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Adam Fleming
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Helen McNamara
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Adam Fleming
hello. The curse has held true. I disappear for a day or two and some massive news happens. But I'm glad to be back and I'm making up for it because later on in this episode of Newscast, we're going to chat to Helen McNamara, who is the former Deputy Cabinet Secretary. So we'll have a really good idea about how Andy Burnham and the Civil Service might be preparing for his impending arrival in number 10 Downing street as our new Prime Minister. So that is one of the really interesting conversations we're gonna be having on this episode of Newscast.
Helen McNamara
Newscast, Newscast from the BBC.
Adam Fleming
I will resign as leader of the Labour Party.
Helen McNamara
And what will you do? Stare at a wall?
Adam Fleming
Humanity's next great voyage begins. You know, I like my buses. I'll come on to them. It's supposed to be me as a doctor. Ooh la la.
Helen McNamara
Thinking about it like a panto helped.
Michael Buchanan
Do we. What do we do?
Adam Fleming
Hello, it's Adam in the newscast studio. And I should just say the first conversation we're going to have on this episode of Newscast might be upsetting because we're going to talk about this huge report that has been done into failings in the maternity unit at Nottingham University Hospitals Trust, failings over years and years and years which saw some babies being really badly harmed or dying, some mothers having terrible, terrible experiences or losing their lives while they were giving birth. And the fact that the leadership at this hospital trust knew that there were problems for years. And so this review has been done by Donna Auckenden, who is the noted midwifery expert. She was delivering her report and her findings today. And even just the press conference was very emotional, let alone reading the hundreds of pages of details about what went wrong and at this hospital trust in Nottingham. And my colleague Michael Buchanan, who's the BBC social affairs correspondent, has been following this for years and years. So I caught up with him to find out what he's been finding out Today, and Michael is here now. Hi, Michael.
Michael Buchanan
How are you doing, Adam?
Adam Fleming
Very well, thank you. Now, you've been following this story for years and I wonder if maybe we should start with the beginning and we can talk about Donna Ockendon's conclusions in a minute. But just tell me how, how this story in Nottingham actually began.
Michael Buchanan
Well, the review which was published in this hotel earlier on today, would not in all honesty have come about if it wasn't for two families in particular getting together in about late 2019. The Hawkins family, who had suffered the loss of their daughter Harriet in 2016, and the Andrews family, who suffered the death of their daughter winter in 2020, earlier in 2019. And effectively what happened is that the Hawkins had been trying to find other families because they affirmately believed that what they had experienced, the avoidable death of their daughter, was not a one off. And the Andrews family were effectively just googling to see what was known about maternity care in Nottingham once they lost their daughter. They found an article about the Hawkins case. Gary contacted Jack and Frank from that small conversation. They found a slightly bigger group of harmed families in Nottingham and they started pushing for this maternity inquiry. Because for years the Trust here in Nottingham used to describe each baby death in particular as a tragic, isolated incident. And when you get more and more families coming together who have been the subject of a tragic, isolated incident, you begin to realize these incidents are not isolated. And so therefore they began to push forward this maternity review.
Adam Fleming
And then when we heard from Donna Ockendon today, the midwifery expert who spent four years investigating what was going on in Nottingham, she ultimately had spoken to 2,500 more families.
Michael Buchanan
Yes, there was two and a half thousand families whose cases were examined by the review. And what they found was that hundreds of families had been failed. Either the babies had died, the babies had been harmed, the mothers had died, or the mothers had been harmed. And, you know, to go back to the central point here, this is not something that the Trust had acknowledged at all previously. It was only forced into this independent review through the actions of these families. And what Donna Occanton said is that they finally deserve the truth. And the reasons why this had happened. And the reasons are things that lots of people have been following the maternity story for years will recognize. It was simply, in particular here in Nottingham, a refusal to listen to women, particularly women in labour who were at home, were phoning up midwives with concerns and being repeatedly told, stay at home, stay at home, stay at home. When in actual fact what they needed was some medical attention. Then when they were coming into hospital, a lot of them were being denied Caesarean sections. Then when something went wrong, there was often no learning, there was no investigation, which means that services weren't improving. And all the while the families were experiencing this. What became apparent from the review is that dozens, hundreds of staff were complaining about the conditions within maternity care, in particular saying, we don't have enough staff and unless you do something about it, then mistakes will happen. The leadership of the organisation, in broad terms, didn't do anything, or certainly didn't do enough. And here we are with all this harm finally being exposed.
Adam Fleming
Yeah, Michael, that's something that really leapt out from Donna Ockendon's statement when she was launching her report today, which was a very kind of powerful address to the nation, really was this little bit where she was talking about the culture and the leadership that led to all those kind of very practical things going wrong that you just mentioned there.
Helen McNamara
Running through all of this is a question of culture. And what the evidence shows is that at Nottingham, a toxic culture was allowed to take hold and was allowed to persist. A small number of powerful leaders, described in both family and staff testimonies as having infected the unit, created an environment in which bullying was normalized, speaking up was dangerous and governance was shaped by self protection rather than patient safety. Midwives described being intimidated in governance meetings. Junior staff described to us being afraid to escalate. The incident review panel was described as intimidating, male dominated and dismissive of non medical voices over very many.
Adam Fleming
And yeah, Michael, there's a paragraph in her executive summary that just talks about all the terrible kind of behavior on the unit, the bullying, nepotism, cliques. It sounds like it was quite a horrible place to work. And not just that, but it had been investigated on those terms six times previously.
