Burnham's survival is the key move in the reshuffle

It seems as though we have waited an age for reshuffles of all three parties’ frontbenches. Often delayed, when they came they amounted to some of the most boring reshuffles on record.

‘As a result of Soubry and Abbott’s moves, frontbench health politics will be a little less outspoken and a lot more predictable’

This was no Macmillan’s Night of the Long Knives, Thatcher’s “purge of the wets” or even Brown’s gamble on bringing back Peter Mandelson. We were even denied the kind of farce that can some times bedevil even the best planned reshuffle. To the best of our knowledge, no ministers were accidentally sacked.

But this reshuffle season could be significant for health for two reasons; the changes that did happen and those that didn’t.

For the government, Jane Ellison replaces Anna Soubry in public health. Having contested a series of unwinnable seats for the Conservative Party, Ellison was finally elected to Parliament in 2010. Since then, she has expressed virtually no strong opinions on health. The same could never be said about Anna Soubry.

This move will please government media managers as much as journalists will mourn it after an easy source of stories. The Soubry show moves on to defence. Quite what she will make of the generals and they will make of her is anyone’s guess.

Immovable object

Labour has made a strikingly similar move. Diane Abbott has been sacked for being too off message (who would have ever thought that would happen?) and is replaced by the ambitious Luciana Berger. Unlike Ellison, Berger does have some background in health, having worked for that renowned finishing school for Labour parliamentarians, the NHS Confederation. She joins Andy Burnham, Liz Kendall and Philip Hunt − who have all spent time at the NHS Confederation in various guises − in Labour’s health team.

‘Campaigning flair, knowledge of the area and far reaching proposals for change are a potent combination’

As a result of these moves, frontbench health politics will be a little less outspoken and a lot more predictable. But the most significant implication of this reshuffle is the change that didn’t happen. Andy Burnham remains firmly in post.

Commentators are wrong to suggest this is a result of a barnstorming speech to the Labour conference. Two events will have secured his future. The threat of legal action against Jeremy Hunt was a dramatic move. It is unlikely to ever come to that, but it changed the narrative on the Burnham-Hunt row over claims of a “cover up” of NHS care failures. Combined with Ed Miliband’s row with the Daily Mail, it made it extremely difficult to move a man who clearly wanted to stay.

Labour activists are jubilant that Burnham is staying and those on the right who saw the prospect of securing the scalp of one of Labour’s more active and effective campaigners are sullen. In truth, the fallout from Burnham’s non-move is more complex and less predictable than that.

Election decider

Andy Burnham knows and has a track record in health. He is effective at motivating Labour’s supporters and he is a man with an ambitious plan of reform, the scale of which marks him out as virtually unique in Labour’s ever expanding shadow cabinet.

All of these attributes should − and could − be great strengths for a party that needs to put the NHS front and centre of the debate at next election. Campaigning flair, knowledge of the area and far reaching proposals for change are a potent combination.

Yet with these strengths also comes a degree of risk. Knowing health means having a track record and, as the past few weeks have shown, in the post-Mid Staffs era this leaves you open to attacks that, whatever their justification, can be wounding.

‘No one can doubt the radical nature of Burnham’s plans for health and social care’

The ability to motivate a party’s base is important, but Labour activists will always care about the NHS. They are not going anywhere. The people who need to be convinced they should vote on the NHS and not the economy are floating voters, who will not automatically find the Burnham pitch as appealing. Engaging activists cannot come at the expense of turning off floating voters.

Finally, no one can doubt the radical nature of Burnham’s plans for health and social care. However, the plan could remove some of Labour’s attack lines. It is a reorganisation and it does involve a degree of localisation, which makes it harder to accuse others of taking the “N” out of the NHS

Labour needs a clear victory on health at the next election. This means not only leading in the polls on the issue, but making health something that people actually determine how they will vote on (which didn’t happen in 2010).

Whether Andy Burnham can translate his attributes into strengths, or indeed whether Jeremy Hunt can make them weaknesses, will go a long way to determining the importance of the NHS in deciding the next government.

Mike Birtwistle is a founding partner of Incisive Health