of negligence, breach of contract and duty of care, The Times reports.
Remarkable story about surgeons at Leeds Teaching Hopital clipping a brain aneurysm via the patient’s eye, having modelled the operation using a 3D printer.
The Times reports that private social care providers may face caps on their profits, following concerns of “profiteering” driving councils into bankruptcy. Local government secretary Steve Reed will apparently promise to bear down on “excessive or unjustified profits” and ask councils for examples of “unreasonable cost escalation or particularly egregious behaviour”.
Entertaining summary of the new book ‘How To Take Drugs’ by its author, pharmacist Dr Nick Barker.
This intelligent HSJ comment pievece by Bryan Jones and Ian Kirkpatrick argues that any new NHS workforce plan must finally address the overlooked management workforce needed to drive improvement, innovation, and reform.