Michael Buchanan
Indeed. I think, you know, when you look at the fact that more than 800 current and former staff of the Trust came forward and spoke to the Auchenden Review, which is hugely different, a much greater number than I've spoken to previous maternity inquiries. They were keen to emphasise both that they had been shouting about what was going on in the unit to their managers for years, but also that culture to which you talk about. I think there was particular issues with Labour ward coordinators who would form cliques and would often leave the most junior and inexperienced midwife to deal with with the most complicated cases, on the promise that if anything went wrong, they would be there to help out. But we know from sort of people that I've spoken to over the past few weeks and months that often when something did go wrong, or not necessarily wrong, but when that inexperienced midwife felt that she needed help, she'd call out and she would not receive the help at all. She would then begin to feel that this was not something that she was able to cope with on her own. And further down the line, often the consequences that people would walk away and the retention rate for staff was terrible purely because they found the culture so intolerable. And these cliques and this intolerable culture within midwives is something we've seen in other reviews, but it also obviously drips into the attitudes and the experiences of the women in their care. And, for instance, we know that one Labour ward coordinator used to write F or H beside the names of some women who were often at home or sometimes in the hospital, and she was wanting to move them off the unit. The F is a swear word. Oh, standing for off home. And so that sort of culture of sort of trying to keep the unit running in a way that they felt they had to, regardless of what the experience of their colleagues were, regardless of what the women actually wanted, was very prevalent for a number of years in Nottingham.
Adam Fleming
And I know you've got to know lots of the families who've been affected by. By this, and I'm sure there are lots of different views about what happened there in Nottingham and also different views about where they're at now, now that this report has come out.
Michael Buchanan
There are lots of different views in many ways, but in some ways there is also quite a clear request for them now, particularly the wanting a public inquiry. They basically believe that Don Aucan has revealed the scale of the harm, but what she hasn't been able to do, because that wasn't her remit, is to hold anybody accountable. And that's the thing that the families are now pushing for in particular, because, you know, there are no names of any individuals who are responsible from a leadership point of view, for what happened in Nottingham. And that's been the same with a lot of these maternity reviews, is that was individual midwives have perhaps been struck off their medical register for the mistakes that they have made. No leader or executive at any of these trusts have been held to account. And that is the same here in Nottingham. A good chunk of them actually didn't. Former executives at the trust actually didn't engage with the review at all. And that is something that's particularly annoyed the families who are saying, you can't have this situation where you uncover and reveal all this harm. But Nobody's held to account for it. So they want the public inquiry and they want accountability and they believe that if they get the public inquiry, then they will get a chance at accountability,
Adam Fleming
because, of course, a statutory public inquiry, those NHS employees would have to give evidence. They wouldn't be able to avoid it. And, Michael, in a minute we're going to be Talking to Helen McNamara, who's been the Deputy Cabinet Secretary for quite a few Prime Ministers, and I'm going to ask her about how she thinks Andy Burnham will be preparing to take over as Prime Minister. Has Donna Ockendon given any kind of pointers or advice or tasks for the next Prime Minister to take up if he wants to address this? Pretty quick?
Michael Buchanan
Yes. So the current Health Secretary, James Murray, announced in response to these findings that they would come up with an action plan for maternity improvement within the next six months. Because next week there's another maternity review reporting, and that's one that was set up by the former Health Secretary, west treating that, chaired by Baroness Amos. That's a sort of broader inquiry into maternity care in England. A broader inquiry, but in many ways a shallower inquiry as well. So he was saying, look, by the time we'll listen to Ockington today, we'll listen to Amos next week, and then within the next six months, we will come up with an action plan. He also announced that, for instance, a law known as Martha's Law, which gives people a statutory right to a. A second clinical opinion that will be extended to maternity care. What Donna Orkinden said in response to that today is that's just simply not good enough. The government needs to act faster, because in the next six months you will get more harm if you allow maternity care to go on as it is. I think the families built up a good relationship, a reasonably good relationship, with West Streeting, and they had confidence that he got this and that he was their side. There's undoubtedly, because James Murray is new in the job, there's undoubtedly questions amongst them as to what he will do. But a broader question is that even if he is committed to it, will he still be in post in the next few weeks because of this pending change of government? So a lot of uncertainty. Yes. The words are heard that the government has said today by the families, but they want action now and not words, because repeatedly, governments of different colors over recent years have made similar statements. We will improve maternity care, and that hasn't happened.
Adam Fleming
Michael, talking about words, I see that Nottingham University Hospitals Trust has put out an open letter about this today. What did they say?
Michael Buchanan
Well, the chief executive of the Trust said today that he unreservedly apologised for the harm and the distress that the Trust had caused over a number of years. He wasn't in post when a lot of the harm took place. He's been relatively newly appointed in 2020 after the review began, and he has got a new leadership team as well. But undoubtedly he said to me today that he had considered his position because of the sheer scale of the harm that had been revealed by this review. But he did say that he believed, for the moment, he continued to have the confidence of the board of the Trust, that he continued to believe that they were on the right path, that maternity care was improving, but that work had to be done, not just to improve care in the hospital, but to rebuild Thrust with a wider Nottingham community.
Adam Fleming
Michael, thank you very much and thanks for doing this story in such a sensitive way, because I imagine it's a very tricky one to talk about, so thank you very much.
Michael Buchanan
Yeah, not at all. Thanks, Adam.
Adam Fleming
I can't believe they're having a gender reveal for their dog. No, no, no, no. This is a breed reveal.
Helen McNamara
Oh.
Adam Fleming
So, yeah, they're finding out the breed of the puppy they're rescuing, so they could just be spending all their money on, like, pet insurance. Instead, we got lemonade for Roscoe and it covered vaccines, microchipping. We saved 90% on vet bills. Oh, here we go. What do you think beige confetti means?
Helen McNamara
I don't know.
Adam Fleming
That we'll never get this Saturday back. Get a quote for any breed@lemonade.com Pet Aprobecha Los de walt Deals and lows obtain gratizune ra mienta de vault selecta de veinte voltos Max al compra unqui de bateria de cinco amperios ora evente voltios Max selecto ademas die vagratis una bateria additional de vault. Now, as promised, we're going to catch up with Helen McNamara, legendary former Civil servant who was the Deputy Cabinet Secretary in 2020 and 2021, so knows a few things about what happens when a new prime minister takes over in Downing street. Because she witnessed a few leadership changes in that time, and now that she's out of the civil service, one of the things that she does is hosting a podcast called in the Room, where she lifts the lid on some of the things that happened in the many important rooms that she was working in. And the important room she's in today is the newscast studio. Hello, welcome to our reasonably temperatured studio.
