Symptoms of polycythaemia vera (PV)

How is it treated?

Andy Burnham delivers his first speech as Prime Minister (Xinhua/Alamy)

4 min read57 min

That responds to one of the biggest challenges Sir Keir Starmer’s government faced. But the voters who put Labour into office do not feel they have benefited greatly during its two years in power. Delivering serious economic change – and ensuring that its own voters actually feel the benefits – will therefore have to be at the heart of Burnham’s premiership.

One of the key benchmarks we track at Opinium is how people describe their own financial situation. This measure is fundamental to understanding the cost of living crisis: do people feel comfortably off, are they coping, or are they struggling financially? Before the crisis, more than half the public described themselves as comfortably off, with the figure reaching 57 per cent in one poll in 2021.

The spike in inflation was the catalyst for the crisis. But lower inflation does not reverse the damage or return prices to where they were. It is therefore no longer a particularly useful measure of whether the crisis is over. It is over when people feel it is over, and that is when people feel comfortable again.

The real nadir in our polling came in March 2023, when just 24 per cent said they were comfortably off. The story since then has been one of painfully slow improvement, leaving us nowhere near the days when most people felt things were going OK.

By August 2024, shortly after the general election, the proportion comfortably off had edged up to 29 per cent. In our latest polling, it has reached 36 per cent. But set against the 57 per cent recorded five years ago, it also means that roughly 10 million people who once felt they were doing OK no longer do.

The particular problem for Starmer’s government was that the improvement did not especially benefit its own voters. Economic performance is a key measure of government success, and most people experience ‘the economy’ through their own financial situation.

Just after the election, 32 per cent of Labour voters felt comfortably off. That has edged up to 37 per cent: an improvement of five points, but one that has not even kept pace with the national recovery, which is itself already slow.

Contrast that with other parts of the electorate. Among people who voted Conservative in 2024, 51 per cent now feel comfortably off, up 12 points since the election. Among Liberal Democrat voters, the figure is 48 per cent, up 13 points. Even 2024 Green voters – who started as the least comfortable group – have seen a 12-point rise, to 35 per cent.

Labour therefore ended up in a strange position: Conservative, Liberal Democrat and Green voters have seen faster improvements, while the Labour voters who put the government into office have seen much less progress, and have been leaving the party since the election.

Labour voters who put the government into office have seen much less progress

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The only voters faring worse are those who voted Reform in 2024: just 35 per cent now feel comfortably off, down one point since the general election. This makes them the only group to have seen no improvement and reinforces Reform as a repository of anti-Labour sentiment.

That is the real challenge for Burnham. His pledge to deliver “good growth in every postcode and hope in every heart” suggests that he gets it. It is a political narrative that fits the scale of the problem and, crucially, recognises that national economic progress alone will not be enough.

The test is whether the government can turn that pledge into improvements in people’s disposable income. Voters will judge it through their wages, housing costs, energy bills, food prices, childcare and taxation – the things that determine what is actually left in their bank accounts at the end of each month. Growth may be part of the answer, but abstract economic growth (even regionally rebalanced) will mean very little politically if the households who put Labour into office continue to feel stuck.

Burnham will therefore be judged on whether he can do more than tell the right story. He will have to improve the day-to-day lives of the people who put Labour into office in the first place. The cost of living crisis will not be over because inflation has fallen or a national growth statistic says so. It will be over when those voters feel the recovery themselves. 

James Crouch is head of policy and public affairs research at Opinium

9 min read1 hr

Andy Burnham, say friends, runs towards problems, not away from them. In making social care reform a priority, the new Prime Minister is certainly doing that – he is charging straight at one of the most intractable issues in British politics.

Four previous efforts at reform in the last two decades have foundered. Public understanding of the issue is limited, indeed even experts can’t agree which of the series of interlocking problems is the most urgent. Is the main problem the ruinous consequences for some of having to pay catastrophically high care costs, usually in later life? Or that the creaking sector is a potentially fatal drag on the NHS? What about the huge skill shortages? Or the ever-increasing costs of caring for working-age disabled people now living long lives thanks to improved medicine?

The only point of agreement so far is that cutting this Gordian knot is going to require a very expensive knife. With no appetite for additional taxation, and borrowing levels already nudging the UK into the sights of bond vigilantes, it takes a bold leader to decide that this is the moment for another crack at social care reform.

