Three tests for the Burnham administration

How the difficult leap between vision and policy will define his premiership

Andy Burnham is going to be the next Prime Minister. Right now, he is reported to be ensconced with a handful of trusted advisors, doing in a few weeks what the current incumbent had years to work on: the construction of a policy agenda.

Burnham’s recent speech gave us some of the big themes, but none of the detail. It is clear that he is ambitious to transform the State. Doing so, though, might involve bigger and more foundational decisions than most administrations feel able to contemplate, even given a full term in office – and Burnham will not have that before he is encouraged, or required, to hold a general election under the most uncertain of circumstances.

We at Re:State have been working on these questions for years. So in this piece I have identified three explicit ambitions that are likely to be at the heart of the coming Burnham project, and what our research suggests he will have to do in order to actually achieve them.

These are the policy tests that will define his premiership.

Test one: real devolution will mean going far beyond Manchesterism

On June 29^th, Burnham promised the “biggest rebalancing of power our country has ever seen”. His remarks focused more on how central government would have to change (more on that below) than on the particulars of more thorough-going devolution – perhaps because Burnham thinks his ‘Manchesterism’ vision, which centres the Greater Manchester approach as a model for the rest of England – speaks for itself.

The reality is that the next phase of devolution cannot simply be ‘Greater Manchester everywhere’. Our new Devo Next Initiative is bringing together strategic authorities with the specific aim of setting out an ambitious future vision for devolution. And Re:State’s existing work provides a useful starting point.

Some places are far more ‘polycentric’ than Manchester, London, or any other subregion dominated by a big urban core. Some are rural or coastal. Some have no obvious single economic centre. Some have counties, towns and cities whose futures are interdependent but whose identities do not fit neatly into a metropolitan template. For these places, different kinds of institutions and governance will be needed to give them strategic capacity.

For many polycentric regions, this will eventually require larger institutions. Our proposal for larger, pan-regional governance in England would bring together populations of at least three million, creating bodies capable of coordinating infrastructure, transport, investment, labour markets and spatial planning over a genuinely regional footprint. Existing authorities could continue to represent their sub-regions, but would no longer be expected to solve strategic problems at a scale too small for the task.

London, meanwhile, needs its own fresh settlement, rather than being left outside an English devolution model designed largely in response to the rest of the country.

And, crucially, devolution will ultimately break down unless it is accompanied by a transformation of financial autonomy within places. This is the same vast barrier that has frustrated every devolution agenda before: Whitehall devolves tasks while retaining control of the money.

If local leaders are to carry responsibility for growth, they need a direct stake in the results. Burnham should use his first fiscal event to begin assigning revenues to regional government, with effective equalisation to ensure that places are not trapped by their starting conditions. Our fiscal devolution proposals would give Strategic Authorities a retained share equivalent to 2.5p of the basic rate of income tax, alongside full retention of business rates growth. The exact mechanism can be debated. The principle should not be: responsibility and revenue must begin to move together.

Burnham should also choose a small number of significant functions and transfer them early, in an act of explicit democratisation. Housing is an obvious candidate. He has promised the largest council housebuilding programme since the post-war period, but the current system divides land, investment, planning and regeneration responsibilities between local government, Strategic Authorities, departments and Homes England. A serious devolution programme would move most of Homes England’s functions and assets into locally led institutions, as New House Rules proposed. Employment support and regional health budgets should follow.

The first test, then, is whether Burnham can resist the temptation to attempt to universalise his own successes as mayor. Manchesterism should be a source of lessons, not a constitutional template. Real devolution means metro mayors where they fit, larger-scale regions where they are needed, neighbourhood power where community-scale governance makes most sense, and fiscal devolution wherever government expects places to take responsibility for results.

Test two: ‘No 10 North’ will be worthwhile only if it helps make itself less necessary

Burnham’s most striking institutional promise is ‘No 10 North’. In his Manchester speech, he said that change would be driven through an extended prime ministerial operation based in Manchester, creating a more streamlined state with a clearer purpose.

But relocating some of the centre is not the same as reforming the centre. The deeper challenge is that Whitehall is not currently designed to give power away. Departments tend to see local systems as delivery channels, not governing partners. They create programmes, attach conditions, control pots of money, demand returns, and then wonder why local leaders cannot act with speed or coherence. In ‘Devolve by default’, Re:State argued that devolution should be treated not as a favour bestowed by ministers, but as a default operating principle for the State. That requires Whitehall to justify what it holds centrally, rather than forcing places to endlessly prove why they deserve more control.

That principle has consequences. It means departments must become smaller, more focused, and more strategic. It means central government should focus on national priorities, standards, funding frameworks, accountability and system stewardship, not micromanagement. It also means confronting the reality of a system that very often governs via arm’s-length bodies (ALBs) – Burnham himself, after all, pointed out that power is too often “held by an insufficiently accountable, outsourced state.”

The central argument of Quangocracy was that public bodies need a clearer purpose, stronger sponsorship and much more direct accountability. Burnham should turn that analysis into a presumption: every arm’s-length function must justify why it needs to remain at arm’s length, and why it needs to remain national.