Helen McNamara
It's lovely and cool.
Adam Fleming
How's your podcast going, by the way?
Helen McNamara
It's going very well, thank you. We're having a lovely time, me and Cleo on in the room together. It's really good.
Adam Fleming
We've got promo down to a tea.
Helen McNamara
That's great.
Adam Fleming
See how I've learned also, I mean, it is a. I hope you're finding that it's a good medium to really explore things. And you probably find yourself saying way more than you've ever said before.
Helen McNamara
Yes, and surprisingly comfortable with saying way more than I've ever said before, actually. Who knew?
Adam Fleming
Which we benefit from too. So watching Andy Burnham's preparations to take over as Prime Minister, like, what's your take about what's going on and how he might be going about it?
Helen McNamara
Well, I mean, you've got a feel for the guy, right? It's not a lot of time. Well, I think it's. It's not a lot of time. So if you think it was last, only last Thursday that he won the Makerfield by election and nobody seems to be putting their hat in the ring or having enough MP supporters to be able to actually challenge him to a leadership contest. So the default on is he's going to be Prime Minister of the United kingdom on, what, the 17th of July, is it?
Adam Fleming
The nominations open on the 9th, close on the 16th, so there's no other candidates, then it's a day or two after that.
Helen McNamara
Yeah.
Adam Fleming
What do you think about that timing? Because some people are saying, oh, Starmer did it to kind of stiff him a bit because Team Burner maybe had wanted longer to prepare, maybe until September.
Helen McNamara
I mean, you always want longer to do your homework, don't you? You'd rather have a bit more of an extension and a bit of time to think about things. I actually think it was the right thing to do because you can't have a Prime Minister who can't take decisions and can't do things. It's just we don't really have a setup in government that allows for a caretaker Prime Minister or whatever.
Adam Fleming
Three months of lame duckery.
Helen McNamara
Yeah, it's not. It's not good for anybody, actually. It's unpleasant for the person, for all the person in the job, the person who's going to the job. It is just nothing's going to happen. So it's much better for the country to have an actual Prime Minister who's motoring and can do things as soon
Adam Fleming
as possible, but it just shows you all the contradictions. In our system because you've just said, oh, you can't, you can't have a vacuum for too long. But equally, Andy Burnham's sort of not got as long as. As you would like in an ideal world. So the sort of. There's no answer to that.
Helen McNamara
Welcome to being in charge. I mean there's a lot, a lot of the difficulties I expect he's going to have in the next few weeks is basically a brilliant run up to actually what it's like once you're behind that big black door in real life and it is where you work and there's not a huge amount of optionality and you are totally at the mercy of events and you're always trying to run your program and do things but you know, you're not entirely in charge.
Adam Fleming
Have you managed to get any hints about what he is actually doing? So we know he had a one on one with Starmer a couple of days ago. His team are sort of letting it be known, the gist of some of his personnel decisions. Like overnight they let it be known that Rachel Reeves could still have a job in the government but it won't be as good as Chancellor. What are you sort of sensing?
Helen McNamara
Well, the really exciting thing is, you know, I think it is true that James Pinnell is going to be his Chief of Staff. That is a really brilliant thing for anybody who cares about competent government and proper grown ups being back.
Adam Fleming
Why is that?
Helen McNamara
Well, James Pinnell, I should. Is it.
Adam Fleming
Should we do a little. Should we do a little Wikipedia about James Purnel? I mean, we will have met him in various guises through our lives. So I knew him first of all as a very, very junior political reporter because he was in Gordon Brown's government in a few jobs. And he famously resigned the night after the local elections in 2009 and said that Gordon Brown should resign too. And I remember that being one of the most dramatic 10 o' clock news I'd ever seen at that point that was. Tells you what a quiet era that was.
Helen McNamara
It was a gentle time. That's when he was Secretary of State for dwp, I think.
Adam Fleming
Yes. And he was trying to do some quite big welfare reforms. And I then next met him when he came to work at the BBC as Head of Audio and Education and he was quite instrumental in setting up BBC sounds.
Helen McNamara
There you go.
Adam Fleming
Like weird irony. Yeah. And how did you know him?
Helen McNamara
So I knew James first when he was first a Minister at the Department of Culture, Medium Sport. So I worked for Tessa Jowl, who was then the Secretary of State. And James's first ministerial job was as a junior minister in that department. So, yeah, which is also. We've got Andy Burnham, also used to be Secretary of State for Culture, Medium and Sports. So my little DCMS heart is very happy. So, dc, finally, a DCMS takeover of government. And I do think that the reason why. There's lots of reasons to be excited about the notion that James Pannell might be a Chief of Staff because he's a very deeply experienced, serious person who's got all sorts of things. So he went from being here at the BBC with you guys, he then ran a university. He's now worked in the private sector for a bit as well. So he ticks an awful lot of boxes. He's a very decent, good, proper liked man. He's also known Andy Burnham for a very, very, very long time. And I think that that's the bit that, you know, having been in the centre for a long time, it makes such a difference if people are able to draw on real life relationships, not relationships that are political convenience or very new ones. They've got really, really, really deep roots. They worked together for Tony Blair, I think. Although every time I get this slightly wrong, I get all of the special. No, it's not valuable.
Adam Fleming
Actual good that you've got your own fancy.
Helen McNamara
I've got my own. Got my own nagging.
Adam Fleming
And also they shared an office, didn't they, when they were very young MPs.
Helen McNamara
They did. And so they really have a very strong bond from a long time ago and I think that's a really good thing.
Adam Fleming
Although I remember in the COVID era, you were very worried about, like, the macho culture in Downing Street. Isn't there a danger that it's like two lads running the show Again?
Helen McNamara
I wouldn't. I mean, I've known James and Andy for a very long time. That's not really their vibe. So I wouldn't be as worried about that.
Adam Fleming
Okay.
