Burnham should learn from Starmer’s successes and failures on public services

Labour was handed a poor inheritance on public services in 2024. It responded by increasing funding for services considerably in 2024/25 and 2025/26 compared to pre-election spending plans.

That extra funding helped to stabilise some services and contributed to minor performance improvements in others: there has been a small reduction in waiting times for elective care, though nearly no progress in other areas of NHS care such as long A&E waits. More people are accessing adult social care, though there is still a vast amount of unmet need. In other words, there is a long way to go on public service performance.

If Burnham sticks to current spending plans, he won’t be able to throw money at the problem. Starmer’s funding increases were heavily frontloaded. The average real-term increase in departmental day-to-day spending was 3.2% between 2023/24 and 2025/26. It will be only 1.1% between 2025/26 and 2029/30. Put another way, roughly 40% of the way through this parliament, departments have received more than 60% of their anticipated real-terms funding increase.

Drill further into the detail and the picture is even less rosy. In some services, notably the courts and prisons, spending commitments elsewhere in their parent departments imply cuts to their budgets over the rest of the parliament. Given current poor performance in those services, Burnham may come under political pressure to top up those budgets.

There are other headwinds. The government has already diverted capital funding away from public services to fund the Defence Investment Plan and may need to divert more. Any inflationary spike from Donald Trump’s war with Iran will reduce the real-terms generosity of settlements. In the NHS, Starmer’s trade deal with Trump will see the service forced to spend billions more on pharmaceuticals than it budgeted for. ⁴ https://www.bmj.com/content/394/bmj-2026-340588

With little flexibility, to drive noticeable improvements Burnham will need to focus on a small number of priorities so that funding is not spread too thinly. He should also be honest about the trade-offs – not every service will be able to return to 2010 performance levels by the end of this parliament (it’s still unclear that any will) – and he should learn from one of Starmer’s weaknesses and clearly communicate when that is the case and where and why he’s focusing attention. 

Burnham should keep the best bits of Starmer’s reforms

The Starmer government also launched a huge number of reform programmes across public services. Common themes have emerged across departments: ministers have set out major structural reorganisations, frequently involving the consolidation of subnational organisations and often with the justification of saving “back office” costs. They have also tended to centralise powers in ministers’ hands.

This also constrains Burnham’s options. Structural reforms will consume a lot of time and attention. That isn’t to say he should reverse course. Some reforms are so far down the line that it would be damaging to stop them, regardless of their merits. Halting the abolition of NHS England, for example, would only cause more uncertainty and distraction.

And Burnham should look to build and expand on a number of positive developments, including the progress towards a more preventative children’s social care system, the vital rebalancing of local government funding and the right approach to sentencing reform. Elsewhere, the vagueness of some reform programmes – for example the community and prevention shifts in the NHS – mean that Burnham can imprint his own priorities on an agenda that is has momentum, but that is in need of more purpose or direction.

Burnham should learn from Starmer’s mistakes and omissions

The IfG has been critical of the Starmer government’s lack of a coherent direction on public service reform, which has left departments and ministers chasing their own priorities, without considering how the system should hang together as a whole. Uncoordinated structural reforms across departments mean that the government is moving services from one unplanned system to another.

Burnham has an opportunity to correct that mistake, but with choices constrained he will need to have a clear vision for what he wants services to achieve and consequently how they should operate. His ambition to extend devolution, including further responsibilities for public service reform, is a good organising principle for how services should operate – and the direction that Greater Manchester Combined Authority is taking could provide a blueprint for a Burnham reform agenda. But for it to work effectively he needs to ensure that all Whitehall is pushing in that direction. That requires stronger coordination from the centre of government.

The new prime minister should identify areas where he can bend the path of current reforms closer to his own goals.

A pressing priority should be aligning the boundaries of local services. Burnham will find it much easier to realise his devolution vision if NHS, local authority, mayoral strategic authority, and police boundaries line up. A better designed system will reduce the complexity of cooperation and create common objectives. But ongoing subnational reorganisations are not prioritising alignment. Burnham should pause the restructures and push for a better designed system. That won’t be easy. Each department will plead special status as to why they should be allowed to stick to their preferred footprints. But trading off competing demands is exactly what Starmer failed to do.

The outgoing prime minister leaves his successor with a better inheritance than the one he was handed in 2024, but he also missed his chance to meaningfully and effectively reform services. Andy Burnham must learn from Starmer’s mistakes if he is to seize the opportunity to push services in a better direction.