Wes Streeting didn’t think it was worth an early fight. As health secretary he announced a National Care Service but then set a 10-year timeframe on defining what that meant.

Burnham has picked up the structure of that effort led by Louise Casey but wants to turbocharge the process.

Baroness Casey’s Independent Commission on Adult Social Care will now report a year earlier.

A ‘national conversation’ that seeks to engage voters has been launched, while at Westminster Burnham has initiated a fresh set of cross-party talks.

“There is a massive public job to be done to explain just how ungenerous and how unfair the current system is,” Sebastian Rees, a principal research fellow at the Institute For Public Policy Research, tells The House.

Rees believes this was a key barrier to Theresa May’s ill-fated proposals in 2017, branded as a “dementia tax”, which she was later forced to abandon. While Rees argues that May’s reforms were “relatively generous and relatively well thought through”, they ended up collapsing after her party failed to make the case to the public that the current approach was “disproportionate and unfair”.

“But if people don’t believe that to be true, then advocating for reform is very, very tricky.”

This plays out in the figures. Research by Ipsos published last year revealed that nearly one-third of the public mistakenly believe the NHS provides the majority of social care services for older people, with a similar figure incorrectly believing that social care is free at the point of need.

Labour MP Anna Dixon, who has spent the majority of her career so far working on the issue, agrees that the conversation needs to be approached from a different direction this time around: “This touches on so many people, and that’s the point that we keep failing to get across – that this is not something over there that affects a few people. Caring one way or another impacts us all, either at some point in our lives needing care, or giving care.”

Dixon tells The House that she hopes the groundwork being done now to build cross-party consensus will protect any progress that is made from party politics.

“I hope there will be a Labour government to see this through. But just making sure that there’s enough groundwork being done, enough consensus built, that if there were any change in government, that the progress wouldn’t be reversed and halted or put off as we’ve seen has happened before.”

Two sets of cross-party talks had already taken place with Casey under the Starmer administration. Liberal Democrat spokesperson Helen Morgan tells The House that while they were “broadly helpful”, she is not convinced that they moved the conversation forward, describing them as a “general talking shop”.

The House understands that there will now be quarterly cross-party talks for both health teams and leaders separately. The former will next meet after Parliament returns from conference recess in October, and party leaders will do so the following month. It is understood that Casey will attend the talks with the shadow health team, while Burnham will join the Baroness for the leader talks.

As Conservative health spokesperson at the time, Stuart Andrew attended the first cross-party talks on behalf of leader of the opposition Kemi Badenoch. Speaking to The House before he was shuffled out of his shadow cabinet role, Andrew – who almost lost his seat in 2017 over May’s “dementia tax” proposals – thought that the dual approach being taken would encourage real reflection, allowing leaders to bring key discussion points they have considered with their health teams between the meetings, sharpening the focus.

While the talks are well-intentioned, there will be concerns that leaks and briefings could lead to them quickly breaking down. Andrew insisted the wish of the health teams was that any talks would not be leaked, allowing them to take place without fear that ideas would appear in the headlines the following day.

Andrew argued that “outlandish ideas” can sometimes breed a feasible and workable solution.

But without the confidence to be frank and open in these discussions, he did not believe parties would be able to “really get into the weeds”.

There is a massive public job to be done to explain just how ungenerous and how unfair the current system is

The shadow health secretary was positive about Casey’s ability to manage the talks and move the dial, praising the peer for visiting the constituencies of each health spokesperson to talk about social care in their area. Andrew believed first principles for reform would be discussed once Casey returned to the health teams with more information gathered.

He said Casey was working with a big team, including many individuals she has worked with for years. While the peer has been visiting constituencies, Andrew said her people had been going further afield as part of their work on the commission.

Working closely with government on the talks could be seen as a real opportunity for the Liberal Democrats. But The House understands that there is concern within the party that people don’t see raising taxes as translating into better outcomes. Working in coalition with other parties has not, of course, ended well for the Lib Dems in the past.

Speaking to The House, Morgan says the party is open-minded but makes clear there are red lines. “We wouldn’t sign up to anything that we thought would be damaging in the future,” she says, clarifying that this would apply both to the party and the country.

Morgan says the Lib Dems will be approaching the talks with three tests: reforming the carers’ allowance; a universal safety net, including free personal care; and protection from catastrophic costs, so that people aren’t faced with having to sell their house to meet their care needs.

