Politics
Politics Home | Wes Streeting Insists NHS England Abolition Is Still Right Thing To Do Despite “Astonishing” Opposition

Wes Streeting spoke at an event hosted by the IPPR on Monday morning (Alamy)
4 min read
Wes Streeting has defended his decision to abolish NHS England, but admitted he can “understand why so many of my predecessors didn’t bother” given the scale of disruption and opposition.
The Health Secretary insisted the overhaul was necessary to cut duplication and improve accountability in the NHS, despite critics warning that the reorganisation risks distracting wider efforts to improve patient care.
His comments come after the Institute for Public Policy Research (IPPR) think tank published a report which found that transforming the NHS funding model to a European-style insurance system would not improve performance across the healthcare system. The report highlighted the high risks of transitioning from one system to another, which could cost billions and take decades to complete.
Speaking at the report launch on Monday morning, Streeting agreed with the findings, saying that the government’s approach would instead be to “invest in the NHS, to modernise it and transform the way it delivers healthcare”.
However, one of the biggest reforms Streeting has introduced so far has been the abolition of the arms-length body NHS England (NHSE). Prime Minister Keir Starmer announced in March 2025 that NHSE would be abolished and its responsibilities brought into the Department for Health and Social Care over a two-year transition period, as part of a wider bid to make the state more efficient and remove unnecessary red tape.
While Streeting’s allies argue the old structure was dysfunctional, with blurred accountability and internal gridlock frustrating ministers and stalling policy, NHS insiders say the transition has not been totally smooth up to now. At the same time, experts have described the move as risky.
Staff are due to reapply for roles in a merged organisation in early 2027, a timeline many insiders expect to slip, while others warn the upheaval could consume energy better spent on improving services.
Asked by PoliticsHome whether the abolition of NHSE was also proving to be a distraction from improving care for patients, Streeting said: “We’re doing the right thing for the right reason, and in process terms, I don’t see how else we could have gone about this, because there wasn’t a way of engaging with the workforce of that size…”.
“I have to say I can understand why so many of my predecessors didn’t bother and just sat there with a totally unsatisfactory bureaucracy and loads of waste and duplication,” he continued.
“The level of opposition that you get when you try and do things like this is astonishing, and the weight and volume of vested interests is just extraordinary.
“And I’m afraid this is why you do need strong political leadership. I’m not interested as a politician in meddling in clinical decisions.”
He said that he thought it had been the right decision to keep the planning of the NHSE abolition “quite close with NHS leaders” before it was announced.
Streeting acknowledged that the restructure was “hard on people who work in ICBs [Integrated Care Boards], and it’s hard on people who work in NHS England”: “I don’t treat that lightly or carelessly.”
However, he defended the decision and said that the idea that “democratically elected politicians shouldn’t keep an eye on how that money is spent and to make sure it’s used effectively is for the birds”.
“There are so many professional vested interests with a quiet, easy life who will always oppose these big changes, and I think ultimately, we will have done the right thing and the benefit will be to frontline patient services.”
A source close to Streeting previously told The House that the health secretary has found the “invisible barriers” to getting things done in government “harder than most”.
“He has struggled to get his priorities through,” they said. “He’s a very sharp guy. But when he came in, after getting his own way on policy in opposition, he was shocked about needing Treasury sign-off… It was a rude awakening.”
Commenting on the IPPR report findings, head of health at IPPR and report author Sebastian Rees said: “There is no structural silver bullet for the NHS. The idea that simply switching to a European-style insurance model would fix its problems is a pointless distraction and not supported by the evidence.
“The NHS’s challenges are real – but they are the result of a decade of chronic underinvestment and choices on how money is spent, not the funding model itself.
“Policymakers should focus on what actually works: investing in infrastructure, strengthening primary care, and tackling the drivers of poor health.”
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Politics
The House Opinion Article | Worker Bees: Inside The Burnham Operation

9 min read
Andy Burnham remains a likely candidate to replace Keir Starmer if the Prime Minister leaves office before the next election. Tom Scotson goes in search of the people, ideas and forces shaping what would be his third leadership campaign
Last October, Andy Burnham was a badly damaged figure. A series of high-profile interventions in the run-up to and during Labour’s conference – widely interpreted as a soft coup – had misfired.
