The Labour Party under Andy Burnham

[brad465]

While we like the NHS, sadly spending there does not have any direct benefit unless you actually build a new hospital. So that could be a clear focus.

There's no point building new hospitals until all the existing ones are fully staffed, which various sources put at 25k-100k vacancies nationwide. This is also the reason the Nightingale hospitals move during covid was nothing more than a PR stunt; there were hardly any staff available for them. If more spending here went towards recruitment and retention, the results would be seen in shorter waiting lists and better/faster A&E/GP experiences, and given how dire these currently are, marked improvements are both possible and noticeable.

Topic: NHS staff shortage

Discover all statistics and data on NHS staff shortage now on statista.com!

www.statista.com

NHS staff shortages​

The National Health Service (NHS) in England, one of the world’s largest employers, is grappling with a severe staffing crisis, as evidenced by the alarming vacancy numbers across various healthcare roles. In the third quarter of 2024/25, there were over 106,000 vacancies in the NHS workforce, with 27,000 positions alone needed in nursing. Yet at the same time, NHS staff vacancy rates have shown signs of decreasing, particularly nursing vacancies, which are at their lowest since 2017. Nevertheless, the number of doctors and nurses leaving the workforce has been steadily increasing. These contrasting data highlight different aspects causing the staff shortages. Retention strategies aimed at the current workforce may be equally, if not even more, important than recruitment planning. Despite some signs of improvement in staffing levels, persistent understaffing has taken its toll as widespread staff burnout has led to a mental health crisis among healthcare workers.

 

[Topological]

There's no point building new hospitals until all the existing ones are fully staffed, which various sources put at 25k-100k vacancies nationwide. This is also the reason the Nightingale hospitals move during covid was nothing more than a PR stunt; there were hardly any staff available for them. If more spending here went towards recruitment and retention, the results would be seen in shorter waiting lists and better/faster A&E/GP experiences, and given how dire these currently are, marked improvements are both possible and noticeable.

Topic: NHS staff shortage

Discover all statistics and data on NHS staff shortage now on statista.com!

www.statista.com

All very noble and needed.

However, voters are selfish people who have mainly not been to hospital.

Add 100,000 Nurses and you will soon find that you need 50,000 more because expectations adjust. People already see through the "we added x000 new Nurses" because x000+ retired.

Would that we lived in a world where statistics were trusted.

 

[johntea]

I worked on one of the Nightingale hospitals and one interesting thing that came out of it was it proved it is more than achievable to knock up a decent infrastructure rather quickly when you're just left to get on with the job rather than 100 levels of bureaucracy wanting to review and sign off every...single...step in the project! (basically they just handed out a blank cheque and told us to get on with it!)

 

[Egg Centric]

I worked on one of the Nightingale hospitals and one interesting thing that came out of it was it proved it is more than achievable to knock up a decent infrastructure rather quickly when you're just left to get on with the job rather than 100 levels of bureaucracy wanting to review and sign off every...single...step in the project! (basically they just handed out a blank cheque and told us to get on with it!)

This is the general reason state run stuff isn't great - it's not (mostly) cause of something unique to government run projects. It's simply cause large organisations can't run things efficiently due to perverse incentives everywhere, and privatisation gets around that. In principle we could acheive exactly the same thing in the state sector if we could somehow get through bureaucratic thinking, unions, etc. I've always believed this but am experiencing it in person now where I'm tied by golden handcuffs to a large company for another year or so. Compared to how much I used to do, I don't bloody do anything although I'm handsomely rewarded for it and if I were purely motivated by money could vegetate here for decades (until randomly laid off cause of business cycle).

Unfortunately most politicians tend to come from such institutions. There's a general problem that no one who's a) talented b) sane c) non evil would want to be a politician at the moment. I don't know what the solution is to that (well I do - raise MP salary to 500k - but good luck getting that through!)

 

[edwin_m]

I worked on one of the Nightingale hospitals and one interesting thing that came out of it was it proved it is more than achievable to knock up a decent infrastructure rather quickly when you're just left to get on with the job rather than 100 levels of bureaucracy wanting to review and sign off every...single...step in the project! (basically they just handed out a blank cheque and told us to get on with it!)

