Start rebuilding, Keir Starmer, and show us you’re different from the last group of cowboys | Isabel Hardman

IWill this really be the year in which the government ‘gets things done’? Labeling it a ‘year of rebuilding’, Keir Starmer is getting back to work with a series of announcements that he says show the government is serious about overhauling the NHS. Tomorrow he will unveil a health recovery plan that he hopes will be received as a radical overhaul – and a sign that he is on the right track after a rocky start to his premiership.

The changes include allowing patients to self-refer for tests and scans, as well as consultations on the same day as those tests, so they can continue with treatment or have reassurance that nothing is wrong. There are also changes in the way surgeries are scheduled so that hip and knee replacements are not routinely canceled during winter crises.

That’s all well and good, but Starmer’s first act in his rebuilding year was to delay addressing one of the greatest failures of modern public policymaking. By setting up a long-term commission to set up a national health service that won’t report until 2028, the Prime Minister risks looking more like a builder who shows up when he feels like it and leaves the site under a tarpaulin for months . at the same time.

Social care is an extreme example of the policy problems that Labor needs to do some serious rebuilding work on: successive governments have produced towers of documents in the form of committees, task forces and even manifesto proposals, all of which deliver very little in the form of concrete proposals. reform.

The 2028 deadline for the final report seems almost deliberately designed to prevent meaningful reforms and place blame on the other parties for not helping. We know from Andy Burnham’s experience in 2009 what happens when a government does that cross-party conversations about social care reform who come to a conclusion shortly before the elections: the consensus turns out to be false, the parties turn against each other and use the proposed reform as a means of attack, with a terrifying slogan such as the ‘death tax’ – or even the “dementia tax” which Labor itself campaigned against in the 2017 election. Politics hasn’t suddenly changed since then to everyone holding hands and singing Kumbaya, so it’s not clear how trying a commission with interparty talks will work out again this time.

If Labor does not want to give urgency to social care reform, it will struggle to deliver the party’s desired improvements to the National Health Service. I say “whatever” because we don’t really know what those changes are either, beyond the kind of rough draft that no decent builder would accept as a plan. We know that ministers want to shift resources from the acute sector to preventative and community settings, but we won’t know how until this spring.

Starmer and the Chancellor Rachel Reeves went from emphasizing that there would be “no more money without reform” for the NHS to announcing £22.6 billion for the health service in the Budget – with no further details on the reforms needed. These will not arrive until a “national conversation” has taken place about how health care needs to change.

Both this conversation and the cross-party talks on social care, due to start next month, are largely focused on gaining public and political support for the plans the government ultimately pursues, rather than coming up with new ideas that are of no use to anyone thought. from yet.

If the ‘national conversation’ does not lead to a clear plan put into practice by the end of this year, then it will not be unreasonable to suggest that Starmer and his ministers are not taking their big plans very seriously. reconstruction project as they claim.

Real reforms take a long time to implement and even longer to deliver results, which means there is also a political reason to pursue them now. By the time of the next election, Labor should have signs of solid progress that can be shown to the highly volatile electorate as proof that it is worth staying with the party for a second term to complete the rebuilding project, rather than of turning to someone else in the hope that they would do better.

It’s not just in the NHS and social care that this is the year to get on with building work. Ministers have started talking about their general intentions for welfare reform, but have so far only provided outlines on how benefits should work differently, and no details. Getting people back to work with the skills they need is an essential part of growing the economy, rather than a fun side project for this government.

Dissatisfaction with the welfare state and the labor market is often reflected in voters’ anger over uncontrolled immigration, both legal and illegal, meaning that this year should be the year that the regular but piecemeal announcements about destroying the gangs and reducing dependency on employers abroad will take place. employees are connected in meaningful strategies.

Immigration is not a side project either: there is now a populist alternative in the form of Reform UK, which poses a real challenge to both Labor and the Conservatives in ‘red wall’ areas. Right-wing politicians are undoubtedly guilty of pushing this issue, but it is also true that those who have honestly looked at the current problem have concluded that the system as set up does not allow a government to control its borders – unless they are for the kinds of changes that Starmer has already ruled out, such as violating the international legal framework of the European Convention on Human Rights (ECHR). Voters are unlikely to give them honor for their moral fortitude.

The justice system, which is as overlooked and beleaguered as social care, has been on its knees for years, and is once again something Starmer has loudly complained about from the opposition. That of the government sentencing reforms will need to be accompanied by proper investment and reform in the rehabilitation of the prison system so that those incarcerated get more than a prison library with a few dog-eared books they can’t read and too few staff to open their doors for exercise every day.

Those at the sharp end of the justice system – the victims of crime – also need to feel that the government has not forgotten them, as increases in national insurance contributions for employers, coupled with cuts to funding for victims’ charities , mean that the sector has serious difficulties to remain operational. Ministers insist that more details will emerge about how victims will be supported this year: at the moment the sector is holding its breath and hoping to have the wrong idea about what a Labor government means for the people they helps.

Starmer has a lot of confidence in himself as a politician who is better than the Conservative leaders who came before him and who knows how to run a public service. Most people on the left sincerely believe that they came into politics with a moral mission, and that the right lacks the compassion and ethics to rebuild the country. It would therefore be a particularly uncomfortable experience for Labor backbenchers if the Conservatives are able to establish a narrative in the coming months that Labor will not continue with the things MPs entered politics to do.

Letting down the NHS, leaving vulnerable people without the social care they need and deserve, cutting the winter fuel payment, failing to deliver on promises to Waspi (Women Against State Pension Inequality) women and charging of taxes on charities and hospices: these are not the things we should be doing. for which Labor MPs were elected. You can imagine Starmer’s response to Conservative leader Kemi Badenoch as she says that, pointing out that the Tories have also done absolutely nothing to protect vulnerable people. That might remind the Conservatives how much work they still have to do before they are eligible again, but it’s hardly inspiring to rally the troops behind the Prime Minister, since it’s essentially him saying, “Yes, we’re a bit of nonsense. , but you were worse.”

Starmer really enjoys the ‘you were worse’ line of attack, like a builder complaining about the last bunch of cowboys. But this is the year he has to prove that he can actually continue the construction work and not just talk about it. If at the end of 2025 he is still keeping his plans under a tarpaulin and blaming the latter party, it will be much more difficult to convince voters that they have chosen the right builder when he asks them to join him in the next elections to stay. Before then, his own MPs will be seriously worried if they start to believe the Conservative attack that they are not rebuilding the country for the people who need them most.