Showing posts with label NHS. Show all posts
Showing posts with label NHS. Show all posts

Wednesday, May 06, 2015

Five reasons why I'm backing a Lab/Lib coalition

Yesterday I outlined why I don't think the current Tory-Lib Dem coalition deserves to be re-elected.  Here's why I hope a Lab-Lib coalition will emerge in its place.

1.  Labour has fought the most positive campaign. Call me old-fashioned if you like, but I still believe that politics should be about sharing a vision of a better world rather than promising to protect us from nightmares - the politics of hope versus the politics of fear. While the Tories have relied on negative campaigning and the tired old tactic of better-the-devil-you-know, Labour has set out a positive case for change, outlining how they would change this country for the better. Even if you don't agree with all the details, this is the right way to do politics and it deserves to succeed.

2.  Ed Miliband has exceeded expectations and has demonstrated that he is ready to be Prime Minister. Despite being subjected to the most disgraceful and frankly juvenile abuse from certain elements of the national press, the Labour leader has held up well under pressure.  As someone said on Twitter today: "I’m sure Cameron eats a bacon sandwich really well. But he’s overseen a million people visiting food banks. I know which matters more."  Ed M may never have that easy rapport with the public that Tony Blair had in his pomp, but in a contest with Cameron he wins hands down, simply because he is more in touch with the lives of ordinary voters.

3.  Labour is the only major party committed to repealing the 2012 Health and Social Care Act. I've heard it argued by health service professionals that the horse has already bolted on this, and that the unleashing of private sector forces into the NHS cannot now be undone.  Well, maybe, but it can be contained.  The Health and Social Care Act - that massive, top-down reorganisation the Tories promised us would never happpen - was a deceitful piece of legislation that set out a route-map towards a system of privatised health care that few people actually want.  It needs to go so we can rebuild our NHS according to the principles on which it was founded.

4.  Contrary to the received wisdom, Labour's policies are actually more business-friendly than those of the Tories. People who do not realise this are faling to see the elephant in the room, namely David Cameron's commitment to an in-out referendum on European Union membership in 2017.  The uncertainty created by this will wreck the so-called 'recovery' and prolong the economic pain for those households, businesses and regions who have yet to see its benefits.  On the question of the deficit, there is very little to choose between the two big parties and, since 2010, Labour has moved significantly in the direction of greater fiscal responsibility.

5.  In coalition with the Liberal Democrats, Ed Miliband would lead a social democratic rather than a socialist government.  Nick Clegg has been absolutely right in this campaign to position the Lib Dems as a moderating influence on left and right, maintaining his equidistance between the two big parties and appealing to the centre ground which is where British politics should continue to be anchored.  Many see Clegg as a Tory collaborator but to be fair, he has made it clear he will talk first to whichever party has the most seats.  For the other reasons set out above, I hope - and pray - that this will be Labour.

Tuesday, May 05, 2015

Five reasons why the Tories do not deserve to be re-elected

Despite having a very good local constituency MP in Pauline Latham, here's why I won't be voting for her party on Thursday.

1.  The Tories have fought a negative and uninspiring campaign characterised mainly by telling lies about Labour's tax plans, lies about Labour's 'relationship' with the Scottish National Party, and a complete lack of candour about their own plans to slash welfare benefits in the next Parliament. Apart from a brief period around their manifesto launch, when David Cameron brought his 'sunshine' agenda back out of cold storage, the party's campaign has focused almost exclusively on spreading fear rather than hope. Such an approach is unworthy of a major political party and does not deserve to succeed.

2.  David Cameron has failed to engage with the public at any level, turning the campaign into a series of carefully-managed photo-ops rather than the conversation with the voters it should have been. His disdainful treatment of the regional press - for instance keeping local journalists in a room while he toured a factory - has been well-documented on HoldtheFrontPage, but is symptomatic of a wider reluctance to engage, of which the scrapping of the morning press conferences and his refusal to debate Ed Miliband head to head are also part and parcel.  The British public deserve better than a Prime Minister who is seemingly afraid of the voters, afraid of legitimate questioning by the media and afraid of what an opponent he has repeatedly sought to denigrate as not up to the job might do him in a one-on-one encounter.

3.  The Tories cannot be trusted with the National Health Service. Having pledged not to introduce a top-down reorganisation of the NHS at the last election, they then passed the Health and Social Care Act 2012.  This provides a route-map towards a nightmarish future in which the NHS ceases to exist as an organisational entity, with health care commissioned by GPs from a panoply of mainly private providers.  Once the profit-motive becomes embedded in our health service, it will be impossible to maintain it as free at the point of delivery.  Private providers have shareholders to please and profit margins to meet, and this will inevitably get passed on to patients.

4.  George Osborne's management of the economy has led to an uneven recovery which has widened the divide between the haves and the have nots and kept wage levels depressed while the cost of living has increased. The economic statictics may tell a positive story for the Conservatives, but the experiences of people at the sharp end tell another and small business people, public sector workers and anyone living north of Watford Gap have seen very little evidence of recovery at all. For all the Chancellor's talk about creating a 'Northern Powerhouse,' the economic divide between the North and South of the UK has grown over the past five years, with potentially baleful repercussions for the unity of the British state.