Keir Starmer’s allies mocked the so-called ‘King of the North’ as a presumptuous, vainglorious blowhard, a risk to the UK’s financial credibility and a political dead-end for Labour.
At this low point, an old friend offered some comradely advice to the Greater Manchester mayor. “Remember what Lenin said in 1917 as he waited for a train in Switzerland,” David Blunkett recalls telling Burnham. “Timing is everything in politics.”
The timing – six months on – looks rather different. Labour is braced for heavy losses in elections in Scotland, Wales and England’s local councils. And while the Iran conflict is dampening speculation around Starmer for the moment, it is likely to reignite soon enough.
And while Angela Rayner has ensured she remains part of that conversation in recent weeks, many MPs believe that only one figure can save them. As one ally puts it, “It’s Andy Burnham or bust.”
Supporters believe he continues to hone his strengths (communication), jettison past mistakes (support for the Iraq war), and is building a coherent political philosophy (Manchesterism).
Quitting Westminster for the mayoralty is cited as the best move Burnham made to rebuild his profile. It is now, ironically, a major obstacle between him and the job of prime minister.
Ahead of the Gorton and Denton by-election, Burnham put his hat in the ring to stand as a candidate but was rejected by the party’s National Executive Committee (NEC) officers by eight votes to one, with only deputy leader Lucy Powell on side. The House understands that, despite boldly resolving to apply to stand, Burnham made little to no effort ahead of the vote to lobby any of the NEC officers who declined to back him.
Polling by Britain Elects suggests Burnham would have won the parliamentary seat comfortably.
Insiders working on the campaign say internal figures were even more positive, with one believing he would win with almost 60 per cent of the vote, as voters saw him as the obvious ‘Stop Reform’ candidate.
It is a thesis now safe from contact with reality. But Gorton is unlikely to be the last Labour-held seat to become free this Parliament.
To find out whether the twice-failed leadership hopeful has what it takes to return and topple a sitting Prime Minister, The House spoke to a wide range of Labour sources, Burnham allies and close friends.
Burnham, a local journalist for a short while, sees policy through the lens of how it will land in the press. “It is all media,” says a senior former aide, who helped run one of his failed leadership campaigns.
They added: “He was always very good at ‘the story’: where can I go, or what can I go and do, so that I get noticed?”
Burnham read English literature at the University of Cambridge after devouring the collective works of Philip Larkin and Shakespeare. Despite this, his friends are unsure if he continues to read for pleasure anymore.
“I can’t see Andy reading Jane Austen,” says a long-standing ally and Labour MP. “It would be interesting to know why he did English. Usually, lads would do history or PPE at Oxford. Maybe it would be the Morrissey type thing, the Oscar Wilde’s, that more romantic side of things.”
A minister adds dryly: “He travels lightly: both intellectually and politically.”
Nonetheless, he has a deep love for romantic poetry and Irish history. Steve Rotheram, Burnham’s best friend in politics, recalls the Manchester mayor chatting away with Michael D Higgins – the former Irish President and poet – about poets and ancient philosophers.
Burnham is a Roman Catholic. His Irish ancestry has been researched by Liverpool Central Library. “He does feel firmly attached,” says Rotheram of his Irish genealogy, “but he’s also one of those people who… is very patriotic as well.
“Andy’s always nailed his colours firmly to the mast. I think he’s a royalist, he loves the country.”
Burnham begins his mornings running regularly while listening to music on a predictably ‘Madchester’ playlist featuring The Stone Roses – his favourite band – as well as Joy Division, Oasis and New Order.
He works on his box over breakfast while preparing for a full day of meetings and events, which stretch into the afternoon and evening. Accompanied by his political aide Kevin Lee, Burnham drives around Greater Manchester in a run-down Volkswagen usually littered with disposable coffee cups.
You won’t find many of these speeches published because most of them are written and delivered from a set of notes that he’s made – they are his thoughts
Working late makes family life more difficult, but friends say he and his Dutch wife Marie-France van Heel remain close. The couple, who first met at university, live with their children and dog Axel in Leigh. Even at home, however, Burnham is said to chase colleagues and advisers over the weekend with questions arising from new academic reports and what he is reading in the papers. This is in contrast to the disengaged attitude the Prime Minister is accused of adopting.
