Geeky Burnham promises 'sensible' reform

“Oh, no you won’t,” I murmured. There’s not a lot of subtlety in a tweet. So when I asked the party leader’s staff about Miliband’s remarks and caught up with Burnham at the now-familiar “health hotel” the tone was more nuanced.

Good, though it’s hard to convey nuance to voters who aren’t listening carefully and are upset by lurid leaflets through the letter box warning against local hospital reorganisation. The one we got at home from the Lib Dems was also the lead story (no less!) in Saturday’s communist Morning Star, both equally alarmist. “There’s no need for any closures,” a male nurse vehemently assured me in Manchester. I fear there is. Labour’s Number 10 health veteran Paul Corrigan agrees.

‘Burnham said it would be too easy for Labour to join demos against every closure’

Actually the 2012 conference speech which I will remember was a “What money can’t buy” seminar against market societies (as distinct from efficient market economies given by a thoughtful Harvard political philosopher called Michael Sandel. As I listened I felt reproached for my own acceptance of greater private and voluntary presence inside the NHS, although Sandel is nuanced too.

But first Ed and Andy. What Miliband said at a Q&A session was that it would “not be sensible” simply to reverse the Lansley legislation at great cost with top-down reforms of his own. Instead he promised to “put the right principle back at the heart of the NHS” and explained that Lansley explicitly saw (“I’m sufficiently geeky that I read” the small print) an NHS like competing privatised utilities – gas or water. Putting it on a better legal footing - cooperation, not competition, enshrined in law - is what he and Burnham hope to do.

OK. When I later heard Burnham at the health hotel (the forum where health fringe sessions are staged) he was fired up in that boyishly enthusiastic way of his: “I’m so happy to be back at this job, leave me here for ever, Ed.” He teased low-profile Jeremy Hunt  - “we call him Hunt Jeremy” - but also said it would be too easy for Labour to join demos against every hospital A&E closure. He will only oppose those driven by cost-cutting, not by justified clinical improvement.

Room for voter disappointment there then, but that’s surely right. In substantial terms Handy Andy promised to set out more NHS thinking in his Wednesday speech – after my deadline – but hints that integration between health and social care, “a one-system approach”, is central. He likes Norman Lamb, the new Lib Dem health minister, and thinks a cross-party consensus on the urgent need to resolve social care for the elderly ill is possible.

That may be a hint of Lib-Lab cooperation in a future coalition after 2015. We’ll see. What did Professor Sandel say that impressed me? That the ability to buy anything, a place in a theatre queue, even a nicer cell in a US prison (for $90 per night), had slowly squeezed energy, morality and values out of western societies these past 30 Thatcher/Reagan years. We need to debate more.

But it isn’t simple. Did his Labour audience oppose super-casinos which create jobs? Overwhelmingly. Cheap supermarket milk that ruins farmers and bankrupts small shops? Er, yes. Paying poor people (“health bribes”) to take pills they should be taking anyway, as so many don’t? That was trickier. Using money is inviting people to “do the right thing for the wrong reason,” he explained. It’s corrosive.