But it's much more difficult to get trained staff to operate them. I don' t believe any of the Nightingales saw a single patient!

Infrastructure projects always take a long time, usually longer than a Parliament, so people won't see those benefits in time for the next election. Instead Labour should be talking about how they are actually helping people, such as with employment rights, and probably also pushing and achieving closer ties with Europe which is something Reform can't match.

 

[JamesT]

But it's much more difficult to get trained staff to operate them. I don' t believe any of the Nightingales saw a single patient!

No, they did get patients. Not as many as expected, but they weren’t completely useless. https://www.bmj.com/content/374/bmj.n2013

Yet between them they admitted fewer than 1000 patients over the whole course of their existence, before they were mothballed and then decommissioned from late 2020.

 

[Tetchytyke]

The thing Labour most need to do is to convince a lot of people that, whilst the current situation is far from perfect, life under a Reform government would probably be a catastrophe for much of the population.

Labour are playing right into Reform's hands by trying to be Reform. Labour can never out-Reform Reform. As I've said before, you don't go and see the tribute act when the original band are in town.

Beware the bogeyman doesn't work as an election strategy. It certainly doesn't work when you spend the rest of your time trying to ape the bogeyman.

Labour need to sell a vision of what they want the country to look like. People are rightly cynical about promises of jam tomorrow, but people do need to see something of the values and ideas that drive a government.

What on earth does Labour stand for? Where are the people who will grab the bull by the horns?

The fact that Wes Streeting- who, in his NUS days, was one of the stupidest and most unpleasant men I've ever had the misfortune of having to work with- is being seen as the heir apparent sums up the current Labour Party perfectly. Streeting is slippery, stands for nothing, loves private equity money. How is he any different to Farage or Tice?

== Doublepost prevention - post automatically merged: 28 Jan 2026 ==

This is the general reason state run stuff isn't great - it's not (mostly) cause of something unique to government run projects. It's simply cause large organisations can't run things efficiently due to perverse incentives everywhere, and privatisation gets around that.

Privatisation doesn't get around anything. You still have the large organisational structure and you still have the perverse and contradictory incentives within the organisation.

The idea that private companies are these thrusting, energetic, efficient entities is, quite frankly, complete nonsense. Some of them will be, but only where there is a genuinely competitive marketplace. Otherwise no. And genuinely competitive marketplaces are now few and far between.

Earlier in my career I spent a year working for Accenture. That company made the civil service look dynamic and lean. And it's only companies the size of Accenture, Serco, or Capita that have the scale needed to win public contracts.

Outsourcing and privatisation are false economies. Always have been, always will be.

 

[Kite159]

This is where you need spades in the ground, demonstrable and irreversible actions that prove change is being made.

People have become tired of "we will" and switched on to the changing of policy after an election.

Concrete steps to actually cement commitments to the left-behind communities would be the best possible indicator that Labour were different.

While we like the NHS, sadly spending there does not have any direct benefit unless you actually build a new hospital. So that could be a clear focus.

I think we should build more prisons. Again a tangible sign that something is being done on crime.

What we get instead are lots of reasons why things cannot be done. But I gaurantee that there is a long list of areas where private investors would happily lend to government without it having any impact on the credit rating. What investors need is payoffs, debts for current spending are not investments, but tangible steps to a better future are.

For all the faults at least Truss went with an ideology. It is time Labour started to go with theirs.

Agreed, governments (of all colours) are quite happy to announce various projects in a blaze of glory, which never get off the ground other than various companies pocketing millions in fees to develop plans. Until spades are in the ground it's all hot air.

 

[oldman]

Labour need to sell a vision of what they want the country to look like. People are rightly cynical about promises of jam tomorrow, but people do need to see something of the values and ideas that drive a government.

What does that vision look like? The populist left has a vision - tax the super-rich and spend, spend spend. The populist right has a vision - cut migration, cut welfare, cut taxes. Simples.

In practice all the government can do is try and make incremental improvements on a number of fronts in the hope of making things a bit better for people. How do you make a vision out of that?