5.  The Tories' reckless promise of an in-out referendum on European Union membership in 2017 will create two years of uncertainty in the business community which will further paralyse already sluggish economic growth in the UK.  The Europe question was decisively settled by a previous generation in 1975 and millions of British jobs and livelihoods now depend on EU membership.  The issue does not need to be reopened now just so Mr Cameron can appease his recalcitrant backbenchers or seek to win back a disaffected, xenophobic minority who have temporarily deserted his party for Nigel Farage and UKIP

Tomorrow, I give my five reasons why I'm backing a Labour/Lib Dem coalition as the best election outcome.

Friday, February 27, 2015

Does Labour want regional devolution - or a truly national health service?

Pains me to say it, but Osborne has played a blinder over the £6bn Greater Manchester health funding deal and in so doing posed a real political dilemma for Labour.

Here's this week's Journal column.

http://www.thejournal.co.uk/opinion/paul-linford-george-osborne-seems-8737333

Saturday, January 31, 2015

The time for internal debates has passed, Alan

The forthcoming election is, first and foremost, about the future of the NHS and whether, under a majority Tory government, it will by 2020 have ceased to be a direct provider of healthcare altogether.  Which is why Alan Milburn should really have kept his mouth shut.

Here's this week's Journal column:

http://www.thejournal.co.uk/opinion/paul-linford-alan-milburn-should-8553467

Saturday, October 04, 2014

Saturday, September 13, 2014

Thatcher, Blair, Brown, Cameron...All are to blame

Today's column in The Journal, tying together some of the independence referendum threads I have blogged about this week.



SOON it will all be over.  By the next time this column appears, the debate that has dominated British politics for the past six months will finally have been settled, and Scotland will have voted yea or nay to independence.

It has been, without doubt, the hardest vote to call in living memory.   For a long time the ‘Better Together’ campaign appeared to hold an unassailable lead, but as was always likely, the gap began to close as the emotional case for independence began to sway the hearts of voters.

Belatedly, the No campaign has this week tried to come up with some emotion of its own, temporarily setting aside all the dry arguments about currency with a series of impassioned ‘Please Don’t Go’ type appeals.

Prime Minister David Cameron has even joined the fray, despite having previously concluded that such direct personal involvement would simply play into the hands of the Yes campaign with its adroit portrayal of him as the representative of an out-of-touch, English Westminster elite.

Writing as a committed unionist, these have been worrying days indeed.   Many of a similar persuasion have asked the question how on earth we got into this mess, and specifically, how Mr Cameron allowed us to get to a point where the break-up of the UK is now a very real prospect.

To my mind, the answer is clear.  What we are now seeing is the inevitable outworking of the Conservative Party’s decision, after 1979, to eschew One Nation politics in favour of a free market ideology that found little favour with the Scots – or, for that matter, the Northern English.

It is easy to blame Margaret Thatcher for the country’s ills, but it was her government’s abandonment of the post-war political consensus that began the progressive estrangement between Scotland and Westminster that could now lead to outright separation.

It may have won her three elections, but it was done with no regard for how it would affect the social fabric and essential political unity of the UK, and no thought for whether the Scots would still want to be part of the country she was creating.

Three and half decades on, the differences over the future of the National Health Service provide perhaps the clearest illustration of the growing disconnect.

Mr Cameron’s decision to enact the 2012 Health and Social Care Bill, which potentially paves the way for the future privatisation of the NHS, has been exploited to the full by Scottish First Minister Alex Salmond.

It matters little, as Gordon Brown pointed out this week, that health is already a devolved matter for the Scottish Parliament and that a Westminster government would therefore find it hard if not impossible to privatise health services in Scotland.

The fact that the legislation was passed at all is tells Scots all they need to know about the gulf in values that now exists.

There was a brief, evanescent moment, in May 1997, when I thought that Tony Blair was going to restore that lost sense of shared values, to stitch the country’s frayed political bonds back together and forge a new consensus.

Asked to describe the new Prime Minister’s mood following his landslide victory the night before, Alastair Campbell responded:  “He realises he has been given a remarkable opportunity to unite the country.”

Alas, he chose instead to triangulate Labour’s own values out of existence to the point where even a relatively left-leaning leader such as Ed Miliband is now no longer trusted by the party’s traditional voters - in Scotland most of all.

It is too late to put Humpty together again now.   The only thing that will now save the union is rather by recognising the distinctive political cultures that exist within different parts of the UK and allow them to go their own ways, within the overall UK umbrella.

Mr Brown, belatedly, has come to realise this, although his intervention in the debate this week rather begs the question why he did not do more to decentralise the UK while in office.

Devolution could have been his Big Idea.  But though we waited and waited and waited for him to “set out his vision,” his government had become so politically enfeebled by then that it seemed in a permanent state of intellectual stasis.