When the cross-party talks were announced in July, Reform UK was not included, and while the party voiced anger at its exclusion from the talks, arguably such a move by Burnham could suit it well. 

While former MP and Tory defector Anne Marie Morris was brought onto Reform’s shadow team to carry out a social care review, she has now left her role. It is unclear how much progress, if any, was made on the area. The role of health spokesperson has also taken a back seat after David Bull took up a role at Talk TV and was made party chairman.

A source close to Reform tells The House that the party would be reluctant to touch the policy area due to the NHS attack line – one of the few levelled at the party that has stuck.

Louis O’Geran, external affairs manager at More in Common, also points to Reform tensions over the economy, an area over which the party’s voter base is split. He argues that the party “has to straddle this really awkward coalition when it comes to the economy, which is why on questions like this you tend to get split right down the middle on issues of taxation”.

Taxation is also a matter of contention for the Tories and one they made clear from the start.

Rees believes that cross-party talks can only take the country so far on the road to reform. 

“The biggest barrier is some sort of consensus on the funding model and the approach to funding is ultimately the thing that always brings down social care reform, and it probably calls into question trying to do this through cross-party consensus,” he says.

“My retort, whenever I hear, ‘You need different parties on board for this’, is if you’d taken that approach with the foundation of the NHS, we never would have had an NHS because at some point it requires some political bravery.”

Another sticking point for Burnham is how this all fits with his ambitions for devolution, Rees argues. While the conversation around public services has been very much geared towards moving decision making out of Westminster, the tide when it comes to social care seems to be moving the other way.

“Where we’re going with social care reform looks quite centralising: we think it should be a universal entitlement, we think everyone should be supported more, and there should be some national standards. And it will be difficult to tease out how you negotiate some of those tensions and trade-offs.”

In his first major speech as Prime Minister, Burnham said the failure of past governments to grasp social care reform had been a “major dereliction of public duty”, adding that it was “shameful that politicians have put point-scoring before fixing this issue”. 

Time will tell whether Burnham becomes yet another prime minister whose efforts to reform the system are resigned to a footnote in the history books. 

What Is The AfD?

Was This Local Election Result Particularly Shocking?

How Has The Rest Of The World Responded?

Why Does This Matter?

What Happens Next?

(Jonathan Goldberg / Alamy)

4 min read40 min

A new survey by Unite’s Parliamentary Staff Branch found that 70 per cent of staff respondents reported having to dig into savings or use credit to cover everyday expenses in the last year. A total of 96 per cent said their financial situation was causing them stress and anxiety.

One MP’s staffer told Unite in their April 2026 survey that they “struggle to afford to eat, especially near the end of the month”, while others reported keeping their home heating switched off and taking cold showers to keep their bills down.

The Independent Parliamentary Standards Authority (IPSA), which allocates the budgets through which MPs pay their staff, insisted they “recognise the dedication” of staff and “continue to work closely with and respond positively to recommendations from unions”.

Unite’s survey was circulated to the office of every MP in Parliament, with 346 responses received from staff from every region and nation.

The survey found that staffers aged 18–24 have an estimated average salary of £32,229, compared with £39,676 among those aged 31–35. One staffer told Unite: “There is a complete lack of awareness of how difficult it is for younger people these days… little recognition of how low these salaries are in a time of high inflation and cost-of-living.”

Unite warned that low pay was having a “severe impact on work that staff are able to deliver”, and that there was also a “cost of high turnover to the public purse”, as MP employees seek better paid and less stressful jobs.  

“Unpaid overtime is how offices keep going,” another staffer told the union. “We all do it, we do it because we care, but we do it because we have to as well, as so many of us are overwhelmed.”

According to Unite, an automatic pay uplift for MPs’ staff was successfully negotiated in 2021, but since then inflation when measured using RPI “has consistently outstripped the annual pay awards”. Unite claims that on average, MPs’ staff would now require a 10.57 per cent pay increase simply to restore the purchasing power of their salaries to 2021 levels.

Earlier this year, Unite’s Parliamentary Staff Branch overwhelmingly voted to reject a 3.5 per cent pay offer, but Ipsa refused to improve it. Ipsa points out that MPs employ their staff – not Ipsa – and Ipsa therefore does not have the power to set exactly how much they are paid.