Burnham has long traded on being a lifelong Evertonian. “You’d always see him in animated conversation with the doorkeepers, and then when you eavesdropped, it was always about football,” says an MP. He had a season ticket at Goodison Park in the Gwladys Street end and renewed his ticket when the club moved to the Hill Dickinson stadium at the start of the season.
The mayor of Manchester is also a real ale enthusiast. Another MP friend reports that, although “not a piss artist”, Burnham does enjoy a drink: “You could see him drink eight or 10 pints without appearing to be pissed.”
Outside of his day-to-day schedule, his inner circle, like all metro mayors, remains small. Lee, Burnham’s political secretary, is a Manchester United season ticket holder who has been working for him for 16 years.
Amy Davies now runs his office and his diary. Kate Green, Greater Manchester’s deputy mayor for policing and crime, is also a close associate of Burnham’s, having left Parliament in 2022 to join ‘Team Andy’.
The list of those in Burnham’s orbit but outside the inner circle makes for more interesting reading. It includes around 14 experts working on policy to flesh out his own political offer.
A close confidant of his remains Neal Lawson, director of centre-left pressure group Compass, who continues to introduce the Manchester mayor to more left-wing voices. Lawson and Burnham first met playing for the Labour football team Demon Eyes; the Compass director was goalie, Burnham up front.
Other influential voices close to Team Andy include Mathew Lawrence of Common Wealth, Zoë Billingham from IPPR North and Andrew Carter, CEO of Centre for Cities.
Lawrence has recently been tasked, alongside the Mainstream group, with fleshing out Manchesterism. His phrase “the Privatisation Premium” was used in a recent speech of Burnham’s – which the mayor continues to write himself, often in bullet point form.
“You won’t find many of these speeches published because most of them are written and delivered from a set of notes that he’s made – they are his thoughts,” Lawson says.
Lawrence is in the middle of writing a separate upcoming paper, which will flesh out Manchesterism in more detail. It will attempt to connect the affordability crisis and related pressure on public spending to the structural retreat of investment in energy, housing and water.

A sympathetic minister tells The House: “What we are building is a movement, so it doesn’t matter about the individual, it’s who can drive it.”
Aides of Burnham say civil servants attend his events and snoop at his press conferences as he critiques Whitehall and lays the foundations of his political position.
Critics of Manchesterism – which, paradoxically, were once associated with free trade and laissez-faire economics – believe it lacks any meaning apart from nationalisation.
His supporters contend that the framework is meaningful while reflecting his pragmatism and keen eye for the most useful political fights. Capping bus fares across Greater Manchester to £2 is a perfect example, they say, as it brings in a visible change to the daily lives of so many.
“‘Transport is number one, transport is key,’ he would say as the gamechanger for Greater Manchester,” another former long-serving aide of Burnham tells The House.
He surrounded himself with a bunch of yes people, which is a challenge in itself
But there are long-running criticisms of Burnham, including from allies. The most notable is his tendency to be indecisive at key moments. Former colleagues point to his failed leadership campaigns as evidence.
During the 2010 leadership race, Burnham’s campaign was split over whether to take money from Unite, then run by Len McCluskey. One person who was working on Burnham’s campaign recalls: “We had a very, very polite but nonetheless heated discussion. He believed the right-wing press during the leadership camp would assert the fact that they’re in the pocket of [Unite]. My contention was I couldn’t give a monkey’s – the membership of the Labour Party [is] what matters.”
In the run-up to the 2015 leadership election, there was still considerable discontent despite being a leading contender.
“He surrounded himself with a bunch of yes people, which is a challenge in itself,” one former aide tells The House. A crucial downfall of the campaign was when he could not decide whether to rebel after the then-acting leader Harriet Harman urged colleagues to abstain on a controversial welfare bill.
Jeremy Corbyn was one of the 48 rebels who voted against the bill, which is commonly thought to be a major factor in his subsequent victory. The former aide says: “Classic Andy, he found a reasoned amendment which didn’t mean anything to anyone, while Corbyn was explicitly against it.”
Allies acknowledge he has made mistakes yet believe he is now more comfortable in his own skin.
