Andy Burnham: You Ask The Questions

The Labour MP for Leigh and Secretary of State for Health answers your questions, such as 'Why aren't nurses paid a living wage?' and 'Shouldn't you abolish targets?'

Do Labour's wars against smoking, drinking, and eating fatty foods amount to a New Puritanism? Peter Fletcher, Reading

Not at all. People should be free to make their own choices, even unhealthy ones. But the Government does have a role in encouraging informed and healthy choices, particularly when there are such worrying trends in lifestyle-related diseases. There is a fine line, though, between helpful advice and finger-wagging. I accept that, at times, we have got the tone wrong and it has looked like we enjoy doing the latter – which I can assure you I don't and, though I can be accused of being many things, a Puritan is certainly not one of them! Our response to all this is the Change4Life campaign – a new, more positive approach suggesting what people should rather than shouldn't do.

Is addiction a moral or medical problem? Why should I pay for the treatment of addicts? Duncan Cobalt, London

It's both – but it's very dangerous to start applying moral judgements to the provision of healthcare. Life is complicated and there are many reasons why people make what others might see as wrong or unhealthy choices. I am very uncomfortable with the idea of withholding treatment for problems perceived as self-inflicted. That would fundamentally alter the character of the NHS where need alone determines treatment. The simple answer to the second question is that for every £1 we spend on drug treatment there is a saving of £9.50 to society. Effective treatment saves money, saves lives and builds safer communities. Drug-related crime has fallen by 22 per cent since 2003 largely because of the increasing numbers of people entering treatment.

How can the state possibly justify spending money on quack medicine like homeopathy? Helene Seddon, Bromsgrove, WORCESTERSHIRE

Say what you really think, Helene! I can see where you're coming from but there are other people who feel equally strongly the other way. As a percentage of overall spending, the NHS doesn't spend a great deal on alternative treatments such as homeopathy. I believe that these things are best decided at a local level, by doctors and patients rather than politicians. If people believe that a treatment is helping them, then, surely, that is important.

Doesn't Tory policy on abolishing central targets seem the most effective way to end NHS bureaucracy? Patricia Newling, Lincoln

I am now genuinely confused about Tory policy. Up to now, they have said they would replace target with new "outcome" measurements, which sounds bureaucratic itself. But, at the weekend, Andrew Lansley appeared to perform a fairly major U-turn when he said he would ensure the NHS continues to focus on treatment times. That is exactly what our targets do, particularly in areas like cancer treatment where time is critical.

Our two-week urgent referral target to see a cancer specialist isn't pointless bureaucracy – it saves lives. We will turn this target into a cancer guarantee, alongside a new one-week pledge for people to get the results from tests for cancer. The Tories are trying to have it both ways. They need to spell out urgently whether they will keep our cancer guarantees or cut them.

For me, targets represent the basic standards that every patient should be able to expect in a national service. Our four-hour A&E targets ended the scandal of people waiting on trolleys for hours on end. A recent study by the Nuffield found they have played an important role in improving standards in England. Removing them is a recipe for a return to postcode prescribing.

If government spending on health rose fastest since 1997, shouldn't your department bear the brunt of impending cuts? Charlotte Tusk, Oxford

No, because the NHS was under-funded a decade ago and the increases you mention were needed to put it back on its feet. Health spending is now close to the EU average and it needs to stay there. But it is the case that the era of large catch-up funding growth is over. The challenge is to get more from every pound by rethinking how we deliver services and taking more services out of hospitals.

Given your support for nationalised medicine, will you come off the fence and say the behaviour of the Republican Party in America is a disgrace? Wendy Samuelson, Boston, US

There have been some ill-informed attacks on the NHS during the US healthcare debate from right-wing politicians on both sides of the Atlantic that are nothing short of disgraceful. Over here, a recent Tory poster on social care using gravestones imported some of the worst kind of campaign techniques from your debate. In time, President Obama will be shown to right. Over the last century, the British right was comprehensively defeated in the intellectual battle on health policy. They vigorously opposed the creation of the NHS, and were ambivalent about it for years, but have only recently become converts because they recognise the overwhelming public support the NHS has.

Why are so many nurses not paid a living wage, while bankers bailed out by nurses (among others) are making multimillion-pound bonuses? Dani Ralph, Manchester

Nurses are paid a living wage – thanks to Labour. That was certainly not the case in the mid-90s. The current minimum starting pay for newly-qualified nurses and midwives is over £20,000 – up by 24 per cent – almost a quarter – in real terms since 1997. Today, there are also much better opportunities for career progression, to become specialists, matrons and consultants. More broadly, we have already set an NHS minimum wage of £6.77 an hour – 17 per cent above the national minimum wage.

Several hundred thousand long-term illegal immigrants in this country would happily work in the NHS on a low wage (some already do). Why not give them the chance to do so legally? Joseph Scudamorem Ipswich

Because there are many other people who would also like the chance to work in the NHS, particularly young people who may have struggled to find work recently. Since coming into this job, I have placed a new emphasis on providing more apprenticeships in the NHS. In the last year, we have increased the number from 1,000 to 5,000 and I'm very proud of that. As the country's biggest employer, I think the NHS has a responsibility to lead and show good employment practice.

Isn't the directing of Health Department funds to Labour constituencies over Tory ones basically corrupt? Tamara Wilkins, Southampton

It would be if that was what we are doing, but it isn't. It is morally right to target health resources to need and we have an independent working group to advise us on a formula to do this. We think we have got the balance about right – but the Tories have recently said they would give even more money than us to "deprived areas". I asked the Tories weeks ago for a list of the PCTs that would be winners and losers under this new policy. I'm still waiting.

Did Gordon Brown abolish boom and bust? Serious answer please, including a "yes" or "no". Naomi Fugge, Barnsley

If you look at Gordon's decade as Chancellor, from 1997 to 2007, you would be hard-pressed in history to find a similar sustained period of stability and growth in the British economy. So, yes, I think he did break a debilitating cycle that had been present in the British economy for decades. No economy in the world has been immune from the problems that began with the credit crunch, and, as we know, they did not start here.

Will you put your name in the hat to lead Labour after the election? Neil Farrow, London

Neil, there are two problems with that question: (a) it assumes I will hold my seat in Leigh, and no MP should be taking anything for granted; (b) it assumes Labour will lose the Election and we're not going to lose.

Have you ever been bullied by Gordon Brown? Or had the "forces of hell" unleashed on you? Iris Upton, Warwick

I have received nothing but tremendous personal support from the PM in all the jobs I've done. My only quibble was the time we both spoke at a sport conference. He told the audience that Everton Football Club should be charged under the Trades Descriptions Act for having a Latin motto that reads "Only the best is good enough". I thought that was a bit uncalled for.

Who was your political hero growing up, and which figure from the Tory benches, past or present, do you most admire? Jane Kitson, Sheffield

This might be career-limiting to say but, as a young teenager, I was very taken in by Derek Hatton who in the early 80s seemed to be on the North-West news every night taking on Maggie. But I grew out of it and looked up to Neil Kinnock, who I think was one of the most inspirational speakers that the Labour movement has ever produced. Red Wedge also had an impact on me and Billy Bragg remains a political and musical hero. On the Tory side, David Mellor has always been a great friend and help to me. I have also got a great deal of respect for John Major and what he did to lift the place of sport on the political agenda. You can't help but admire someone who on leaving No 10 goes straight to the Oval to watch the cricket.

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