So he, too, is culpable along with Thatcher, Blair and Cameron for what has been a collective failure of leadership over many, many years. 

One thing is certain whatever the result on Thursday.  The country over which they presided will never be the same again.

Wednesday, September 10, 2014

Doing my bit to save the union

I've been thinking for some time about starting blogging again.  When I put the blog on hold last October, I said that the level of interaction no longer  justified the effort, and to be honest I don't expect that to change in a hurry.  But I have missed having an outlet for my thoughts on the political scene, and the current state of play in the Scottish independence debate, with the United Kingdom facing a real threat of break-up, means it's all hands to the pump as far as I am concerned.  And while I am not expecting the traffic on this blog to reach the levels it achieved eight years ago when political blogging was all the rage, if just one person - just one - reads anything I've got to say over the next eight days and votes no as a result of it, then it will have been worthwhile.

Why do I care about this? Well, fundamentally because I consider myself to be British.  Indeed, with Highland Scots ancestry on my father's side and Jersey ancestry on my mother's, I think my antecedents can claim a fairly wide geographical spread of Britishness!   But it's also because I believe in the idea of Britain - not just as a geographical entity but as a political union.  And as a man of the centre left, I believe the Scots - as well as the Northern English - bring something to the UK politically - not just Labour MPs, but a belief in the value of collective effort that helps to balance out the more individualistic culture prevalent in London and the South.

It is the juxtaposition of these essentially contradictory values that makes Britain what it is, but the problem is that those on the right of politics have by and large failed to appreciate this for the past 35 years. What we are seeing with the way the referendum debate is playing out is the outworking of the abandonment of the post-war political consensus after 1979 - the imposition of free market ideology by the Tories with no thought for how this would be perceived in Scotland, Wales and the North and seemingly no regard for how it would affect the fabric and essential political unity of the UK

I gave an example of this on my Facebook page today in a link to David Cameron's otherwise welcome defence of the union in today's Daily Mail. I wrote:
Welcome from Cameron, but if he really wants to save the union, he should announce the immediate repeal of the 2012 Health and Social Care Act which potentially paves the way for the future privatisation of the NHS and make clear that a future Conservative-led government would never do this. It is clear  to me that it is fears about the future of the NHS - particularly among traditional Labour voters - which is driving the Yes campaign and has brought this country to brink of disintegration.
I don't really expect Cameron to do this of course, but the point is that he should have realised that the NHS is part of the glue that holds this country together, and that embarking on a road which seems likely in the end to turn it into no more than a brand operated by multifarious private providers was always likely to weaken those bonds.

I will develop some of these thoughts this weekend in my column in The Journal - still going strong after 17 years but still only available in the paper's print edition - and this will also be posted here.

Saturday, October 13, 2012

Deeply disingenuous, but Cameron has the final say

Seven years ago, the Conservative Party faithful gathered in Blackpool for what most observers expected would be a leadership stand-off between right-wing former council house boy David Davis and veteran Europhile Ken Clarke.

That was, of course, before a young MP by the name of David Cameron came along and tore up the script, delivering a speech without notes that electrified the party and made them believe that, with him in charge, they could finally put an end to their losing streak.


That all seems a long time ago now.  Although he did become Prime Minister, Mr Cameron did not turn out to be quite the winner his party had hoped for, and this week’s conference in Birmingham had an element of seven-year-itch about it.

So notwithstanding the fact that his speaking-without-notes routine has since been successfully imitated by other political leaders, it was perhaps no surprise that Mr Cameron eschewed it this week in favour of a traditional, scripted address.

It was, by some distance, the most serious speech of the conference season and indeed of Mr Cameron’s political career to date.

His talk of an “hour of reckoning” for the British economy was a far cry from the David Cameron of a few years back who exhorted us in a previous conference speech to “let sunshine win the day.”  

If that was possibly the worst Cameron soundbite ever coined, someone had clearly been working on them in the run-up to Wednesday’s address.

“The party of one notion:  borrowing” and “I’m not here to defend privilege, but to spread it” may not be in quite the same league as “the Lady’s not for turning”  but they are likely to stick longer in the memory than anything either of the other two party leaders have come up with in the past three weeks.

But for all its statesmanlike qualities and oratorical panache, it was, however, a deeply disingenuous speech by the Prime Minister.

Nowhere was this more so than when Mr Cameron sought to claim that only the Conservatives had ‘protected’ the NHS from spending cuts, saying:  “Be in no doubt:  this is the party of the NHS and that’s the way it’s going to stay,”

Leaving aside, for a moment, the fact that the government’s Health and Social Care Act has actually turned the NHS into no more than a brand, the situation on the ground is very different.

The reality, in my own local health trust at any rate, is that a fifth of the workforce is to be sacrificed over the next four years to meet the government’s spending squeeze.

In terms of political positioning, the core message of Mr Cameron’s speech was in its appeal to the aspirational voters who previously helped deliver election success to both Margaret Thatcher and Tony Blair.