“He doesn’t have to think about slicing and dicing for particular audiences in particular ways,” Lawson says. “I don’t think it’s enormously calculated. I think it’s quite authentic and quite genuine.”
Nonetheless, Burnham still faces one problem which could be insurmountable: returning to Westminster.
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Politics
The House Article | Team Burnham Is Getting Organised Ahead Of The May Elections

4 min read
Labour MPs say Angela Rayner is down, Andy Burnham is up. Sienna Rodgers reports on the obstacles on the mayor’s path to No 10
Even the most enthusiastic advocates of a change in the Labour leadership are starting to wonder whether the current stalemate will really be broken by terrible results in May.
The party’s press operation may not yet have begun its expectation management ahead of the elections, but a very low bar has already been set in the minds of its MPs. “Ah, but that’s baked in,” they often say when asked about the possibility of shocking outcomes such as losing power in Wales for the first time ever. The number of Labour councillors lost in England could easily exceed 1,000, one whip privately conceded with a shrug.
The mood of the Parliamentary Labour Party (PLP) can shift quickly, however, and allies of Andy Burnham hope that, in the case of truly dismal results, MPs will wake up to the severity of the crisis the party finds itself in and get moving. The best-case scenario for them would be an orderly transition in which Keir Starmer sets a date for his departure, allowing time for the ‘King of the North’ to get into position.
Although the Iran war makes this less likely, the good news for Burnham is that he appears to have secured the support of senior members of the PLP, especially the Tribune group. Ed Miliband, Louise Haigh, Lisa Nandy and Miatta Fahnbulleh are all now considered by sources close to the mayor to be on board the Burnham train. He has moved from 50-odd potential nominees in the PLP to triple figures, says a backer.
After being promised by a senior Labour figure that his Gorton and Denton candidacy would not be blocked, Burnham failed to lobby National Executive Committee officers ahead of the vote and was blindsided by the outcome of his application. He is a busy politician with significant responsibilities, so “trying to find the time to be the saviour of the Labour Party and the civilised world is quite tough”, reasons one ally. But The House understands that Burnham is now doing the outreach required for a move.
He has started meeting with Labour MPs in a more intentional way, and a supporter of his ambitions says he is beginning to organise among trade unions too. Unison – a huge party affiliate that is best associated with Rayner but is now led by Andrea Egan, a Burnham fan – is regarded as key. The unions are significantly more amenable to the idea of a Burnham bid than they were pre-Gorton, says a source.
The increase in backing for Burnham has run parallel to a waning of Rayner’s star power. The more she says, a critic on the left asserts, the worse it gets for her.

Although the speech she delivered to soft-left group Mainstream’s March reception was successful in creating headlines, multiple sources say some of the contributions to it from left-wing partner Sam Tarry, MP Clive Lewis and ex-MP Jon Cruddas were removed by her parliamentary team. “The deeper thinking was ripped out,” as one disappointed insider puts it, adding that this left her with a classic Friday night Constituency Labour Party stump speech.
So, MPs on the soft left and left are waiting for Burnham instead. Getting into the PLP nonetheless remains a challenge, of course – but his allies are confident that appropriate options exist and that it will be easier to exert control over the timing of such by-elections this time.
They will not comment on which specific seats Burnham is eyeing. But with Marie Rimmer’s Merseyside seat out of the running (the MP has told The House in no uncertain terms that she would not be stepping aside to make way for the mayor), one friend of the mayor suggests that Manchester Rusholme (Afzal Khan) and Bootle (Peter Dowd) are seen as the favourites – and that the promise of a peerage could smooth this path.
Labour’s third-place result in Gorton and Denton has worried local MPs, they say, making it easier to persuade them to quit the green benches before they are pushed. Another idea floated is that Nandy could swap places with Burnham, though there is no suggestion that the Culture Secretary has endorsed such a plan.
So, as Burnham looks increasingly like the desirable choice for Starmer critics, his operations, organisation and policy work are all being ramped up.
For supporters, what worries them above all is the scale of the repair job needed. “Gorton and Denton had to happen for Andy’s support to rise this much, but on the other hand, Gorton and Denton may have been the death of the Labour Party,” says a Burnham-allied MP.