 

[Topological]

The Keynsians used to have a vision of Government Spending leading national income (Y). The model is

Y = C + I + G + NX

C - Consumption from the private sector
I - Investment from the private sector
G - Government spending (net of tax)
NX - Net exports

The focus was then on the thing that the government could control, G. Then things got a bit more advanced when the fiscal multipliers were added to the model and certain elements of G could have a greater impact on Y than others. However, Labour have typically subscribed to the idea of influencing GDP through G.

There is the tax private investors highly approach, which some in Labour flirt with, but that reduces I and is usually not seen as the best option. Hence we never really had a high tax Labour government in the UK.

For Labour the aim is to show demonstrable G that invests in communities and supports organic development of C and I. That is what was previously behind big infrastructure projects, enhancement of local facilities, supporting of communities etc.

The NHS logic is that healthier people increase C and I. However, it is not as easy to demonstrate progress as a load of diggers driving a new tram network through an urban wasteland (or motorway through a field as it was last time we had a meaningful attempt at a G led recovery)

Remember that the Conservatives are typically Monetarists and minimize G. They control the economy through monetary policy that promotes C and I.

 

[ainsworth74]

There's no point building new hospitals until all the existing ones are fully staffed, which various sources put at 25k-100k vacancies nationwide.

Probably need to build some replacement hospitals at the very least though as there are a number of them that are physically falling apart...

But it's much more difficult to get trained staff to operate them. I don' t believe any of the Nightingales saw a single patient!

I was sort of a patient in one as I got two of my Covid jabs in the Sunderland Nightingale hospital! Must admit it was quite grim to think about if it had gone into service as an actual hospital seeing as it was basically just a large industrial warehouse with temporary walls forming corridors and rooms but with no ceilings so sound travelled and looking up you could just see the warehouse roof far above.

 

[Tetchytyke]

What does that vision look like? The populist left has a vision - tax the super-rich and spend, spend spend. The populist right has a vision - cut migration, cut welfare, cut taxes. Simples.

That's a very good question. Both the populist left and populist right are offering simple solutions to complex problems, neither of which will work.

In practice all the government can do is try and make incremental improvements on a number of fronts in the hope of making things a bit better for people. How do you make a vision out of that?

That in itself would be a good start.

Right now all Labour are offering is more austerity, even though taxes are rising. I understand why this is happening. The rising interest payments on the national debt are swallowing up the money from the tax rises, and the national debt is so big because Johnson and his cronies spaffed it all up the wall during Covid.

But they need to do something about the persistent inflation rates. Personally, I'd start with a windfall tax on the supermarkets. Tesco is making record profits, both in real terms and in margin terms, and Sainsbury's are the same. I'm not one for taxing the rich until the pips squeak but I think Labour should be gunning for these big conglomerates who are, quite simply, ripping people off.

I think they have tried to do this to an extent with the increases in employer NICs- employer NICs are the one tax that even aggressive tax avoiders like Amazon can't get around- but the messaging on this has been appalling. They've let business argue that the NICs are the reason why they're putting prices up when that simply isn't true.

Tesco's profit margin was about 15% before Covid and now its about 25%. That means they're putting their prices up by more than their cost base has increased. That should be the messaging, instead Labour are silent and Tesco are able to argue that all they're doing is passing on the extra tax costs.

 

[JamesT]

Right now all Labour are offering is more austerity, even though taxes are rising. I understand why this is happening. The rising interest payments on the national debt are swallowing up the money from the tax rises, and the national debt is so big because Johnson and his cronies spaffed it all up the wall during Covid.

Presumably you're referring to the PPE Scandal by spaffed up the wall? That was a fraction of the spending during Covid. Most of it went on the various support schemes such as furlough. Which the Labour Party tended to criticise as insufficiently generous, rather than warning about excessive spending.

But they need to do something about the persistent inflation rates. Personally, I'd start with a windfall tax on the supermarkets. Tesco is making record profits, both in real terms and in margin terms, and Sainsbury's are the same. I'm not one for taxing the rich until the pips squeak but I think Labour should be gunning for these big conglomerates who are, quite simply, ripping people off.

I think they have tried to do this to an extent with the increases in employer NICs- employer NICs are the one tax that even aggressive tax avoiders like Amazon can't get around- but the messaging on this has been appalling. They've let business argue that the NICs are the reason why they're putting prices up when that simply isn't true.