Ipsa instead provides an automatic uplift to MPs’ staff pay, unless an MP opts out from it, though MPs can also choose to award higher increases if their staff budget – set by Ipsa – allows.

Staff were angry that MPs were themselves awarded a higher pay increase of five per cent, with one staffer telling Unite: “It is not the MP answering the phone to angry constituents, it’s not the MP sitting in the constituency office all day where people may drop round unannounced and it’s not the MP managing huge levels of casework and correspondence.

“Our pay is no longer reflective of the difficulties and pressures experienced by those of us in public facing roles.”

Fintan McDonnell, vice chair of the Unite Parliamentary Staff Branch, said the union’s survey “should shame Parliament into action”, adding: “Behind every constituency office and parliamentary office are workers who keep our democracy functioning and support constituents through some of the most difficult moments of their lives. Yet many of those workers are now struggling to survive themselves.”

Responding to Unite’s findings, an Ipsa spokesperson told PoliticsHome: “We recognise the dedication of MPs and their staff, and continue to work closely with and respond positively to recommendations from unions, the Wellness Working Group, and other staff representative bodies to ensure we understand how we can best-support the people who work in MPs’ offices.

“We have recently consulted on the framework for setting MPs’ budgets, seeking feedback on the principles which should guide our decisions. The feedback we have received will be considered as we put together MPs’ budgets for the next financial year.”

They added: “We have also received feedback from some offices about the impact of rising and increasingly complex casework, alongside safety and security concerns, on the wellbeing of MPs’ staff. In response we have introduced additional, dedicated funding to support those offices facing particular pressures, alongside a ring-fenced training and wellbeing budget.

“We also have a separate budget which funds workplace adjustments for MPs’ staff in constituencies, as well as for MPs, volunteers, job applicants, or constituents visiting offices or surgeries.

“Ipsa’s role is to balance the resources MPs and their staff need with public confidence in how those resources are used.”

5 min read34 min

It is early 2011, a few months after I had joined the crossbenches in the House of Lords. The place? The grand staircase linking the cloakroom with the Principal Floor. The company? A pair of young naval officers who had come in for a cup of coffee and a chat.

The conversation ran like this.

Naval officer: “What makes the House of Lords run?”

PH: “I’m too new to answer that?”

At that moment Maurice Peston (old friend, Labour peer, distinguished economist, Robert’s dad) passes us in the opposite direction.

PH: “Ask Maurice. He’s been here for years.”

Maurice obliges without hesitation.

MP: “The House of Lords runs on gossip and the exchange of symptoms.”

Perfect. To the point, accurate, very Maurice.

I shall miss all that this autumn. I retired at the end of June. The Parkinson’s sapping and mining the old cognitive powers means I can no longer manage the reading and thinking required to do the job properly. The ‘symptoms’ have put paid to the ‘gossip’ – though I live in hope of the occasional weapons-grade morsel coming over the phone.

The job? Lawmaking plus scrutiny, plus running commentary on the government of the day.

Room for improvement? Certainly – one activity in particular. The Lords’ use of their select committees. The red benches are brimming with men and women who have been around the block a bit. It is vital for the country – never more so than in these anxious times – that the accumulated wisdom of the past is applied to the needs of the present and placed at the disposal of the future.

There are at least five previous political generations stockpiled in the Lords. That is a great deal of experience on which to draw. For a political historian of modern Britain, it was pretty close to heaven. You could even have lunch with your exhibits. On these fronts, not least as a provider of continuity and context, the Lords provides in some abundance, but rarely is there a flicker of it reflected in the media coverage of Westminster. The output brims with insight and utility, but what use is that if it is also shrouded in invisibility?

An institution that could be a very fine rolling think-tank for the nation, especially on the many knotty intractable problems and on scientific and technological matters in particular (we have many more experts here than in the House of Commons), the output is not, I fear, reaching those parts of policy, analysis and remedy that it could do. It’s as if the institution has become a slightly embarrassing relic of a past age. Alf Dubs warned me about this in, I think, my first week as a crossbencher. “Remember,” he said, “we’re all on a farewell tour in here.”

We have lived all our lives so far inside a comforting cocoon

There is nothing more irritating than hearing a retiree preaching to those he has just left behind. But I went one step further in my valedictory speech when I asked the members of the Constitution Committee on which I once sat to undertake a special inquiry into the vulnerable points of our unwritten constitution to a future authoritarian government uncaring of – or hostile to – the conventions that enable our constitution to work, day in day out.