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Politics
Politics Home | Ed Davey: Hillary Clinton Told Me To “Stand Up To Bullies” Like Reform UK

9 min read
Former US presidential candidate Hillary Clinton privately urged Liberal Democrat leader Ed Davey to “stand up to bullies” like Reform UK during a recent visit to London.
In an interview with PoliticsHome ahead of the 7 May local elections, Davey revealed that he had a “long chat” with the former US secretary of state when she spoke at a business reception in the capital late last year.
“We talked about how we need to fight Reform in the way they need to fight Donald Trump, and she gave me some choice advice, which I’m not going to repeat because that would be unfair on her,” he said.
When pressed, he added: “She said you have to be very strong and stand up to bullies and don’t cave in and cosy up to them. She didn’t say she was criticising Keir Starmer, but I think the approach we [the Lib Dems] have taken, and the approach that someone like the Liberal Prime Minister of Canada, Mark Carney, has taken, is the sort of approach she will endorse.”
He described Clinton as “very friendly and very warm”: “You could tell that she realised that we had shared values.”
Davey sat down with PoliticsHome a month out from voters going to the polls for highly-anticipated elections in Scotland, Wales and council areas across England.
Ahead of those elections, the Lib Dems have sought to frame themselves as part of the broader pushback against the rise of the populist right, taking strong positions against Trump and his actions in Iran, and calling on King Charles and Queen Camilla’s planned visit to the US to be cancelled over the US president’s treatment of the UK.
Speaking at the party’s local election campaign launch in Birmingham on Friday, Davey accused Nigel Farage’s Reform of “importing the divisive, nasty politics of Donald Trump into the UK”, adding: “This does not sit well with British values.”
The Lib Dem leader said he hopes that the Democratic Party defeats the Republicans in the US midterm elections in November, and while he joked that his party was “pretty busy in the UK at the moment”, he said they do have a “good relationship with a lot of Democrats”.
“We’ve helped Democrat politicians in the past,” he said.
“They have a good relationship with our party. We had a good relationship with a few Republicans, but I’m afraid lots of Republicans from that great party have now backed the MAGA movement and now support Donald Trump and some of his nasty, divisive, damaging policies.”
As well as Canadian Prime Minister Carney, Davey praised the “strong leadership” of Spanish Prime Minister Pedro Sánchez, who on Wednesday issued a thinly veiled swipe at the Trump administration by saying Spain “will not applaud those who set the world on fire just because they show up with a bucket”.

With Trump continuing to be a deeply unpopular figure in the UK, Davey hopes that his party’s opposition to the US president will boost Lib Dem prospects on 7 May.
Last month, The Spectator obtained internal plans revealing a belief among Lib Dem strategists that their position on the Iran war will pay dividends at those elections, with a memo reading: “For the first time since the Iraq war… we have a chance to turn a distinctive and principled Liberal Democrat position on foreign affairs into significant election gains.”
However, despite leading the Liberal Democrats to their best general election result two years ago, Davey is heading next month’s locals under pressure from restless Lib Dem MPs who complain that the party is drifting and failing to capitalise on the 2024 success.
The polls are the polls, but the elections are the elections
Most opinion polls show that the Lib Dems have hovered around 12 per cent of the national vote since the 2024 general election, with no significant increase.
Last month, PoliticsHome reported concern within the party that a handful of Lib Dem MPs could be tempted to join Zack Polanski’s surging Greens.
“I’m restless like they are… I share their restlessness,” Davey told PoliticsHome, while stressing that his MPs and the party “work really well together”.
However, in a bid to face down his critics, the Lib Dem leader pointed to his electoral record.
“The polls are the polls, but the elections are the elections,” he told PoliticsHome.
“Winning elections is what we’ve done under my leadership. If we make net gains in May, it will be the eighth year in a row we’ve made net gains, the sixth under my leadership. It’s never happened before. That’s a continual increase, year on year.
“This year we could well beat Labour and the Tories for the number of councillors we elect for the second year in a row, and it’s never happened previously.”
He insisted that the Lib Dems are “still the most united parliamentary party” despite recent negative briefings.
