Michael White: Burnham's return signals the start of a grudge match

Like a fullback in a hard fought game, Healey was expected to kick for goal from some very oblique political angles.

In office Labour had imposed top-down NHS reforms (and how!), committing itself to choice and competition.

“We’re only building on Blairism,” was what Lansley and Stephen Dorrell were able to claim – much as education secretary Michael Gove does over his academies programme. Not true, say Labour, but tricky.

Last autumn when “Handy Andy” pleaded to stay at health, Miliband insisted on a change so that the new opposition need not be wedded to old positions. As this column reported last month there was muttering that Healey had not kicked enough goals, although he points out that he built a broad behind-the-scenes coalition against the Health Bill and turned the Tories’ 2010 poll lead on health into a fat deficit today.

“We made a hell of a lot of headway,” he told me on Sunday as he and Miliband (praising him as “an exceptional… tireless colleague”) exchanged friendly letters.

If Healey was due to be pushed, he jumped first, doing what Alan Milburn and Norman Fowler both did from Richmond House, resigning for family reasons. In Healey’s case, his wife, Jackie, has put up with long absences, raising their only child, now 16. Time to put family first.

That’s OK by me. The former disability rights campaigner, an MP since 1997, is 51 and can come back. I detect no ill-feeling with Burnham (41) who admires his work and shares much of his analysis (as does Dorrell, of course). Lansley made a huge strategic error in imposing major structural changes in commissioning which was bound to distract from Sir David Nicholson’s £20bn efficiency drive, itself a Burnham legacy.

Sir David’s leaked weekend letter about the need to pass the bill and concentrate on modernisation suggests even he may be panicking as “rudderless” PCTs collapse, leaving a vacuum, a directionless system where costs mount and waiting times stretch. Yet Burnham’s first move was to write to Lansley, offering cooperation on reform in return for withdrawing the bill.

Fat chance, says me. But Burnham was calculating that Lib Dem and cross-bench peers might just join Labour by backing ex-Labour renegade and Barbara Castle’s health deputy Lord Owen’s amendment and send much of the bill for detailed examination by a select committee packed with medical grandees. It would amount to another, potentially fatal, “pause”.

You know the result of yesterday’s Lords second reading vote, as I do not as I write, although my prediction was that ministers would win. Either way, the battle rages on. Healey insists Labour’s choice programme envisaged “planned and managed choice as a supplement alongside the NHS as the core public service” – not exposed to the full force of EU/UK competition law.

Burnham concurs, noting in passing that Sir David has been risking peers’ wrath by letting PCTs be dismantled before the bill is law. Remember, this is now a grudge match. Burnham still fumes over events following Lansley’s pre-election request in 2010 for cross-party talks to find consensus on elderly care reform.

The health secretary then allowed hooligans at Tory HQ to stitch up Labour and the Lib Dem spokesman with that tabloid “death tax” scare.

“Spineless and unforgivable” remains his verdict.