Our health ‘policy tracker’ reveals the challenge Burnham faces to build a healthier nation

In his first speech as Prime Minister, Andy Burnham called for a ‘preventative state, investing in people’s success, rather than paying for failure’. It’s an ambition we wholeheartedly support. Burnham’s Labour and Conservative predecessors all argued that more should be done to address the root causes of ill health, and there is little dispute about the scale of the problem – six charts we recently published show sharp falls in healthy life expectancy, UK life expectancy falling behind international peers, and deeply entrenched inequalities in health. This has serious implications for the economy and the sustainability of public services, as well as for the millions of us whose health is worse than it should be.

Yet the new government’s plans are being built on the foundation of policy action – and sometimes inaction – that it has inherited. Our new Health across government – policy tracker assesses ambition and progress across 14 policy areas that shape our health beyond the NHS and social care, based on a snapshot of their status on the last day of Keir Starmer’s premiership.

Our health is shaped by a wide range of factors, from the jobs we do, to where we live. These building blocks – the ‘wider determinants of health’ – are influenced by government policy, which is why many government departments have a part to play in improving our health; for instance, policy on employment and social security, as well as housing and the role of local government. 

Our tracker looks at health-influencing policies that sit outside of the NHS and social care to understand how their ambition and delivery measure up. It covers the overarching ways that government is organised (funding, oversight and the role of local and regional government), the wider ‘building blocks’ (like housing and employment) that support health, and risk factors like tobacco or alcohol use that reduce our chances of a healthy life. 

It paints a picture of a few successes against a backdrop of limited progress in many areas, hampered by the lack of a clear strategy to create a healthier country.

Policy on health across government: what has Burnham’s government inherited?

When it entered government, Labour promised a ‘mission’ for health that would take a long-term, cross-government approach. And while there have been various health plans, there is still no health improvement or inequalities strategy that sets out what a healthier country looks like or how we should get there. The new structures developed to deliver the health mission have largely been wound up. Intentions to shift to a more cross-cutting and preventative approach to public spending have not yet been fulfilled, despite analysis showing that restoring health to 2014 levels could unlock economic output equivalent to 2% of GDP, as well £72bn of public finance capacity via increased tax and lower demands on spending. 

More positively, English regional devolution has progressed, with new duties for strategic authorities to consider health and health inequalities. Despite continuing challenges, local authorities have new outcomes frameworks that take a holistic view of health, and a multi-year funding settlement has provided greater certainty. The role of local and, particularly, regional government is of great interest to the prime minister, so it will be interesting to see how this develops in the coming months. Yet, even in a ‘devolution-first’ world, the responsibilities – and budgets – of Whitehall departments mean that central government will continue to have a crucial role for health, even if this does evolve to focus on supporting and empowering action elsewhere.

The picture is more mixed on progress in policy areas like housing and employment, the wider ‘building blocks’ that support health. While there have been good levels of ambition, challenges remain around delivery in some areas. For example, we’ve seen significant action on renters’ rights and housing standards, but housebuilding delivery is off track. For children’s health, the importance of removing the two-child benefit limit is hard to overstate – though it came 2 years into the parliament – and there have been other positive interventions, such as expanded eligibility for free school meals.

Among health risk factors like smoking, diet or exercise, the most positive story is smoking, where the ‘smokefree generation’ and other measures in the Tobacco and Vapes Act 2026, together with more smoking cessation funding, offer real hope. At the other end of the scale, alcohol policy has had scant ambition and seen little progress.

Between those extremes, many risk factor policy areas have received government interventions that are positive as a first step, yet risk offering too little to shift concerning trends. For example, policies on diet include a commitment to work with supermarkets to make the average basket of goods healthier, but implementation has been slow.

The lack of a cross-government plan to improve health and reduce health inequalities makes it far more difficult to assess progress and hold the government to account. A plan with timescales and success measures not only enables ministerial accountability but crucially acts as a tool for ministers themselves to make sure that the system is delivering. More fundamentally, the reason that a genuinely cross-government plan is challenging to develop is because it involves inevitable trade-offs around where money and political capital can be spent to greatest effect. Yet this is precisely why it would have such value.

There is no single lever to pull that can improve health. But there is a great deal more that could be done if we have a prime minister who sees his role in galvanising that change. The upcoming Budget and 10-year plan for Britain are opportunities for Andy Burnham to show that he sees better health as a national priority.