Tesco's profit margin was about 15% before Covid and now its about 25%. That means they're putting their prices up by more than their cost base has increased. That should be the messaging, instead Labour are silent and Tesco are able to argue that all they're doing is passing on the extra tax costs.

Where are you getting 25% profit margin from? https://www.tescoplc.com/investors/...tions/financial-performance/five-year-record/ has operating profit for 2025 as 4.5%

 

[edwin_m]

The rising interest payments on the national debt are swallowing up the money from the tax rises, and the national debt is so big because Johnson and his cronies spaffed it all up the wall during Covid.

Reductions in economic activity are also reducing the tax take. These are due in a large degree to austerity and Brexit.

 

[Richard Scott]

What does that vision look like? The populist left has a vision - tax the super-rich and spend, spend spend. The populist right has a vision - cut migration, cut welfare, cut taxes. Simples.

In practice all the government can do is try and make incremental improvements on a number of fronts in the hope of making things a bit better for people. How do you make a vision out of that?

That's a very simplistic view but, even if it is true, they don't even have that much of a vision.
Both Labour and Conservative seem to stumble from one idea to the next and neither really know what they're doing.
You could say a chief executive in a company has the aim to make as much money as possible but some are much better than others as they have a vision and know what they want to do, unfortunately Labour seem to have no clue about either.

 

[Bantamzen]

The thing Labour most need to do is to convince a lot of people that, whilst the current situation is far from perfect, life under a Reform government would probably be a catastrophe for much of the population. With a leader who seemingly "approves" of Trump, do we really need Trump-like policies in UK? Tax policies that favour the rich. Do we really believe that NHS would remain "free" ? And scrapping aims to reducing greenhouse gases, instead increasing profits for oil/gas companies. And how would he treat railways and other public transport -- reduce investment for a start; maybe another Beeching ??

That would play right into Farage's hands, just as it did with Trump. Why have a debate when you can have a slanging match, and Farage is an expert on dishing it out. He'd chew Starmer to bits in a campaign like that.

Perhaps, just perhaps Labour need to roll their sleeves up and actually start talking about the issues that people are concerned about and that Reform use to cover their lack of in-depth policies. It's going to need them to deal with a whole bunch of stuff I'm sure some would prefer not to, but the reason Labour are losing ground to Reform is because many people don't think they listen to them any more.

 

[ainsworth74]

That would play right into Farage's hands, just as it did with Trump. Why have a debate when you can have a slanging match, and Farage is an expert on dishing it out. He'd chew Starmer to bits in a campaign like that.

Perhaps, just perhaps Labour need to roll their sleeves up and actually start talking about the issues that people are concerned about and that Reform use to cover their lack of in-depth policies. It's going to need them to deal with a whole bunch of stuff I'm sure some would prefer not to, but the reason Labour are losing ground to Reform is because many people don't think they listen to them any more.

Labour Strategist 1: Has pointing out how terrible the populists would be in power ever worked to stop them being electorally successful?

Labour Strategist 2: No, it never does. Those people somehow delude themselves into thinking it might... But it might work for us...

 

[Egg Centric]

Privatisation doesn't get around anything. You still have the large organisational structure and you still have the perverse and contradictory incentives within the organisation.

The idea that private companies are these thrusting, energetic, efficient entities is, quite frankly, complete nonsense. Some of them will be, but only where there is a genuinely competitive marketplace. Otherwise no. And genuinely competitive marketplaces are now few and far between.

Earlier in my career I spent a year working for Accenture. That company made the civil service look dynamic and lean. And it's only companies the size of Accenture, Serco, or Capita that have the scale needed to win public contracts.

I agree with all that. But what you're missing is that they can then subcontract to the smaller dynamic organisations (which the government can't, in practice).

 

[Magdalia]

The Keynsians used to have a vision of Government Spending leading national income (Y). The model is

Y = C + I + G + NX

C - Consumption from the private sector
I - Investment from the private sector
G - Government spending (net of tax)
NX - Net exports

This is the expenditure method of deriving GDP.

There are 2 important differences between what happened in the days of Keynes and what happens now.

