The UK must move beyond fragmented public services if it is to address the overlapping challenges of ill health, youth inactivity, and declining employment opportunities, Alan Milburn has warned.
As Chair of the Independent Review into Young People and Work, he spoke at a discussion organised by the University of Liverpool’s Civic Health Innovation Labs (CHIL) in Liverpool at the Labour Party Conference, bringing together leaders from health, local government, universities, social care, and business. The former Secretary of State for Health argued that technological advances could help public services intervene earlier. But delivering change would also require stronger local powers, different funding arrangements, and greater accountability for shared outcomes.
Milburn, who is leading a review into young people not in education, employment, or training, described a generational crisis driven by the collision of economic change, and rising health needs.
The discussion, chaired by CHIL Director Professor Iain Buchan, focused on closing the gap between what public services know about people’s circumstances and what they do to improve them.
A Generational Crisis at the Intersection of Health and Work
Milburn argued that youth inactivity cannot be understood through employment policy alone.
The decline of traditional industries and entry-level jobs has made it harder for young people to take their first steps into work. Alongside this, increasing mental health needs are creating additional barriers to participation.
He cautioned against treating these challenges simply as a consequence of COVID-19. The pandemic intensified problems that were already emerging, leaving services facing a combination of longstanding economic disadvantage and changing health needs.
For Milburn, the central weakness is that government continues to organise its response through separate departmental structures, while people’s difficulties cross those boundaries.
Health, education, employment, and family circumstances interact throughout a young person’s life. A response built around individual services risks missing that wider picture.
Local Places Must Have the Power to Deliver
Milburn called for a clearer distinction between national frameworks and local delivery.
National government has a role in establishing the conditions for change, but interventions must reflect the communities they serve. Even neighbouring city regions can have different economies, demographics, and employment opportunities.
His argument was that devolution must extend beyond transferring responsibilities. Local leaders need the authority, resources, and capacity to bring services together around people.
However, he warned that moving existing structures to a regional level would achieve little if the same divisions remained.
“If we do that, honestly, nothing will really change.” – Rt Hon Alan Milburn, Chair of the Independent Review into Young People and Work
The challenge is therefore to change how institutions work together, alongside where decisions are made.
Roundtable participants also highlighted the need for stable funding and stronger local institutions. Young people who have experienced disappointing encounters with schools, employment services, or healthcare may already distrust the organisations intended to support them.
From Knowing the Risks to Acting Earlier
A central theme of Milburn’s contribution was that public services already hold information that could support earlier intervention.
He pointed to longitudinal research in Bradford, describing how researchers could identify early patterns associated with a greater likelihood of young people later becoming disengaged from education or employment.
Schools and other services also see warning signs, including deteriorating attendance, changes in behaviour and unmet support needs. The difficulty is turning those observations into coordinated help.
“It’s one thing to know, it’s another thing to do.” – Rt Hon Alan Milburn
Participants discussed how information held separately by education, health, local government and benefits services could provide a more complete understanding of a family’s needs.
The ambition was to reduce repeated assessments, identify gaps in support and act before difficulties become entrenched.
Milburn acknowledged the importance of confidentiality and appropriate governance, while arguing that decisions about data use must also consider the benefits of timely support.
AI Must Support Relationships and Public Trust
The discussion positioned AI and connected data as tools to improve people’s lives, with their value depending on the actions they enable, and the public trust needed to use them at scale.
Participants stressed that identifying someone who may need help is only the beginning. Services must have the staff, skills and trusted relationships to respond.
Community-based approaches offered practical examples. Representatives described parent champions working with families, alongside opportunities for young people to support their peers and help services build stronger connections with communities.
Social care was also identified as a potential route into meaningful employment for some young people, provided employers offer appropriate training, support and opportunities to progress. Participants noted that many young people bring valuable lived experience that could enhance their contribution to the sector, helping to create more understanding, person-centred services that better reflect the needs of those they support.
Public involvement will be central to the next stage of the Liverpool work. Professor Buchan outlined plans to take the discussion into citizens’ panels, allowing communities to help shape how data and AI are used across health, work and opportunity. This approach is outlined further in the Keep Britain Working prospectus on data and AI uses, which was launched at the roundtable.
Funding Must Follow Shared Outcomes
Milburn’s closing message was that better information must be matched by changes to funding, workforce capability and accountability.
Connected data can reveal where intervention would make the greatest difference. But services will struggle to respond if budgets and incentives remain confined within organisational boundaries.
He also called for an honest assessment of the skills required to deliver reform.
“Some of those skill sets don’t exist, and some of the skill sets that we’ve got are now redundant.” – Rt Hon Alan Milburn
His review is considering financial incentives that would give local authorities a stronger stake in improving outcomes, with recognition and reward for successful action.
For Liverpool and other city regions, the opportunity is to demonstrate how health, education, employment and community services can work together to prevent disadvantage.
The test will be whether earlier insight leads to earlier support: helping more young people stay connected to education, enter employment and build healthier lives.
(Photos: Gareth Jones Photographer )