“They call us the party of the better-off.  No, we are the party of the want to be better off,” he said in another of those catchy soundbites.

But the truth of the matter is that, in the public sector at any rate, there are tens of thousands of “want to be better offs” who have simply had the rug cut from under them - a disproportionate number of those being in the North-East.

If the unspoken assumption behind this is that no-one with any genuine aspiration actually goes into the public sector in the first place, then that betrays how little Mr Cameron knows about the way most of us live.

The conference season ends with the battle line starting to be drawn for an election which, on the evidence of the past few weeks, is shaping up to be much more of a two-way fight than the last one.

Ed Miliband’s speech, with his audacious bid to grab the One Nation mantle of the old-style Tory moderates was, once again, the boldest of the three, while Nick Clegg’s, at a time when he needed to put clear yellow water between himself and the Tories, was sadly forgettable.

Mr Cameron’s was the most sombre, but perhaps more importantly in terms of shaping the political agenda going forward, also the last.

It’s purely an accident of history that always lets the Tory leader have the final say in this three-week battle for political supremacy, but this year, at least, it was one he took full advantage of.

Saturday, March 10, 2012

The Coalition will not last five years

In last week's column, I suggested that the key strategic task facing the Liberal Democrats as they gather for their spring conference in Gateshead was to find a way of winning back the support that has deserted them since they joined the Coalition in 2010.

And doubtless there will be plenty of ideas floating back and forth at The Sage this weekend as to exactly how they should go about it.

They could, as some argue, stop the Health and Social Care Bill in its tracks. The Guardian commentator Polly Toynbee is among those warning this week that if they don’t take what may be their last opportunity to do this, it will seal their fate as a party.

Or they could, as Business Secretary Vince Cable has suggested, use their influence to help shape next month’s Budget, taking everyone earning less than £10,000 a year out of tax and introducing a ‘mansion tax’ for the super-rich.

Their leader, Nick Clegg, certainly wants to see the party getting on the front foot and proclaiming its successes in the Coalition rather than apologising for being part of it.

“Now it is time to move on. To stop justifying being in government and start advertising being in government. To stop lamenting what might have been and start celebrating what is. To stop defending our decisions and start shouting our achievements from the rooftops,” he said yesterday.

But whichever way they turn, will it make the slightest difference to the party’s electoral prospects?

Well, if history is any guide, no. The plain facts of the matter are that involvement in a Coalition is almost always disastrous for the smaller party, whatever political achievements it manages to extract from it.

The most recent example was the Lib-Lab pact in 1977/78. This was perhaps the most enlightened and humane period of government in my lifetime, but it still ended up doing the then Liberal Party terrible damage.

Far from emerging strengthened, their vote went down at the subsequent general election in 1979 and several of their most high-profile MPs, including the deputy leader John Pardoe, lost their seats.

Further back, the 'National Liberals' who joined the Tory-dominated National Government in the 1930s ended up simply becoming absorbed by the larger party.

And David Lloyd George’s 1916-22 Coalition, in which the Tories also held a numerical majority, likewise ended disastrously for the Liberals and their leader despite victory in the First World War.

It is partly for this reason that I have argued from the outset of the Coalition that, while the Lib Dems probably had no choice but to join it, they also needed to find a way of getting out of it alive – preferably well before the next election is due.

The Health and Social Care Bill, on which the Lib Dem rebels are more in tune with public opinion than the government is, would have given them a plausible pretext, although the party activists’ last-ditch bid to halt the Bill now looks unlikely to succeed.

Europe, by contrast, would not be a good reason for the Lib Dems to try to collapse the Coalition, for the simple reason that on this issue, it is the Tories who are much closer to the mainstream public view.

One less widely-canvassed possibility is House of Lords reform – not the sexiest of issues, for sure, but one on which the Tory ‘backwoodsmen’ seem almost certain to thwart Mr Clegg’s well-meaning attempts to drag the British Constitution into the 21st century.

The last time I discussed the possibility of the Coalition ending before its due-date of 2015, a commenter on my blog reminded me that the government has already passed legislation to bring in five-year fixed-term Parliaments.

My view, however, is that this could turn out to be no more than a quaint constitutional notion, given that the legislation also allows for a two-thirds majority of MPs to dissolve Parliament ahead of its term.

Let’s just suppose that David Cameron decides he wants an election. Would Labour MPs, in such circumstances, really vote to keep him in office until 2015?

It stands to reason that the Coalition will not last five years. It will, rather, last just as long as both of its partners want it to.

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Sunday, March 04, 2012

The real issue which the Lib Dem spring conference needs to address

Back in the bad old days of two-party politics, the Liberal Democrat spring conference was one of those recurring events in the political calendar which even political journalists struggled to get too worked up about.

Sure, the BBC invariably ran a short item about it – but that was only because its rules on impartiality oblige it to give Lib Dem gatherings the same coverage as those of the other two main parties.

How times have changed, however. Not only is this year’s spring conference in Gateshead a big story in the North-East, but it is also set to attract the kind of national media attention which the third party could once only dream of.