Government final expenditure (G) is on goods and services and public sector investment. It does not include transfer payments to other sectors of the economy. These are much bigger now than in the days of Keynes, for example welfare and pension payments. A lot of what people think of as government expenditure does not directly add to national income, it just redistributes existing income from one part of the economy to another.

Net exports (NX) in the days of Keynes never strayed far from balance because of fixed exchange rates and exchange controls. But NX has been substantially negative for decades now, which is mainly funded by borrowing or selling assets. Furthermore, increasing G does not inevitably lead to an increase in Y, it may just make NX even more negative, requiring more borrowing and/or more asset sales. Note that this applies to increases in consumers expenditure (C) too, and more so, because of the UK consumers capacity for spending on imported goods and foreign holidays.

But they need to do something about the persistent inflation rates. Personally, I'd start with a windfall tax on the supermarkets.

A windfall tax on supermarkets would increase inflation, not reduce it. The windfall tax would be passed on to consumers through higher prices in the supermarkets.

I think they have tried to do this to an extent with the increases in employer NICs- employer NICs are the one tax that even aggressive tax avoiders like Amazon can't get around- but the messaging on this has been appalling. They've let business argue that the NICs are the reason why they're putting prices up when that simply isn't true.

For any business where labour is the main input, the increase in employers' NICs has had a major impact on their costs. Businesses that use a lot of labour at or near to the minimum wage have had that to contend with too. Any business in a position to pass on those costs to customers, through higher prices, will take the opportunity to do so.

 

[Topological]

This is the expenditure method of deriving GDP.

There are 2 important differences between what happened in the days of Keynes and what happens now.

Government final expenditure (G) is on goods and services and public sector investment. It does not include transfer payments to other sectors of the economy. These are much bigger now than in the days of Keynes, for example welfare and pension payments. A lot of what people think of as government expenditure does not directly add to national income, it just redistributes existing income from one part of the economy to another.

Net exports (NX) in the days of Keynes never strayed far from balance because of fixed exchange rates and exchange controls. But NX has been substantially negative for decades now, which is mainly funded by borrowing or selling assets. Furthermore, increasing G does not inevitably lead to an increase in Y, it may just make NX even more negative, requiring more borrowing and/or more asset sales. Note that this applies to increases in consumers expenditure (C) too, and more so, because of the UK consumers capacity for spending on imported goods and foreign holidays.


A windfall tax on supermarkets would increase inflation, not reduce it. The windfall tax would be passed on to consumers through higher prices in the supermarkets.


For any business where labour is the main input, the increase in employers' NICs has had a major impact on their costs. Businesses that use a lot of labour at or near to the minimum wage have had that to contend with too. Any business in a position to pass on those costs to customers, through higher prices, will take the opportunity to do so.

Indeed it is the expenditure method. It works as a nice simple way to think about things.

As you say. Government spending is formally measured as expenditure on consumption, not transfers. So whilst recent governments have done a lot of transfers, the expenditure does little to raise national income (well save that transfers come back as C since the marginal propensity to consume is higher at lower income). The logic of moving money from groups who are not likely to consume, to those who will is sound. However, most would move non consumption income to investment and that is where the higher tax rates hit limits.

My main point in using the Keynesian model was that Labour could, if they so desired, actually get spades in the ground on big Government consumption projects. Recently we have seen talk of such projects but no action. A good old fashioned Labour push on G could actually help growth.

Worth stressing I do not believe in Keynesian approaches (or any of their derivatives). I do not vote Labour.

I would be focusing on making a better environment for entrepreneurial investment and reducing barriers for smaller businesses. However, that is not the ideological position of Labour and I would not be expecting them to go down that route. That is the ground for the Tories to reclaim.

In essence, both main parties need to stop sinking to reform and actually use their own idological route to influence growth.

 

[Bevan Price]

The trouble is that the "economy" has impossible aims. Most people want good services / facilities that are either free or affordable, (e.g. health care, housing, defence, policing, education, leisure facilities, etc.) Private providion of many of these can be unaffordable for much of the population, so they want governments to provide them. But that means higher taxes, which the public do not want to pay. And the solution - I don't know.

But things could be much worse. Does anyone want to see Trump-like policies imported from USA ? No-NHS, just private health insurance costing £(thousands) per year ? "Drill baby drill" for more oil & gas, worsening air pollution, etc.???
"Green" would be a better option than Reform, but some of their policies seem to be unrealistic dreams.