Helen McNamara
We only had here Andy Burnham on the morning after the makefield by election, give full and appropriate credit to all of the women who'd actually done the work for his campaign and been running it all. So I don't think either of them have got that reputation.
Adam Fleming
Yeah. The two MPs are known as the Northern Queens.
Helen McNamara
There you go.
Adam Fleming
So, so many regal metaphors. So in terms of. Of. Of preparing somebody to walk through the black door and take control of the levers of government, whether those levers actually work or not, I mean, where would you start on your checklist of things Andy Burnham needs to be getting his head around.
Helen McNamara
So the thing that my former colleagues would say in the Civil Service that has been really missing in the government since 2024 is, is an idea of, kind of a really clear sense of, what is this government here for? You know, it's a criticism that was made for poor old Keir Starmer for a long time. It wasn't really. Weren't really sure what his politics were, what his motivation was, what were they supposed to be doing? Kind of not the. Not the how of the government, but the what and the who. We're here to serve and I think number one on Antebellum's list ought to be what is he going to say on the steps of Downing street on the day that he becomes Prime Minister? Because that kind of little speech isn't just a, you know, useful thing for the telly and then go off inside. It has absolutely incredible power in the public service for being able to refer back to it. Because you can think, what does the Prime Minister think about this? We had this memorably with Theresa May. She had a really good version of, like, her speech that you. You genuinely found useful. If you were working miles and miles away from her, you could be like, oh, this is what she.
Adam Fleming
She taught. Her theme was the burning Justices and then she listed some of the burning injustices in the country as she saw it. And I can see, yeah, that's a useful guide for if she hadn't had to do Brexit and all that hadn't gone wrong, that's what she would be wanting everyone to achieve on her behalf.
Helen McNamara
Yeah, totally.
Adam Fleming
So it's not a nice TV moment.
Helen McNamara
It's not just a nice TV moment and it's not a moment to just say things that are totally meaningless. It's your chance to really set out. And Andy Benham's going to have to do that because he didn't win the election. So there'll be lots of kind of like, well, where's your mandate come from? What do you really. You're just the MP for Makerfield. You haven't really got all of these things. So it is a golden moment for him, at the beginning of his. Of his being Prime Minister, to actually say, this is who I am, this is what I stand for, this is what my government is about. So I think getting. Getting the words of that right, making sure that it's not just, you know, motherhood and apple pie, and also that you aren't actually committing to some totally deranged Things that three weeks later you're gonna have to say actually no, we can't do that. It turns out.
Adam Fleming
And it's a reminder that yeah, when Keir Starmer came in he basically had change and working people and that was kind of it.
Helen McNamara
It's very vibes based. I think you need to go beyond the vibes based into some actual things.
Adam Fleming
You were talking a minute ago about his remarks, Andy Barnum's remarks in Makerfield the morning or not that Makerfield is a place in itself because lots of towns there is the constituen Bakerfield reminder.
Helen McNamara
He had some complaints.
Adam Fleming
No, no, no. I just like to be accurate as
Helen McNamara
a former geography student
Adam Fleming
listening to that speech, if you were then advising him on things that he could then do, sort of policy wise or announcements he could make or further signals he could send to the civil service and the country, what sort of things would you be pointing him towards to enact what he was talking about that morning?
Helen McNamara
So I think the biggest thing and I, I suspect this is what he. One of the biggest things he's going to do which will change the country is the devolution agenda properly. So he's a man who has been banging on about devolution for a very long time. As mayor of Manchester he's got more devolved powers than any other area of the England in. To. In any extent. And I think he will have to follow that through. He's a big believer in it. It's putting power back into people's hands. So I suspect we'll see some of that. That and then there will be.
Adam Fleming
What would be a good way of doing that? There was like a big bang thing on in week one because think about it, we've spent so much of our time talking about levelling up and how can you create new pots of money that are easier to access. There's already loads of elected mayors with various different types of powers that no one's quite the same as the other. A lot of this stuff kind of does already exist.
Helen McNamara
Oh, okay. This is, this is proper in a. Oh yes. It's not exactly a headline.
Adam Fleming
It's not vibes based.
Helen McNamara
It's not headline grabbing either perhaps, but I would have said yeah, but he'll
Adam Fleming
have to make it sound that way.
Helen McNamara
He can make anything sound great actually. But like proper fiscal devolution. So devolution of. If you really want to have competitive areas for bidding for growth then proper devolution of business rates allowing areas of the country to charge zero rates for certain industries for you if you want a really prosperous life sciences industry, you would be saying, okay, well, in my bit of the country, life sciences is going to be our thing and we want to be able to have a differential tax rate to them to attract the talent, all of those things that. That probably. And I can sort of feel my former treasury colleagues, you know, shouting at me.
Adam Fleming
Yeah, because that's a massive loss of control for that.
Helen McNamara
It's a massive loss of control. But that, that. Hello, welcome to devolution. That's what it means. And some of it's not going to work as well. You have to be quite brave.
Adam Fleming
Who. Which of the potential chancellors do you think would sign up to that? Is that a thing Ed Miliband could sign up to? Is that a thing Darren Jones could sign up to?
Helen McNamara
Is Darren Jones really a potential chancellor?
Adam Fleming
Well, some of the papers are saying that. I'm guessing you think he's not from that reaction.
Helen McNamara
I don't know. Sorry, Dar. I. I think probably Andy Burnham is so powerful now that whoever is his chancellor is going to sign up to what Andy Burnham wants to do, I expect.
Adam Fleming
Okay.
Helen McNamara
And I can't see as doing anything other than some quite strong fiscal devolution. And also, if you remember right at the beginning of this army premiership, when Angela Rayner was the Secretary of State in clg, the Communities and Local Government Department, which sort of has control of some of these things, she had quite an ambitious agenda for devolution and power to places. And I think we might see some of that back. And who knows, even Angela Ray back.
Adam Fleming
Yeah. And I wonder if she'll go back to do that again, actually, because if that suddenly becomes the hot ticket in government, then that's. She presibly want to be at the hot ticket dispensary.
