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Andy Burnham's letter to Andrew Lansley


“Taken together, the proposed reforms risk undermining the stability and long-term future of the NHS.”

Text of the letter:

House of Commons



1st October 2010

Dear Andrew

NHS White Paper Reforms


I would like to put to you a way forward on NHS reforms, in light of the fierce criticism that is emerging from professional bodies.

As you know, we support giving doctors more say over decisions in the health service. That was the thrust of the Next Stage Review, conducted by Ara Darzi. However, we have grave reservations about your plans to do this, and our warnings have today been endorsed by the BMA.

On Wednesday, in my speech to the Labour Party Conference, I asked the Prime Minister to put these plans on hold, give the NHS the stability it needs to face up to the financial challenge, or get ready for the fight of his life.

Your plans are completely unacceptable to us and if you proceed on the basis you have set out, we will launch a major campaign in every community.

However, if you are prepared to listen, we will step back from that and engage constructively in the debate over the future of the NHS.

The BMA have today said:

“Taken together, the proposed reforms risk undermining the stability and long-term future of the NHS.”

All of us who care about the NHS must agree that such a risk is too great.

I strongly back the sentiment of the BMA, and the group of GPs who wrote to the Editor of The Times on Wednesday, that a “less disruptive, more cost-effective process” could achieve the aim of clinical empowerment.

I would therefore like to make three constructive suggestions that I believe would allow you to pursue your objectives, but avoid exposing the NHS to intolerable levels of risk:

1.    Make the White Paper a Green Paper

This would bring the reforms into line with usual Government protocol. It would allow for further engagement and development on a range of policy proposals, with a subsequent White Paper setting out the Government’s clear policy intentions. A Bill would follow, with significant time put aside for pre-legislative scrutiny.

I therefore ask you to delay bringing any legislation affecting the future of the health service before Parliament, by at least a year.

2.    Maintain PCTs in their current form for the medium term

Today the BMA have warned about the ‘implosion’ of PCTs. This is simply too great a risk to the public. I believe the lack of a population-wide commissioning body is a major flaw in your plans, and I would argue for the retention of PCTs or a similar statutory body in the NHS.

While we debate that issue, I would ask you to signal that PCTs are secure in the medium term. This would give the NHS the organisational stability it needs over the next few years to meet the unprecedented productivity and efficiency challenge.

3.    Pilot GP commissioning

With the current organisational structure in place, GP commissioning could be piloted in a limited number of areas. This would allow the model to be tested for applicability in a range of settings, and for evidence to be gathered to make the argument for national roll-out.

This pilot process would help test the concerns of groups representing those with rare and complex needs that the proposals would reduce equity in the system and fail to support those who need long-term, integrated care.

It would enable us to debate a major hole in your plans – the arrangements for specialised commissioning. I find it staggering that you have published a White Paper that does not adequately address this critical area of the NHS.

I believe these are measured and reasonable requests that will be supported by many in the NHS, and could help to calm fears over these reforms.


I hope you will agree that in light of growing opposition to the timing, pace, scale and cost of the proposed reforms, these steps would be in the best interests of the NHS.  

You have an opportunity at your conference next week to signal the way forward from here. I very much hope that you will consider these suggestions and that we are able to avoid a divisive and damaging period for the NHS.

But if you proceed as planned, we will fight you every single step of the way, because, in the words of the BMA, your plans present a ‘risk to the long-term future of the NHS.’



Yours sincerely,



Shadow Secretary of State For Health


  • Andy Burnham's letter to Andrew Lansley

    Andy Burnham's letter to Andrew Lansley


Readers' comments (6)

  • Interesting this from the man who's political party instigated commissioning (and therefore privatisation)....hypocrite springs to mind Andy.

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  • Yes, P. Damien, you are right, Labour did pave the way for privatisation. However, it is necessary to consider the here and now. The ConDem proposals will destroy our NHS! What's worse, is that neither the Tories nor the Lib Dems have a mandate from the English electorate to do so!!

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  • what would William Beveridge - make of all this if he were alive.

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  • that's correct Kelvin they don't. UNISON are going to take this poxy lot to court over this issue.....what will happen if the Judge falls down on their side....could be interesting.

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  • As Kelvin points out, we have to deal with the here and now. I find the haste with which the ConDems are trying to rush this legislation through Parliament quite disturbing. It strikes me that they are try to dismantle as much of the Welfare State and the NHS as they can before their time is up!

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  • And their time will be up at the next election! One term wonders and typical tories..wrecking the NHS at the first opportunity. Problem is the incoming govt which will be labour probably won't do much to retrieve the situation as it's pretty much their ethos as well.

    Despite all it's critics and despite it's shortcomings the NHS still remains the envy of the world. It is the mark of a caring society that looks after the health and welfare of it's citizens (and quite often the citizens of other countries) for nothing at the point of entry. It is a truly remarkable organisation and one of which i am very very proud.

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