At stake could be the future of a flagship piece of government legislation – and in the longer-term, the future of the government itself.

Last year’s spring conference saw Lib Dem activists effectively force their Tory coalition partners to order a ‘pause’ in the controversial Health and Social Care Bill designed to hand large parts of the NHS over to GP consortia and increase competition across the service.

A year on, and this year’s may yet result in the hated Bill’s final demise.

Alongside Europe, the Bill remains perhaps the biggest point of division between the two Coalition partners, despite continuing attempts by both party leaderships to soften it at the edges in the hope of avoiding a showdown.

But even a desperate entreaty by party leader Nick Clegg and much-loved veteran Baroness Williams this week looks unlikely to head-off an attempt at next week’s gathering to kill of the legislation once and for all.

Unlike on Europe, it has been clear for some time that the Lib Dem tail is wagging the Tory dog when it comes to the NHS.

Earlier this week, Lib Dem peers put forward a fresh series of amendments to the Bill in the House of Lords designed to further water down the requirements for increased competition.

Initially, the government said it was ‘not minded’ to accept the amendments, but once they were duly passed, it decided not to try to overturn them.

At the same time, Mr Clegg and Lady Williams issued a letter to party members saying that the Bill as now amended contained all the necessary safeguards and should therefore now be “allowed to proceed.”

Early signs are, however, that activists are determined to press ahead with a conference vote on the motion, which calls for the "deeply flawed" Bill to be "withdrawn or defeated.”

One prominent Lib Dem, Graham Winyard, has already resigned from the party over the issue, warning Mr Clegg that his support for the bill would be "a slow-motion disaster" for the NHS and the party.

Labour has not been slow to seize on the divisions, with shadow health secretary Andy Burnham attacking Mr Clegg’s “stage managed posturing” over the Bill.

He urged Lib Dem rebels to work with Labour and dismantle the Bill to remove the provisions relating to competition.

But of course the Lib Dems’ problems go much wider than health. Their real difficulty lies in the fact that voters have deserted the party in droves since it joined the Coalition.

In this sense, it is ironic that they are meeting in the North-East at a time when the party’s standing in the region has possibly never been lower.

A poll carried out by YouGov the week before last showed the party now has the support of just 4pc of the region’s voters – lower than the UK Independence Party on 7pc.

The days when the Lib Dems entertained serious hopes of winning parliamentary seats such as Blaydon and Durham City now seem a very long way away indeed.

Under Charles Kennedy’s leadership from 1999-2006, the party pursued a successful strategy of appealing to disaffected Labour voters as well as its own traditional supporters, gaining its higher number of MPs since the 1920s.

It is now facing the nightmare scenario of its parliamentary representation being reduced to single figures for the first time since the revival of third-party politics began in the 1970s.

It is hard to dispute the analysis of Gateshead councillor Ron Beadle that, in electoral terms, the Coalition has been a “disaster” for the party.

This, not the future of the health bill, is the real issue which this spring conference needs to address.

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Saturday, February 11, 2012

Milburn machinations show governnment's desperation

Back in 2003, I went along to a Downing Street press briefing along with the rest of the Westminster media corps expecting to be given details of Tony Blair's latest Cabinet reshuffle.

We emerged 20 minutes later with the very surprising news that the health secretary, Alan Milburn, had resigned from the government, saying he wanted to spend more time up North with his young family.

The sudden departure from government of the then Darlington MP, who until then had been widely tipped as a future candidate for the party leadership, was possibly the most unexpected resignation of the Blair years.

But for shock value, it would have paled into insignificance if this week's rumours about a Cabinet comeback for Mr Milburn - in the very same job he abruptly left nine years ago - had actually come to pass.

The story went that a newly-ennobled Lord Milburn would be brought back by David Cameron to push through the health reforms that Gordon Brown succeeded in blocking nine years ago.

The Prime Minister would then be able to claim - as he already has with Michael Gove's education reforms - that he is merely carrying on the work that Mr Blair and New Labour began, thereby strengthening his claim to the political centre ground.

It seems likely from what has emerged this week that this bizarre proposal was at least discussed at some level in Number Ten, even if those discussions didn’t actually get as far as Mr Milburn himself.

But the fact that such a conversation could even take place at all is an indication of the mess that the Coalition has got itself into over its own attempts to reform the NHS - and in particular the position of the current health secretary, Andrew Lansley.

Government colleagues of Mr Lansley were pulling few punches this week as his flagship Health and Social Care bill suffered another mauling in the House of Lords.

“Andrew Lansley should be taken out and shot. He’s messed up both the communication and the substance of the policy,” a Downing Street source was quoted as saying.

Of course, had Mr Cameron wanted to get rid of him, he had a perfect opportunity to do so last week with the mini-reshuffle sparked by the enforced resignation of the energy secretary Chris Huhne.

But as I have noted before, the Prime Minister hates reshuffles, having apparently been warned against them by former Cabinet secretary Gus O’Donnell, and for now, Mr Lansley retains his “full confidence.”