Especially pertinent are those human ones that are not written down but together comprise a ‘good chaps theory of government’ (to quote the phrase minted by an old Cabinet Office friend, the late Clive Priestley). To my great relief and intense appreciation, the Constitution Committee is already at work on this under the leadership of Lord Strathclyde.

In my farewell speech, and in a BBC Radio 4 programme I subsequently made with Giles Edwards, I linked the work of the Constitution Committee with a ‘politics of decency’ which we need to succour as our great protection against any future creeping authoritarianism in our politics should, heaven forbid, a politics of pessimism deteriorate still further into a politics of despair.

I think such a descent into darkness is highly unlikely as the future course of our politics and our conduct of public life. But it could happen here. We have lived all our lives so far inside a comforting cocoon – a conviction that our host of often informal, usually unwritten conventions, took care of all this as it if were a state of nature that would see off any such threats that, for the first time in my life, I am not so sure.

We owe it to our children – and to that now gone early postwar British generation that gave my age group (born in 1947) such a splendid start in life – not to let it happen here through insouciance or indifference.

And that is why, in the end, I am optimistic. Most of the time, constitutional questions languish in a deep torpor in terms of public attention. Now is the moment for them to move into the front line of our concerns with the House of Lords and its Constitution Committee in the vanguard. 

Lord Hennessy is a former Crossbench peer

Peter Hennessy, with Giles Edwards and Andrew Blick, The Politics Of Decency, Haus publishing (forthcoming)

The inclusion of outdoor learning, nature and adventure in the new school Enrichment Framework is very welcome. As are the references to access to nature, outdoor spaces and adventure activities in the new Youth Strategy.

There isn’t a subject on the curriculum that can’t be enhanced by outdoor learning because learning in and about nature can re-engage learners with education itself, especially those that struggle in a traditional classroom environment.

Outdoor and adventure learning can simultaneously deliver curriculum outcomes, whilst building employability skills, supporting wellbeing, and connecting young people to real-world contexts and environments.

Outdoor learning works. Numerous government funded projects over many years have demonstrated the benefits time and time again. From London Challenge through to Nature Friendly Schools and more recently Generation Green 1 and 2 we’ve seen life changing results.

However, these benefits are still not a guaranteed part of every child or young person’s education. Funded projects are always welcome, as is their focus on the most disadvantaged learners, but piecemeal funding cannot meet the demand.

Those that would benefit the most are often at the highest risk of missing out. There is a risk that outdoor learning experiences are rapidly becoming the preserve of only those who can afford it.  That’s why this charity fully supports Caroline Voaden’s Outdoor Education Bill which aims to guarantee outdoor learning residentials as has happened in Scotland.

The bill is timely as we await Milburn’s recommendations from his Young People and Work review, following his stark warning of a lost generation unless urgent, systemic reform is undertaken.

That’s because outdoor, nature-based adventure learning also has a distinctive role to play in reducing NEETs. It rebuilds confidence and reduces anxiety whilst re-establishing a sense of competence and belonging. Confidence, resilience, and real-world capability matter to those taking their first steps on the career ladder as they transition to adulthood. “I didn’t learn to avoid uncertainty. I learned how to move through it” said a Year 10 Pupil.

It is also, by design, relational. It relies on trusted adults, peer collaboration, and shared challenges. In a system described by Milburn as fragmented and impersonal, that relational dimension is essential. As one student put it “It wasn’t a teaching leading us, it was a teacher helping us lead ourselves”.

Across our network of field centres, we are already delivering the kind of integrated, skills-focused provision that Milburn’s review calls for.

Outdoor and adventure learning must move from the margins to the mainstream – an entitlement, not an optional extra.

This charity is asking Government to publish the delayed Access to Nature Strategy from DEFRA and then work with DfE and DCMS and any Milburn recommendations to pull the policy threads together into a coherent outdoor adventure learning offer for all young people. Yes it will cost. Our 2 night +Adventure residentials start at less than £200, but if we are serious about tackling the truly staggering financial and social cost of rising NEETs, bold action will be needed.

Find out more at https://www.field-studies-council.org/adventure-residential-trips/ or contact [email protected]