An OVID Health article by Sophie Feary
It’s an especially good morning for Andy Burnham, who didn’t just win the Makerfield by-election last night, but showed Labour that he can go up against Reform. What had been widely tipped as a Reform pickup instead ended in a 9,000 plus majority, with Burnham taking 55% of the vote to Reform’s 35%.
Part of this can be attributed to candidate selection. The Reform candidate, Robert Kenyon, has faced significant scrutiny following a poor Question Time performance and the resurfacing of deeply concerning remarks about women, which he refused to distance himself from. But there may also be a broader ‘Burnham effect’ at play.
So what next
Speculation has quickly moved from the result to its implications. The central question is whether this becomes a springboard for Burnham or simply a moment of noise the current leadership absorbs.
Earlier this week we saw senior Labour MPs seeding the “no mandate” argument, shaping the narrative early. The more likely short term play is therefore political management. Two broad theories are doing the rounds: keep Burnham at arm’s length, allowing the spotlight to fade naturally or bring him closer in, potentially via a Cabinet role, to neutralise him while benefiting from his profile. It is unlikely that Burnham will settle for this, having made it this far.
If this escalates into a leadership contest, it is unlikely to be quick. The process is clear but far from straightforward. A challenger must secure nominations from 20% of Labour MPs, currently 81, to enter the race, and then gain support from either 5% of Constituency Labour Parties or at least three affiliated organisations, including a minimum of two unions. Burnham may be moving within range of that threshold, while Wes Streeting has suggested he has secured sufficient backing. Labour’s National Executive Committee would then set the timetable for the contest. Once triggered, the process typically culminates in a ballot of party members, meaning it could extend into Party Conference season. If a member vote is avoided, it could be completed in days.
What does this mean for health
In the short term, probably less than the politics might suggest. Leadership churn rarely translates into immediate policy overhaul, particularly in a portfolio as complex and operationally constrained as health.
It seems like only yesterday that James Murray took on the role as Secretary of State for Health and Social Care and should Starmer fall, it is unlikely he will remain in post. With a packed health agenda already set by Wes Streeting, it is unlikely that anyone coming in will have the time to drastically alter the course.
This is where Burnham becomes interesting. His record in Greater Manchester gives him a credible narrative around place-based health, integration and prevention. He has consistently framed health as something shaped as much by local systems as national policy.
Social care is the other watchpoint. Burnham has repeatedly signalled it as a priority, and politically it offers the kind of “unfinished business” a new leader could plausibly claim. The constraint, as ever, is fiscal. The ambition may be clear, the delivery route much less so and Burnham has already announced that he will stick to the current mandate set by the Government.
More broadly, any new leader would be looking for quick, visible results. Health is one of the few areas where progress can be seen and communicated clearly. The key question is therefore less about what changes, and more about what is prioritised.
Article originally published on LinkedIn on 19th June