To those of us who have been following the progress of the government’s attempts to introduce greater competition into the NHS - and hand over the running of it to reluctant GPs - none of this should have come as any great surprise.

Mr Cameron has been warned on several occasions that the reforms, which are opposed by just about every leading professional body within the service, risked becoming his Poll Tax.

His apparent obduracy over the issue is all the more surprising in the light of his determined efforts before the last election to “detoxify” the Tory brand when it came to the NHS.

As the Conservative Home website pointed out yesterday; “David Cameron’s greatest political achievement as Leader of the Opposition was to neutralise health as an issue. The greatest mistake of his time as Prime Minister has been to put it back at the centre of political debate.”

Plans are now being laid for a debate at the Liberal Democrat spring conference which is expected to result in fresh calls for the bill to be scrapped, if it hasn’t been already by then.

And Labour’s shadow health secretary Andy Burnham has shrewdly called for cross-party talks on a compromise deal which could see the non-contentious parts of the bill covering public health, social care and GP commissioning kept, while scrapping the bits relating to extending the private sector.

It is understood that this option is now being seriously canvassed within the government, but if adopted it would of course represent a complete humiliation for the health secretary.

When Mr Milburn walked out of the health department, Westminster was genuinely stunned. The greater surprise this time round would be if Mr Lansley stays put.

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Saturday, June 18, 2011

Blair's last mission - to save Labour from the 'sons of Brown'

At first sight, former Labour health secretary Alan Milburn's criticisms of the Conservative-led Coalition's revamped health reforms this week might have seemed like routine political knockabout.

"The biggest car crash in the history of the NHS" was the former Darlington MP's withering verdict after Prime Minister David Cameron and his deputy Nick Clegg performed their screeching U-turn.

But closer inspection of Mr Milburn's argument reveals a rather more subtle agenda than simply Coalition-bashing.

For as well as highlighting the government's ongoing difficulties over the health changes, his comments also illuminate the continuing deep divisions within the Labour Party over its attitude to public service reform.

"David Cameron's retreat has taken his party to a far less reformist and more protectionist position than that adopted by Tony Blair and even that of Gordon Brown," Mr Milburn wrote in a newspaper article on Thursday.

"The temptation, of course, is for Labour to retreat to the comfort-zone of public sector producer-interest protectionism...it would be unwise in my view for Labour to concede rather than contest the reform territory."

This was, of course, an implicit criticism of Labour leader Ed Miliband for having allowed Mr Cameron to seize the reform mantle and supplant Labour as the "changemakers" of British politics.

And coinciding as it did with a renewed bout of internal Labour feuding , the timing of Mr Milburn's comments looked far from accidental.

First, there was the leak of documents purporting to implicate both Mr Miliband and Shadow Chancellor Ed Balls in a "plot" to overthrow Tony Blair soon after his third election victory in 2005.

Then the 'victory speech' that was to have been delivered by South Shields MP David Miliband had he not unexpectedly lost to his younger brother in last year's leadership contest mysteriously came to light.

If that wasn't enough, Mr Blair himself then plunged back into the fray, looking every bit the once-and-future-king as he broke a self-imposed four-year silence on domestic political issues in an interview with The Sun.

By showering praise on the Coalition for its education and health reforms, claiming they had carried on where he left off, he too called into question 'Red Ed's strategy.

"New Labour was the concept of a modern Labour Party in the middle ground with a set of attitudes orientated towards the future – and I believe if we had carried on doing that we would have won the last election," he said.

Asked whether Mr Miliband was right to say the New Labour era was over, he said: "It can't possibly be over, because it isn't time-related.

"It is about the Labour Party constantly being at the cutting edge, being a modernising party – always being full of creative ideas and isn’t pinned in its ideological past.

"That is always the choice for the Labour Party. It is the choice for progressive parties."

Knowing from past experience how these guys tend to operate, it is impossible to believe that this sudden spate of activity by the former Prime Minister and his allies was not in some way co-ordinated.

So what is Mr Blair up to? Is he simply trying to flog a few more copies of his book – or does he have a higher purpose in mind?

Could it be that the architect of New Labour is embarking on one last great battle to rescue the party he dominated for 13 years from the clutches of the "sons of Brown?"

The Blairites are back – and Ed Miliband had better watch his.

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Saturday, May 28, 2011

Are Lansley's health reforms now dead in the water?

First David Cameron announces a “pause” in the government’s plans to reform the National Health Service in order to listen further to the views of health professionals and the public.

Then the doctor’s trade union, the British Medical Association, reveals that it thinks the Health and Social Care Bill should be scrapped, and any changes achieved without legislation.

Finally, deputy premier Nick Clegg announces that the Bill is to go back before a committee of MPs for further scrutiny, setting back its likely passage through Parliament by at least six months.

The question on the lips of many Westminster watchers this weekend is: Are the government’s NHS reforms dead in the water?

Predictably, backbench Tory MPs are up in arms over Mr Clegg's intervention, claiming yesterday that he had "bounced" the government into delaying the Bill.

