In 1997, the New Labour government set up the social exclusion unit in the Cabinet Office. It was tasked with tackling what Tony Blair called ‘joined-up problems’ – social challenges like homelessness, school absence and exclusion, drug use and teenage pregnancy, which often have complex and interlocking causes. Analysis suggests many of the initiatives that followed had real positive impacts. So what lessons can be drawn for the considerable challenges we face today?

In conversation with our Chief Executive Jennifer Dixon, Moira Wallace – a former senior civil servant who led the unit – reflects on its work, the approaches it pioneered and how change was delivered on the ground. With near-record numbers of young people not in education, work or training – and public investment constrained – what options are available to the current Labour government? And how could changes to the wiring of government help to tackle this and other social challenges?

Show notes

Wallace M (2023). Trends in adolescent disadvantage: policy and outcomes for young people under Labour, the Coalition, and the Conservatives (1997 to 2019).

Wallace M (2025). Reducing school absence: innovation lessons from the last Labour government.

Health Foundation (2024). Sure Start: a model for long-term policymaking? – with Naomi Eisenstadt and Donna Molloy.

Health Foundation (2025). No child left behind: what the government’s child poverty strategy should aim to deliver.

Health Foundation (2026). Why are a growing number of young people who are NEET reporting work-limiting health conditions?

Resolution Foundation (2025). False starts: what the UK’s growing NEETs problem really looks like, and how to fix it.

Teenage Pregnancy Knowledge Exchange and University of Bedfordshire (2025). Teenage pregnancy and young parenthood: successes, challenges and opportunities.

Surveys show rock solid public support for the basic principles of the NHS – universal, free at the point of use and mainly tax funded. Yet given widespread public dissatisfaction with the status quo, and non-traditional challenger parties gaining ground in the polls, can we take consensus on the NHS model for granted?

In our second conversation exploring big trends in UK public opinion, we ask what public mistrust and a desire for change could mean for institutions like the NHS. How are policymakers to respond to the public’s concerns? And what could the rise of Reform UK mean for the NHS and wider health policy?

Our Chief Executive, Jennifer Dixon, is joined by Rachel Wolf, CEO of Public First, a policy and strategy consultancy that researches public attitudes.

Surveys show rock solid public support for the basic principles of the NHS – universal, free at the point of use and mainly tax-funded. Yet given widespread public dissatisfaction with the status quo, and non-traditional challenger parties gaining ground in the polls, can we take consensus on the NHS model for granted?

In the first of two episodes, we explore big trends in UK public opinion and ask what they reveal about attitudes to longstanding institutions, like the NHS. With 40% of the public saying it would let our public institutions ‘burn’, how should policymakers respond? And can pressure for quick results be balanced with long-term reforms?

Our Chief Executive, Jennifer Dixon, is joined by Luke Tryl, UK Executive Director of More in Common, a research agency focused on public attitudes.

• Rachel Sylvester, Political Editor of The Observer.
• Hugh Alderwick, Director of Policy and Research at the Health Foundation.

• Andrea Palm, former Deputy Secretary of the US Department of Health and Human Services (2021–25) where she led the development of the Department’s strategic plan for AI in health and care.
• Andrew Bindman, Executive Vice President and Chief Medical Officer at Kaiser Permanente, one of the US’s largest integrated health care systems.

• Health Foundation (2025). Event: AI in the NHS 2025.
• Health Foundation (2024). Priorities for an AI in health care strategy.
• NEJM Catalyst (2024). Ambient AI scribes to alleviate burden of clinical documentation.
• Kaiser Permanente (2025). AI in healthcare: 7 principles of responsible use.

• Michelle Mitchell, Chief Executive of Cancer Research UK
• Jesper Fisker, Chief Executive of the Danish Cancer Society.