Helen McNamara
Do you know what my. I mean, who wouldn't want to be at the hot ticket dispensary? But my little bureaucrat heart also thinks it's quite a good idea to have people who know what they're doing. So one of the big risks that you've got now is that you'll have. It's much better to be doing, getting used to your new department, understanding your new brief over the summer holidays, when you haven't also got to turn up in Parliament every week and explain yourself. But it's a massive mountain to understand what is your job now as Secretary of State for Transport and how does it all work. And the fact that you probably are going to have a whole new set of people is slightly worrying. So if there were opportunities. So I don't know, put a Secretary of state who'd been in that department before back into it.
Adam Fleming
Retread, isn't it?
Helen McNamara
Retread, yeah.
Adam Fleming
That's an interesting point about the summer holidays. I hadn't thought of that. That is very. So there's no urgent questions, there's no legislation you've got to go and launch and then answer hundreds of questions from backbenchers and select committees on. So actually, yeah, you do have. It's about six, eight, 10 weeks even to get your head down.
Helen McNamara
It worked really well when Boris Johnson took over at that sort of time, actually it was a really, it's a big kind of. Is a very useful time to be able to just really read into your brief.
Adam Fleming
Okay, so that's, that's devolution and a revolution in like town halls maybe. What's another big area you think you'll want to watch?
Helen McNamara
Yeah, Defense. I mean that's, you know, obvious as the day is long. But he's going to have to do something quite big on defense.
Adam Fleming
But hang on, isn't the defence investment plan that now infamous cursed document that led to John Healey resigning? Isn't Keir Starmer quite insistent that he will finalize that in the. In his final weeks and take it to the NATO summit in Turkey? And that'll be the last thing he
Helen McNamara
does as Prime Minister, which is lovely, great, fantastic. That doesn't mean that Andy Burnham isn't going to also do some stuff on defense in the summer, I expect, because I'm sure he'll want to differentiate himself. And I expect if you look at what Andy Burnham talked about in Manchester and what he was doing, he will probably talk about defense in terms of re industrialization. That's another thing that Angela Rayner has talked about before is actually how do we increase defense spending but do it in a way that massively backs British business and massively backs British business in parts of the country that really desperately need investment. So I think you'll see A much more kind of Britain first regional devolution. All of those things all kind of bleed through all of the announcements that he makes.
Adam Fleming
I expect I'm sounding a bit like a broken record, but I'm wondering how he will make that sound A exciting and B, that it's happening very quickly because we all know that doing things like investing more in defense as a big number actually then once you start to try and find projects that you can spend it on and structures that you can support or creating new structures or having an aspiration. I remember they have an aspiration to set up six munitions factories, but that will take like four or five years to do. I'm just trying to think of like, what are giant grabby things he can say in that space.
Helen McNamara
And there are things that come on stream faster than that. Right. So if you have apprenticeships, if there are things that you can turn on quicker, I also think it's. We really have to challenge how long it takes to do things. We learned in Covid days that actually if you really want to do something quick, you can. And I think there has to be an urgency. What I, what I fear is that Andy Burnham and his team with all of this exciting new energy are going to get sucked into. I can't possibly and I couldn't. And it takes three weeks and you can't do that before you've done this. And then everything takes years and years and years. They just haven't got time to do that. They need to be absolutely willing to take more risks and move faster. And I hope that. Because that's what the. I mean, that's the kind of arithmetic of Parliament. And the time they've now got yet. They haven't got five years, they've got two.
Adam Fleming
Yeah, right. I'm just trying to find an email we had from a newscaster who's called Nick Mugridge and he says, hi, newscast. I was just listening to Matt Chorley 5 live and Lorraine Kelly was on talking about PMQs. Lorraine said she'd heard that Andy Burnham might have a London based control center and a Manchester based control center at the same time. Have you heard that? Is it practicable?
Helen McNamara
I think that's in the Financial Times.
Adam Fleming
Yeah.
Helen McNamara
As we speak.
Adam Fleming
I think Lorraine obviously reads Financial Times. Maybe Lorraine doesn't surprise me. Surprise me.
Helen McNamara
Icon.
Adam Fleming
What do you think about that idea? Two number tans.
Helen McNamara
Doesn't sound like a tremendously brilliant idea to have two number tens, if that's what it is. If his idea is he wants to keep some of his excellent team who live in Manchester doing excellent work for his excellent government now he's Prime Minister. Great idea, actually, because we've kind of
Adam Fleming
already got that for the treasury, haven't we?
Helen McNamara
Yeah. And there's quite a lot of government departments who are up in Manchester and all over the country anyway. So I'm all for in general, can you take power away from London? I think creating two number tens and putting one of them in Manchester is not a good idea. And I would move Parliament. That's my. I wouldn't I? I this might bear with me.
Adam Fleming
Okay.
Helen McNamara
This might sound a bit crackers. And everybody thought this was Boris Johnson's mad idea and actually I should confess it was my mad idea. Really. Yeah. Because.
Adam Fleming
And what you suggested to him and he ran with it.
Helen McNamara
Yeah. And we did quite a lot. So this is the I.
Adam Fleming
People used to think it was a Dominic Cummings hair brained idea and it was a threat to the Lords if they didn't do what the Tories wanted.
Helen McNamara
I don't think so the plan was the Parliament definitely needs restoring and renewing so they do have to move out of that place or it's gonna. Some of that has to happen quite soon. So if they're move out of it, why not move the House of Lords to York? It was so that.
Adam Fleming
And that was your idea.
Helen McNamara
Yeah, because it's a really good idea, Adam. Because you've got to love. York is actually the center of the United Kingdom, not London. I had quite a lot of fun. I'm from Yorkshire so I had quite a lot of fun explaining that to people.
Adam Fleming
That actually was York ever our capital
Helen McNamara
years ago of course naturally there was a Roman Emperor crowned in York actually. But so. But I do think there are really big symbolic things that Prime Minister Andy Burnham could do that are real about moving power around. Not kind of slightly opening a secondary office somewhere else. But actually what do you really do that changes the power dynamics? Now? I. I suspect that, you know, moving the House of Lords to York temporarily is not on the agenda. But I do think they need to be thinking about really, really big symbolic things that send the signal that he wants to make change happen.
