Andy Burnham is fired up and doesn't have the air of a loser. He's failed in his parliamentary battle to get the Health and Social Care Bill dropped, but Labour's shadow health secretary clearly feels he's on the right side of the argument on NHS reform, and is quickly drawing up plans for how to oppose Andrew Lansley's changes.
HuffPost went to meet Burnham in his Westminster offices on Budget day, about an hour before George Osborne's statement to the Commons. It's a busy office, with half a dozen young, very keen-looking men beavering away. Given the Health and Social Care Bill cleared all its remaining parliamentary hurdles the night before, there could easily have been an air of dejection.
But as I arrived Burnham was finalising the next stage in Labour's opposition, to what will soon no longer be a Bill but an Act of Parliament.
"It's day one," he tells me. "We not hanging around, I want to be clear we're not, like, 'It's all over, we're in the doldrums,' We're going to make this a major local election issue, a major Mayoral election issue. We're going to ask the country to use the local elections to pass a verdict on this Bill."
"Had they dropped the Bill, it probably wouldn't have been in our best political interests, but we still wanted them to do it."
The plan seems to be to encourage everyone in the NHS to "stand out against the logic of the reforms," developing a voluntary protocol which Labour hopes will mean the England-wide, standardised commissioning structure the last government created will continue in spirit, if not in name. It sounds a bit like guerrilla warfare, but Burnham seems keen not to paint it in such an antagonistic light.
"We are developing a Mayoral pledge and protocol, particularly for the big city Mayors, that we're going to launch soon. We're going to ask local councillors to adopt this pledge, and we're going to ask commissioners and providers to sign up to it."
Burnham won't go into the details of what will be in the protocol, due to be announced next week, apparently. But he suggests there will be encouragement from Labour for the new Clinical Commissioning Groups (CCGs) to make the same decisions in future that they would have expected the old Primary Care Trust regime to make.
"It's a very practical thing," says Burnham, although to be honest like everything surrounding the NHS reforms it sounds like a load of management gobbledegook.
Which is why, Burnham believes, it's only really been politicians and those inside the health system who are up in arms about it.
"I think with Welfare reform it impinges upon people in a very direct and immediate way and, with the Health and Social Care Bill I think the government mis-sold it basically. This original vision of Dr Finlay’s casebook with the friendly local GP that arranges all your complex care needs for you wasn’t the issue basically; the issue was the creation of the legal structure of a market.
"I think because of that, it's always suffered from that kind of simplistic selling point that never quite matched up to the Bill and for that reason it has confused people."
Wouldn't it have helped, though, if Labour had been slightly more apocalyptic in its predictions for the NHS, rather than just sounding very ideological about opposing privatisation? Burnham thinks the press dopped the ball.
"I have real concerns about some of the coverage or lack of coverage of the Bill on mainstream broadcast media," he tells me. "I think that fatigue set in,this thing had been going on and on and people were like, 'Oh, that again', but I don’t think the level of prominence that it was getting in the broadcast media reflected the level of concern out in the rest of the country."
But surely Burnham could have been more graphic in his portrayal of what will happen? "The first thing I want to say is that everything is not going to go to hell overnight, I’m not saying that and never have done. But we have responsibility to warn as far as we see it.
"A and E missed its targets 11 weeks on the trot, hospital services are fragile at the moment, there’s temporary closures going on around the country and so as this Bill really begins to bite, let me give you the direct implications as I see them.
"A postcode lottery where you will see real differential standards apply, variation. The Mail last week reported last week that PCTs are beginning to restrict access to various types of surgery based on BMI, and that ain't acceptable as far as I’m concerned. I absolutely fundamentally rejected that as Health Secretary."
(It's a nice image - Whitehall mandarins being told in a thick Lancastrian twang that things "ain't" acceptable)
"I am not going to be sat here in this office waiting for things to go wrong, circling like a vulture and chasing every ambulance. We are going to be working from here to mitigate the worst effects of this Bill," Burnham insists, and you get the feeling that this is not a shadow Cabinet member who hangs around at Westminster.
All the way through our interview he's constantly talking about his constituency - "The practice at Haxby that said it wouldn’t be doing minor operations any more.." is something he throws into a polemic about creeping privatisation and diminishing service.
"I had a woman in my surgery last week telling me that they were going to stop varicose vein treatment, a huge postcode lottery...."
The thing about Burnham is that he doesn't seem like the sort of person who would tire of hearing about his constituents' varicose veins. And there are some MPs that would, very quickly.
So what's the long-term plan? Labour have pledged to reverse Lansley's reforms if they get back into office in 2015. Isn't that just more top-down upheaval for the health service?
"I’m not saying we would do everything anew but we would reverse the legislation," Burnham insists. So would the Primary Care Trusts come back? "I'm not necessarily saying that everything goes back to how it was but what does go back is the basic legal framework that we had, which was an NHS based on planning coordination, cooperation, a national framework for pay and conditions."
But what if Burnham is wrong? What if, actually, the NHS reforms work, patient outcomes improve and money is saved in the process?
"Well, they can all stand there at election time and tell me that I was wrong, and I look forward to the argument about that. I think that the government comprehensively lost this argument, the weight of professional opinion was against it."
And given it takes a couple of years for those kind of trends to become clear, won't the verdict on the NHS reforms come in just before the general election?
Burnham seems to be looking forward to that. "Yeah sure, but it can be measured very easily on patient satisfaction and waiting lists. Those are the barometers and we’ll see whether they are the same as what they inherited."
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