 

[Sorcerer]

The trouble is that the "economy" has impossible aims. Most people want good services / facilities that are either free or affordable, (e.g. health care, housing, defence, policing, education, leisure facilities, etc.) Private providion of many of these can be unaffordable for much of the population, so they want governments to provide them. But that means higher taxes, which the public do not want to pay. And the solution - I don't know.

The problem though is the UK is already not far off paying Scandinavian-level taxes but doesn't receive the same level of public services. To use two examples, the NHS is consistently struggling despite spending increase over the years, and the railways are practically charging Swiss fares for German quality (well maybe not that bad). Metaphorically speaking you wouldn't agree to keep paying luxury high-rise rent just to live in a damp garden shed.

 

[Broucek]

The problem though is the UK is already not far off paying Scandinavian-level taxes but doesn't receive the same level of public services. To use two examples, the NHS is consistently struggling despite spending increase over the years, and the railways are practically charging Swiss fares for German quality (well maybe not that bad). Metaphorically speaking you wouldn't agree to keep paying luxury high-rise rent just to live in a damp garden shed.

The taxes on high-very high earners are not far away from Scandi levels but those on mid-level earners are noticeably lower here. And that's a factor of the points made by @Bevan Price where the median member of the public wants "other people" to pay

 

[styles]

The taxes on high-very high earners are not far away from Scandi levels but those on mid-level earners are noticeably lower here. And that's a factor of the points made by @Bevan Price where the median member of the public wants "other people" to pay

I dunno, tax on £100k-£125k is taxed at 69.5% here. Throw in 9% for student loans potentially also.

 

[Broucek]

I believe £100k+ is worse for those with kids...

The £100-125k is a shocking distortion of the tax system. Of course those people are doing fine in absolute terms but many are among the brightest and best and some (including Doctors) are refusing promotions or cutting hours for tax reasons... Very, very silly

 

[CharlieSpotted]

Metaphorically speaking you wouldn't agree to keep paying luxury high-rise rent just to live in a damp garden shed.

Allow me to introduce you to the British private rental sector! Especially the world of HMOs!

 

[styles]

I believe £100k+ is worse for those with kids...

The £100-125k is a shocking distortion of the tax system. Of course those people are doing fine in absolute terms but many are among the brightest and best and some (including Doctors) are refusing promotions or cutting hours for tax reasons... Very, very silly

Yep, having an effective marginal rate of tax >100% is just obscene really. I can't believe it can ever be beneficial having people take home less money from earning more.

 

[Broucek]

Yep, having an effective marginal rate of tax >100% is just obscene really. I can't believe it can ever be beneficial having people take home less money from earning more.

And yet even the bonkers Truss tax cutting budget didn't tackle these gross distortions!

I mean, giving up 47% above £125k (ignoring student loans) isn't a huge incentive to work harder but the fact you pay a higher marginal rate below that is beyond absurd.

I'm confident that binning the erosion of the tax free allowance but taxing at (say) 46% + NICs from £100k would be at worst revenue neutral and probably positive as people stop going part time, stop dumping money into pension, stop refusing promotions etc.

 

[DarloRich]

The £100-125k is a shocking distortion of the tax system. Of course those people are doing fine in absolute terms but many are among the brightest and best and some (including Doctors) are refusing promotions or cutting hours for tax reasons... Very, very silly

A salary of £100k is a very good one when compared to most people in this country. My heart bleeds for them. How will they afford the school fees for little Quentin?

Maybe we should just give the rich a free pass? Afterall, they will allow thier wealth to trickle down to us plebs. Apparently.

 

[styles]

A salary of £100k is a very good one when compared to most people in this country. My heart bleeds for them. How will they afford the school fees for little Quentin?

Maybe we should just give the rich a free pass? Afterall, they will allow thier wealth to trickle down to us plebs. Apparently.

I think it's possible to say £100k is a great salary and privileged position to be in; while also acknowledging that an effective tax rate of >100% is absurd. Also having the marginal income tax rate go up at £100k then down again at £125k is nonsensical.

Also potentially that taking nearly 80% of pay away at this income level is possibly a bit excessive.