Adam Fleming
So maybe a whole government department.
Helen McNamara
Yeah.
Adam Fleming
And parl cms. Lots of sport at Manchester.
Helen McNamara
Yeah. The Olympics in the north is what we need as well. I think. I think the Parliament is the problem though. Right. Because Parliament is in SW1. So you have to do something where decision making is genuinely outside of SW1, I think.
Adam Fleming
Interesting. And you've got. I mean I'm just trying to think how many MPs there are in York. I think there's is the four M roughly. So that's four MPs who'll be fine with that. Leaving you with 640.
Helen McNamara
I wouldn't leave the comments. I'd leave the Lords. I think that's.
Adam Fleming
So that's 800 plus.
Helen McNamara
Yeah, exactly. They weren't. It wasn't a very popular idea.
Adam Fleming
So also very big train bill because they'd all be claiming expenses for train.
Helen McNamara
Very big train bill live here. Yeah.
Adam Fleming
Exactly. I mean, it does sound like you're an Andy Burnham and also by extension James Pranell fan and you're sounding quite positive about how. How it might go. Do you have any concerns, has anything happened that made you think, oh, I'm not sure.
Helen McNamara
I worried a bit about that photo on the first day. So if you were just a normal person watching telly, you had crying. Keir Starmer.
Adam Fleming
Yeah, Literally crying.
Helen McNamara
Literally crying, which is a horrible, horrible thing to see. And then at the same time you had this wildly over excitable grinning MPs on the steps of Westminster hall in their hundreds, all, you know, obviously, including Rachel Reeves. Yeah, it was.
Adam Fleming
And also Steve Reid, Steve Reed, who'd been Starmer's biggest defender on the airwaves for the three weeks preceding.
Helen McNamara
I mean, he gets a special prize because he was very close to the front of the. That photo. And I just thought, that is crass. So that's the only thing that I've seen that I think, wow, I get that you're all really excited about this, but can you also behave with a bit of dignity and seriousness? And I worry a bit like you would do with any political parties that you've seen up close, that there'll be a bit too much school settling and blaming and all of those things, when actually we really do need. I mean, you know, even people who aren't supporters of, of any particular party, you can see that we need a government that functions really well. We need a government that's working really well and I hope that they can, as we're treating said he would all pull in the right same direction. Whether that holds when there aren't 470 jobs that can be given to everybody.
Adam Fleming
Well, yes, because that's the other thing about that. I mean, I know obviously labor would say, oh, hang on, we do this every time we win a by election and we like get together on those steps and take a picture. But I take your point that I've never the same. The same tradition can feel very different in different circumstances.
Helen McNamara
And also, I mean, you're a close observer. How many times have you seen that many people on the steps of Westminster?
Adam Fleming
I mean, maybe not that many, but I've definitely seen the tradition play out, but maybe not to quite that extent. Yeah. And also just that point about winning, you will. You've seen a lot of winners up close and you've seen what victory does to politicians. They love it. And sometimes I wonder if they go a little bit mad because it's such an unnatural unhuman thing to experience.
Helen McNamara
Yeah. And I think the, the sad thing about being Prime Minister is it doesn't really take very long for the shine to wear off that because even in the process of just, just deciding who gets which job, you've got to disappoint a lot of people. You'll have people who are grumpy with you based. Most decisions you are making if you're Prime Minister are going to upset somebody. If it was an easy decision and the answer is yes, that's being made somewhere else. Somebody else is having the fun of that. That's the Secretary of State or Junior Minister or somebody else. You only do difficult things if you're the Prime Minister. So the relentless reality of having to actually choose X rather than Y and actually this is going to be good for housing, but it's going to be terrible for the environment or it's going to be good for transport, but it's going to be terrible for skills. Like those are the choices and trade offs. So the actual brutal reality of that being the job, I mean, yeah, there's lots of great things about it and lots of people want to do it, you know, but it's not, it's not a kind of fun upside, which of the lovely things shall I do today kind of jobs.
Adam Fleming
Here's another kind of nerd policy question we've all got very used to hearing about. The B network in Manchester.
Helen McNamara
Yes.
Adam Fleming
Integrated bus network that was taken back into kind of public control, not necessarily public ownership, but public control. And the B network in Manchester, everyone loves it. Now what is a way of rolling out that sort of thing on a massive scale so that more people feel that sort of transport revolution. If you were having to design a nationwide or maybe an England wide policy for that, what would you be looking at?
Helen McNamara
Wow, that's quite a question. I think it probably is buses, actually. Our old favorite. There's a lot of the bus network that just doesn't exist anymore. And if you wanted to make people feel happy, particularly in rural areas where people feel like the world is not designed around them because every, every public service is in cities and it's all. If you could just flood the country with, you know, cheap buses, maybe electric ones to keep Ed happy.
Adam Fleming
And of course Boris Johnson had a big nationwide bus plan. So there's a. The shelf that get implemented.
Helen McNamara
Yeah, it's probably oven ready.
Adam Fleming
Oven ready. And this week of all weeks, 10th anniversary of the Brexit referendum. Yeah, that's interesting. I also wonder if there's a few other things not necessarily on the shelf, but already happening. That Andy Burnham can maybe take package up and rebrand. So, for example, GB Railways, turning it into a sort of unified railway network instead of all these different bees on it, basically. Yeah. And it's like that's already happening.
Helen McNamara
Yeah.
Adam Fleming
And I wonder if he could maybe take that and take some credit for that and maybe rebrand it or boost the branding a bit.
Helen McNamara
There's a world in which he's very lucky.
Adam Fleming
And then GB Energy, which is actually only set up to invest in energy projects, but could that turn into something that seems a little bit more consumer facing?