The civil service itself will need to change alongside this. Government will not become more decisive simply because ministers demand greater urgency. Officials need clear permission to take ownership, challenge inherited practice and focus on results, alongside the constitutional requirements of integrity, honesty, objectivity and impartiality. A new Civil Service Code would provide one early signal, setting expectations around excellence, openness, ownership and courage and connecting them directly to performance management.

That change cannot stop with the wording of the Code. Whitehall needs to become better at managing poor performance, bringing in external expertise and developing leaders with genuine depth across policy, operations, digital, commercial and delivery roles. It also needs to repair the everyday machinery through which government acts. Legacy technology, slow procurement, weak data, regulatory accumulation and elaborate approval processes are not secondary administrative concerns. They determine whether political instructions survive contact with the State.

Burnham does not need another Whitehall reform programme that spends two years mapping the problem. Most of the problems are well understood. He needs to use the authority of a new administration to change expectations, alter incentives and force choices about what the centre is for.

Burnham’s second test, therefore, is whether he can make Whitehall capable of the governing style he says he wants. A collaborative, place-based, long-term politics cannot be delivered by a central machine built around short-term announcements, departmental silos and defensive process management. No 10 North may be the right mechanism for change, but the benchmark of its success should be that it makes itself less relevant over time.

Test three: A “national health and care service” means radical reform

In 2013, Andy Burnham was the shadow health secretary. Speaking at the Labour Party Conference that year, he argued that the NHS must transform to become a “whole person” service, uniting the NHS with social care at a fundamental level to form a “national health and care service”.

Burnham has again put this agenda near the centre of his current prospectus. As Mayor, he has extolled the virtues of the (partial) health devolution agreed as part of Manchester’s city deal. In June, he said the need to fix social care was urgent and that he “wouldn’t flinch” from the difficult questions around inheritance tax, care charges and funding. Louise Casey has indicated that she stands ready to accelerate the timeline of her review.

The current social care system exposes the failure of the State to fund honestly. It exposes the pressure on local government and the fragility of the care market and workforce. It exposes the consequences of a health system that itself is in need of reform, and is forced to absorb the downstream costs of wider system failure. It exposes the burden placed on families, and especially unpaid carers.

The idea of a National Care Service – or a unified National Health and Care Service – has never been fully fleshed out. But in ‘Beyond caring’, Re:State argued that later-life social care needs a fundamentally new settlement: working-age adults should make mandatory contributions from the age of 34 into a Later Life Care Fund, privately managed with a mandate to maximise returns and used to pay for each cohort’s future care needs. The proposal is designed to move later-life care away from crisis funding and political avoidance, and towards risk-pooling, sustainability and fairness.

Burnham will also need to connect care reform to a broader rebooting of the health system, across both primary and secondary care.

Re:State’s work on primary care, ‘Prescription for prevention’, argues that there is a “profound mismatch” between the ambition to move care out of hospitals and a funding model that still inhibits the shift towards primary and community care. It explores the technological tools that now exist to make that shift easier, with better monitoring and population health management, but only if we also have the analytical capacity, data foundations and basic hardware/software standards to make it real.

This is where Burnham’s “whole person care” instinct meets reality. A preventative State cannot simplistically mean more services outside hospital, because that risks loading new responsibilities onto already overstretched general practice. It means rebuilding the primary and community care model around population health, continuity, multidisciplinary teams, digital infrastructure and the ability to intervene before people deteriorate. Re:State’s primary care work points towards a system in which funding follows outcomes rather than activity, budgets can be pooled over time and place, and risk is managed earlier.

Hospitals, meanwhile, are in the midst of an identity crisis. They are the most visible edifice of state failure, and their struggles are produced by wider public service challenges: weak prevention, fragile community capacity, poor data-sharing, delayed discharge, underpowered management, and social care that is treated as an adjunct to the NHS rather than part of the core architecture of care.

In our ‘Hospital of the Future’ series, we argued that the shift upstream cannot simply mean asking hospitals to do less. It requires a new account of what hospitals are for, in a system built around earlier intervention, care closer to home and long-term condition management. That means treating the hospital less as a fixed building and more as a service; examining the actual causes of patient gridlock, and implementing sometimes counter-intuitive approaches to improve things; and embracing the technological potential of virtual hospitals (and being ready for the big debate that this could generate in public expectations).

For any of this, Burnham and his team must be willing to throw away the ‘too difficult box’ – because all of these challenges are interconnected. That is the third test. Hospitals cannot solve delayed discharge alone. Councils cannot build resilient care markets without stable funding. Neighbourhood services cannot prevent demand if they are designed as pilots rather than core infrastructure. Local leaders cannot join up services if national funding streams, inspection regimes and accountability structures pull them apart.

The window of opportunity

Burnham’s politics hinges upon the idea that he understands the weightiness of the failure of the current system. People think government is not only inefficient but distant and unresponsive, leaving them unable to change the conditions of their lives.

His answer is to bring government closer to people and places. This is a powerful idea, but it is only a headline.

When Burnham enters Downing Street, he will briefly possess something important: an opportunity to change the rules. The danger is not that ‘Manchesterism’ is too ambitious to implement, but that in practice it ends up constraining the radicalism that will really be needed.

Burnham is making an argument for fundamental change. He should follow through with policies to match.