They made clear that whatever changes are ultimately made to the Bill, there are certain "red lines they wish to draw against Lib Dem encroachment on the original blueprint.

In an email sent to all Conservative MPs yesterday, backbencher Nick de Bois called on his colleagues to "reclaim the debate" over the NHS.

He said the "red lines" should include the requirement for all GPs to take on responsibility for primary care across England – ignoring the fact that GPs themselves oppose this provision.

The backlash against the reforms was growing long before the Lib Dems' hopes of changing the voting system went up in smoke, but it was nevertheless this that proved the tipping point.

Once the Tories decided to throw the kitchen sink at AV, it was obvious that Nick Clegg would have to be thrown some sort of bone to keep the Lib Dems in the government, and it was equally obvious that this would be it.

Politically, sacrificing a set of unpopular health reforms in exchange for keeping a voting system that kept them in power for most of the 20th century might seem like a smart move for Mr Cameron.

But the downside is that so much had been invested politically in these reforms that the now seemingly-inevitable retreat will be seen as a major blow to the Prime Minister's authority.

Even if the reforms are not dead in the water, the political career of Health Secretary Andrew Lansley surely is.

If the government ultimately decides to press ahead with the changes, Mr Lansley is likely to be replaced by someone who can more successfully sell them to the relevant stakeholders.

If on the other hand they are watered down or abandoned, his job is almost certain to go to a more emollient politician who can re-build bridges with the health professionals.

The latter scenario is surely the most likely one. Tory MPs want the new GP fundholding consortia in place by April 2013, but in the light of Mr Clegg's latest intervention, this is looking like an increasingly forlorn hope.

The danger for the government is that, if the measures do not reach the statute book this summer, the institutional upheaval will still be ongoing in the run-up to the next election, due in 2015.

Mr Cameron is nothing if not a pragmatist, and he will surely view the prospect of organisational chaos in the NHS as a risk he can do without as he prepares to face the country again.

In those circumstances, it would make more sense for Mr Lansley's proposals to go into the next Conservative manifesto rather than into a revised Health and Social Care Bill.

And who knows - if Mr Cameron can win an outright majority next time, the Tories might even be able to claim a mandate for them.

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Saturday, April 09, 2011

A listening government - or a government in retreat?

Of all the changes introduced by the Coalition government since it took office last May, it is fair to say that its proposed reforms to the National Health Service have been the most politically controversial.

What about the cuts, I hear you say? Haven't they caused much more widespread public anger and made a much deeper impact on local communities?

Well, yes. But there was a broad political consensus dating back to well before the general election that spending cutbacks needed to be made – the only real disagreement being about the extent of them.

More importantly, the Coalition had a mandate for them. Labour lost the election primarily because, rightly or wrongly, the party was seen to be in denial about the size of the deficit and the remedial action needed to address it.

By contrast, the NHS reforms were not even spelled out in the Coalition Agreement, which infamously promised that there would be "no more top down reorganisation of the NHS."

Indeed, the agreement implicitly accepted that Primary Care Trusts would remain, promising a stronger voice for patients locally through directly elected individuals on the boards of their local PCT."

However when the legislation was published, it turned out that health secretary Andrew Lansley was proposing the abolition of PCTs and the transfer of their entire commissioning role to GPs.

Much of the anger felt by Liberal Democrats over the reforms can be traced back to this piece of perceived duplicity on Mr Lansley's part.

There is said to be anger in Number 10 at the way Mr Lansley has handled the reforms – but to my mind the fault lies more with Downing Street for not paying sufficient attention to their likely political impact.

As with the Forestry Commission sell-off debacle, No 10 seems to have been so focused on deficit reduction in the government's early days that it took its eye off the ball in other, seemingly less contentious areas.

Deputy Prime Minister Nick Clegg must bear some of the blame too, for not realising the strength of feeling in his own grassroots against the proposals.

It is only since his party's Spring conference delivered a huge thumbs-down to the reforms that Mr Clegg has started to argue for changes to the legislation.

So it was no great surprise that, this week, the government was forced to announce it was taking a raincheck on the implementation of the reforms while it conducted a further "listening exercise" with the public and health professionals.

It amounted to an admission that the reforms had been introduced without the necessary buy-in from either the public or, more importantly, those people who will be charged with making them work.

Should we see it as the prelude to a dramatic U-turn? Or is it simply a belated effort by Prime Minister and ex-PR man David Cameron to 'sell' the proposed changes?

Time will tell….but Mr Cameron's apparent openness to changes in the legislation suggests this is more than mere window-dressing.

The backbench health committee of MPs, for instance, wants to see the new fund-holding commissioning bodies drawn from a much wider membership, including councillors and hospital doctors.

Although this is more in tune with the spirit of what was in the original Coalition agreement, any weakening of the central proposal to hand power to GPs will be seen as a major political reverse for Mr Cameron.

The political commentator Benedict Brogan said of this week's events: "The underlying impression was one of an administration in retreat, forced to trim on policy because it got the politics wrong."