Helen McNamara
Yeah, absolutely. And he's quite probably inheriting something where the numbers are all going in the right direction. So sort of the opposite of Keir Starmer's beginning to his term. So migration numbers are. Which everyone cares about, is falling really significantly. The growth figures are actually a bit more encouraging than expected. I mean, still not good. But there's a world in which actually he's luckier than most.
Adam Fleming
Do you think there's a world where Keir Starmer gets kept on as Foreign Secretary?
Helen McNamara
I can't see that happening. I think it's pretty weird if you've been the Prime Minister. I mean, the poor guy probably needs a break apart from anything else, so I would definitely recommend prescribe that. And it's pretty weird if you've been Prime Minister, to then be hanging around the Cabinet table in the wrong place.
Adam Fleming
And are there any things around the machinery of government, like the setup of the Cabinet table, for example, the number of departments that you think actually have been crying out for change for ages, and this could be the opportunity to do it. And Andy Burnham might seem like the guy who would do it.
Helen McNamara
Did you know, one of the funny things was because of the Brexit anniversary and various things, I found one of my old photographs from when Boris Johnson became Prime Minister and he had so many people around the cabinet table that we had to get one of those, you know, Christmas dinner time, when you have the extra. The extra. The extra table and the extra table and the smaller chairs. Yeah, exactly. And if it's not quite the matching tablecloth, that's what we had to sort of. I think that there is definitely a space for trying to have a smaller focus in this cabinet as possible. That actually the time he's going to be most popular and have the most power is right at the beginning. So can he have the necessarily necessary brutality to really make sure that he's got right people in the right jobs? I think one of the things that is absolutely crying out for change is Whitehall itself. You know, everybody says that. The current Prime Minister says it. I'm sure Wendy Bernal will say it. The Cabinet Secretary herself says that actually this needs to happen and that would make a really big difference. I think he starts. It's not just about reducing the size of the State, it's about making it much more effective. It's about changing some of the dynamics about how these things work. I think that is a. That's ripe for the doing, actually rewiring the state. Very good idea.
Adam Fleming
We could talk for hours and hours and hours. You mentioned the Cabinet Secretary, Antonio Romeo. Will she be sitting down with Andy Burnham and having quite candid conversations with him about what he wants to do and how she can help? And the reason I asked that question in that way is I remember when Liz Truss took over as Prime Minister and she says the access talks that she had with the Civil Service were quite weird and that they didn't flag up any pitfalls to her. They were only answering very factual questions in very factual way.
Helen McNamara
Really?
Adam Fleming
That's what she said.
Helen McNamara
I can't. I can't comment on.
Adam Fleming
You weren't there.
Helen McNamara
I wasn't there. I know that when we did the same thing with Boris Johnson and Jeremy Hunt, when Theresa maybe was standing down, we did. We offered to both Jeremy Hunt and Boris Johnson. Obviously, Boris Johnson took more of our ask up and I spent a long time with them, telling them where we were. We weren't. We didn't hold back on the problems and we worked quite closely with them before they came into power. The whole team on exactly what it was going to look like, what his diary was going to be, all of the kind of relentlessly practical things, but also some really big. You are going to have to decide whether it is X or Y, and that's going to be in your intro. So I would expect that the Cabinet Secretary, now that the Prime Minister has said those talks can go ahead, will be doing exactly that. And that's partly where Andy Burnham's team need to focus on the. What is our government here for? And the politics and not slightly get distracted into the bits that the Civil Service will be really good at, which, you know.
Adam Fleming
Oh, let's talk about these processes, Minister.
Helen McNamara
Yeah, exactly.
Adam Fleming
Rather than the decisions themselves.
Helen McNamara
Yeah.
Adam Fleming
Also, I mean, I don't know Antonio Romeo, the Cabinet Secretary, but she doesn't strike me as a very kind of like, yes, Minister, I'll try and pull the wool over your eye, kind of your eyes kind of person.
Helen McNamara
She's not. No, no. And she'll be very ambitious for what a Prime Minister can do and what the government can do and how she can make sure that the Civil Service can deliver for the new Prime Minister from day one.
Adam Fleming
Can the fiscal rules be tweaked in a way that lets the government do more, but doesn't make the bond markets feel that the government's getting out of control with its borrowing drawing?
Helen McNamara
Yes, because the treasury are very skilled and there are plenty of ways in which you can. It's all about confidence. I mean, so your, your bond markets and city question is actually all about that mercurial thing of confidence.
Adam Fleming
Yeah.
Helen McNamara
And so things like. Sounds silly, but actually James Piddell as the Chief of Staff is a massive confidence inspiring thing that the more that Andy Burnham looks like he's going to govern in a very serious way. You know, you saw Andy Benham in a suit and tie, which I hadn't had money on.
Adam Fleming
Wasn't a great suit, though I have to say, I'm no expert.
Helen McNamara
I was a bit sad about that. I thought, you know, come on, surely.
Adam Fleming
Well, there's a dress code in the comments, so he had to.
Helen McNamara
Is there?
Adam Fleming
Yeah. Gentlemen have to wear a tie and a jacket in the Commons. It's the rules.
Helen McNamara
Do you know, I didn't even know that. Yeah, well, there you go. Maybe you can change that too.
Adam Fleming
Good job you weren't. Good job. You weren't advising the Prime Minister on that.
Helen McNamara
Well, I very rarely turn up in
Adam Fleming
his tracksuit for us.
Helen McNamara
I very rarely do. Dressed people I work for. Everyone should be pleased.
Adam Fleming
Oh, yeah. So there's actually a quite a lot more room for maneuver in the fiscal rules and around the fiscal rules. As long as our lenders think you're a serious person and you're credible entirely.
Helen McNamara
And that's. It's like.
Adam Fleming
You shouldn't get too fixated on the actual words of the fiscal rules.