“Labour could have a leadership election after May, the Tories could. They’re certainly losing MPs to Reform, and then Reform is losing those MPs on the other side. We haven’t, we won’t, and we will work really well together. I am determined to lead us into the next election and show that we have the ideas for our country,” he said.
One complaint among uneasy Lib Dems is that the party currently lacks a clear identity and target audience, having spent recent years focusing its electoral strategy on former Conservative voters in the south of England.
According to Davey, the party now has an opportunity to pick up former Green supporters who care deeply about the environment but are not as left-wing as the party’s self-described eco-populist leader, Zack Polanski.
“You’re going to see a fracturing of the Green Party in the sense that there’s a lot of the former Greens before this Corbynista push, who were much more middle of the road,” he said.
“Their focus was on the environment… The stuff that they [the Greens] are now talking about, they don’t really buy… they don’t like what they’re seeing.”
The discussion heading into 7 May has been dominated by the rise of the Greens and Reform, and their threat to the historic two-party dominance of Labour and the Conservatives.
However, the Lib Dems are hopeful of making gains across the country next month, including in East and West Surrey, Hampshire, Portsmouth, and some areas in the north of England, such as Stockport and Newcastle.
Asked what distinct message the Lib Dems are offering to voters, Davey told PoliticsHome they were positioning themselves as “local champions” who will fix church roofs – a deliberate echo of Conservative leader Kemi Badenoch, who mockingly described a Lib Dem “somebody who is good at fixing their church roof” last year.
At the campaign launch on Friday, PoliticsHome spoke to Lib Dem councillors and candidates who felt that while it was unlikely they – or any party – would win outright control of Birmingham Council, the Lib Dems could be left in a good position to play a “leading role” in the administration after the elections.
The question of who Davey would be prepared to work with could be one he faces increasingly in the future, as the fragmentation of UK politics into a multi-party system shows no signs of going away.
Davey was clear that his party has ruled out working with Reform, and the leader of the Scottish Liberal Democrats, Alex Cole-Hamilton, has ruled out entering a coalition with the Scottish National Party (SNP).
However, the party has not ruled out a coalition with Labour, the Green Party, independent candidates, or Plaid Cymru in Wales. Jane Dodds, the leader of the Welsh Liberal Democrats and the only Lib Dem member of the Senedd, said this week that the Lib Dems would only work with Plaid Cymru if they “confirm that they will not spend a penny of government money on independence”.
Asked whether his party might enter an agreement with the Welsh nationalist party, Davey said he had not spoken to Dodds about it yet.
“I’d be really surprised, given our opposition to independence,” he said.
“You would have to speak to Alex Cole-Hamilton and Jane Dodds, because they will run those negotiations. They’re devolved administrations.”
Liberal Democrat MP Roz Savage told The House magazine in March that the party “needs a plan” for a coalition scenario after the next general election, having been “badly burned” by their experience sharing power with David Cameron’s Conservatives.
Asked whether any resulting coalitions from the May elections could provide test cases for where Lib Dems could work with other parties after a general election, Davey said: “Good question, but I am very focused on the local elections and the next general election, maximising Liberal Democrat victories.”
The challenge for Davey and his party, however, is that the 7 May elections are so unpredictable that they are struggling to predict where they might make the strongest gains.
“It’s complicated, because you’ve got the two old parties’ votes collapsing,” the former cabinet minister said.
“Where we’re strong, we’re big beneficiaries of that, but then there’s Reform coming in… And so we’re finding it quite difficult to read the canvassing, because the Reform vote is a little bit shy.”
Davey suggested the Lib Dems could cause “a bit of a surprise” in Birmingham, pointing to the fact that his party are fielding an expanded list of 101 candidates in the city and describing local campaigners as having “really gone for it”.
In the bid for attention in an increasingly fragmented political landscape, Davey intends to continue carrying out publicity stunts for the cameras. Most recently, he was pictured playing chess with Hull City Council leader Mike Ross at the Hull campaign launch last week.
Davey – similarly to Chancellor Rachel Reeves – played chess competitively until he was about 12 years old, though he said he would “not put myself up as a great chess player” anymore.
“Playing the long game, that’s the key thing in chess,” he said.
“You play all your moves, you don’t get worried if you make a sacrifice here, you work out where you’re going to go.”
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