Mr Cameron is finding that the line between being a "listening government" and a "weak government" is sometimes a very fine one.

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Saturday, August 15, 2009

Toxic Tories rain on Cameron's parade

David Cameron and George Osborne want us to think the Tories are the "new progressives" of British politics - but they can't stop reminders of the party's 'nasty' past from reappearing. Here's today's final Journal column before my summer break.



A few years ago, I posed the question as to whether voters of a leftish inclination would be better off with a Conservative party that sought to appeal to them, than with a Labour party seemingly only interested in pleasing those of a right-wing persuasion.

The conundrum arose as a direct consequence of David Cameron’s mission to “detoxify” the Tory brand following his election as Tory leader in autumn 2005.

For Mr Cameron, it meant focusing his energies on winning over left-of-centre voters concerned about public services and the environment, at a time when Labour’s Tony Blair continued to be more anxious about keeping traditional Conservative supporters on side.

Since Mr Blair moved on, Labour has thankfully stopped defining itself in opposition to its core voters, but as Shadow Chancellor George Osborne showed this week, the Tories remain as keen as ever to try on their opponent’s clothes.

The point was certainly not lost on stand-in premier Lord Mandelson, who in a masterly performance on Radio Four’s Today Programme on Wednesday, managed to dodge questions about his own prime ministerial ambitions by putting the boot into Ms Osborne at every opportunity.

“I think my old friend George Osborne is involved in a bit of political cross-dressing and I don’t think it’s going to fool anyone,” he said.

That “my old friend” was a reference to the fact these two have previous form. Nearly a year ago, each was accusing the other of trying to procure a donation to their respective party’s funds from the Russian oligarch Oleg Deripaska.

After briefly looking like he may have to resign from the Cabinet for a third time over a sleaze-related issue, Lord Mandelson decisively won that battle with a counter-attack that came close to ending Mr Osborne’s own frontbench career.

But putting personal rivalries to one side, what was really interesting about Mr Osborne’s audacious “we are the progressives” speech this week was what it told us about the underlying political consensus in the country.

And this, in turn, is perhaps the one thing that can still give Labour grounds for hope as it approaches the coming election battle.

Throughout all the troubles and travails of Mr Brown’s premiership over the past two years, the Prime Minister and his supporters have continued to clutch at a single straw – the fact that even though his government is wildly unpopular, there has been no fundamental shift in the climate of public opinion towards the Tories.

Mr Osborne’s speech this week proves the point. Rather than make the case for “conservative” values as Mrs Thatcher might have done, the Tories still feel the need to fight on what is essentially Labour ground.

As it is, Mr Osborne’s speech on Tuesday demonstrated the extent to which the word “progressive” has lost virtually all meaning in contemporary political debate.

It used to denote a form of taxation which sought to redistribute resources from the better-off to the worst-off, but since all parties subscribe to this to a greater or lesser extent, this definition does not help us much.

The central claim of Mr Osborne’s speech was that Labour’s “opposition to meaningful public service reform” meant it had “abandoned the field of progressive politics.”

While the Shadow Chancellor seems to be using “progressive” here to mean “reforming,” most Labour supporters would argue that a reform is only “progressive” if it actually helps the worst-off.

But this is more than just an arid debate about labels. The nature of Lord Mandelson’s response to Mr Osborne would suggest that Labour too believes “progressive” is a word worth fighting over.

And of course, Lord M. is quite right to point out that, in terms of its effect on the worst-off, the Tories plans for £5bn of public spending cuts would hardly be “progressive” in their human consequences.

The difficulty for Labour, as I pointed out a few weeks back, is that no-one now seriously believes that they won’t also be forced to make cuts of similar magnitude.

Maybe the argument, in the end, will come down to which of the two parties can convince the public they are wielding the axe with the greater reluctance.

Part of Mr Cameron’s problem, though, as he continues to try to persuade the public that the Tories have changed, is that old reminders keep popping up of their ‘nasty party’ past.

We already knew what Shadow Commons Leader Alan Duncan really thought about MPs’ expenses from his performance on Have I Got News For You a few weeks before this summer’s scandal broke.

“It’s a great system, isn’t it?” the one-time property millionaire told Ian Hislop as he struggled to contain the smug grin spreading across his face.

Mr Duncan claimed at the time that he had been joking – but the fact that he was later captured on film whingeing about MPs having to live on “rations” does rather give the game away.

Potentially even more damaging for Mr Cameron, though, were the comments by the prominent Tory MEP Daniel Hannan about the National Health Service.

Interviewed on US television, Mr Hannan backed Republican critics of President Obama’s plan for universal healthcare by saying he "wouldn't wish the NHS on anyone."

As Labour’s big hitters queued up to twist the knife yesterday, Mr Cameron was himself forced to take to the airwaves in a frantic bid to reassure the public once again that the NHS is safe in Tory hands.

Some are already seeing a Tory victory next year as a done deal - but episodes such as this show that Mr Cameron’s big rebranding exercise still has a way to run.

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