Helen McNamara
Well, if you to believe that is almost the wrong. Exactly the wrong mindset which gets us into a pickle in the first place. Because it's not that the people who are expressing confidence or not in our country by buying or not buying our bonds are looking at paragraph three of subsection seven of whatever clause and saying, well, actually, technically, this is whatever it's about. Do they believe that this is a government that is going to be able to competently govern so that you're going to get your money back in the future? It's. It's much more. And I would say this, I'm not a Treasury. Not a Treasury person. But it's more simple than it than it looks which is about confidence. So people confident this is a government that's going to deliver. It's going to do the things it wants to do. It's going to do with a necessary radicalism and with an open mindedness towards actual economic growth. Growth.
Adam Fleming
Last question about his diary. In theory, Andy Burnham could be Prime Minister a few days before the world.
Helen McNamara
I knew this is going to be about the World Cup.
Michael Buchanan
Good.
Adam Fleming
So you prepared then which his officials, if you were one of them, advise him to go if England are in the final of the World Cup.
Helen McNamara
Yes. He and Keir Starmer should go together if England are in the final of the World cup, because that would be the nice thing to do.
Adam Fleming
But Keir Starmer was criticized for traveling too much and being out of the country. Is Andy Burnham gonna wanna make his first thing going to like a nice jolly in America if England are in
Helen McNamara
the final of the World Cup? Can you imagine what people would think if the Prime Minister wasn't bothered about that and didn't go? I think it's much better to go. And also he likes football and he
Adam Fleming
can have his first bilat with Trump exactly as they're handing the trophy over.
Helen McNamara
He will learn very hard that in everything in the Prime Minister's diary, something that looks like it's going to be a nice experience is not gonna be.
Adam Fleming
That's the classic one. Yeah.
Helen McNamara
The service will absolutely put so much around it that they'll suck the joy out of most things.
Adam Fleming
If last. Last question. If this all goes amazingly well and Whitehall is reformed and the culture of our politics has changed by the arrival of one man and his colleagues who you think are serious people, would you go back in?
Helen McNamara
Me?
Adam Fleming
No, no, that's, that's. That chapter is over. Definitely. Yeah, fair enough. Very clear answer.
Helen McNamara
I'm not a politician, Adam, so I can just say no.
Adam Fleming
Yeah. Well, thanks for saying yes to us today. Thanks.
Michael Buchanan
Thank you.
Helen McNamara
It's a pleasure.
Adam Fleming
And we're going to end with a very high quality piece of correspondence as you will hear from newscaster Mara, who says. Hello, newscast team. It's fair enough that Italy is often invoked when discussing political instability. But if Italy is to be used as a reference point, it's worth recalling Giuseppe Tomasi de Lampedusa's novel Il Gatto Pardo, which I as an English speaker know as the Leopard, which is set during the Italian unification. A famous line reads, oh, here we go. Si vogliamo cituto ri manga come,
Michael Buchanan
which
Adam Fleming
I know much better in English. As if we want things to stay as they are, things will have to change. And then, Mara says, a useful reminder that leadership change can easily become theater without real political renewal. Just a thought. Keep up the great work, says Mara, and that's your brain teaser for this episode of Newscast. Does Lampedusa's novel the Leopard tell us anything about the handover of power from Keir Starmer to Andy Burnham? Although maybe you don't know this, but Andy Burnham is actually very, very well read and big into his poetry, and he did English literature at university as opposed to politics, philosophy and economics, which is what lots of them did. Anyway, that's a nice little brain teaser, isn't it? See you for another episode of Newscast very soon. Bye bye.
Helen McNamara
Newscast Newscast from the BBC. Well, thank you for making it to the end of another newscast. You clearly ooze stamina. Can I gently encourage you to subscribe to us on BBC Sounds? And then, without having to do anything else, our meandering chat will miraculously make its way to your phone.
Michael Buchanan
Foreign.
Adam Fleming
As yet another British prime minister steps down, is the country still feeling the effects of Brexit 10 years on? I'm Tristan Redmond, one of the hosts of the Global Story podcast from the BBC. Keir Starmer has become the sixth leader
Helen McNamara
to resign since the Brexit referendum. Ever since that vote in 2016, the country's been racked with political instability.
Adam Fleming
When will it end?
Helen McNamara
For more, listen to the global story on BBC.com or wherever you get your podcasts.
Date: June 24, 2026
Host: Adam Fleming
Guests: Michael Buchanan (BBC Social Affairs Correspondent), Helen McNamara (Former Deputy Cabinet Secretary)
This episode of Newscast dives into the damning findings of the UK's largest-ever maternity review, focused on the Nottingham University Hospitals Trust. Host Adam Fleming is joined by Michael Buchanan and Helen McNamara to discuss the catastrophic failures in maternity care, the leadership and culture issues behind them, and what the review means for NHS accountability and national policy moving forward. Later, the conversation shifts to preparations for Andy Burnham’s imminent arrival as Prime Minister, including expectations for government reform and the machinery of Whitehall.
| Segment/Theme | Key Features | Timestamp | |------------------------------------------------|---------------------------------------------------------|------------| | Nottingham Maternity Review - Launch & Findings | Families’ campaign, Ockenden’s report, culture issues | 00:37–14:10| | Toxic Workplace Culture | Bullying, cliques, staff intimidation | 06:21–09:39| | Accountability & Government Response | Calls for public inquiry, ministerial reactions | 09:53–13:24| | Transition to Andy Burnham PM | Timing, team (Purnell), first steps | 16:00–21:56| | Devolution, Defense, Cabinet Reform | Fiscal power, symbolic moves, Whitehall reform | 24:31–40:31| | Economic Credibility & Civil Service | Market confidence, Cabinet Secretary’s role | 42:23–44:27| | Personal Reflections & Lighter Moments | Victory psychology, transport, World Cup | 34:08–45:41|
The episode brings a sobering, in-depth look at the realities of systemic failings in maternity care, illustrating the real-world consequences of poor leadership and culture in the NHS—and the difficulty in securing true accountability. The discussion then pivots to government renewal and the pressures of political transition, providing a mix of high-level insight and practical advice for the incoming administration as the country awaits Andy Burnham’s first moves as Prime Minister.
Brain teaser from listener Mara: “If we want things to stay as they are, things will have to change” — a reminder that political renewal must go beyond theatre. (46:31)