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I have to state a fact.
That is, most of my best friends are ‘left leaning’ and can’t bring themselves to support Jeremy Corbyn as leader of the Labour Party.
This finding is not surprising, nor is it shocking. In the polls, however reliable they are, Labour is consistently massively behind the Conservatives. But we know that the polls cannot be telling absolutely the truth, in that they were deceptive about the 2015 general election and 2016 EU referendum. Ed Miliband MP in the last parliamentary term had a healthy poll lead, and then went on to lose the 2015 general election. And we all know about Donald Trump.
The problem is that, with the Labour Party brand (of the Labour Party led by Corbyn and McDonnell) having been so comprehensively rubbished, it is very hard for any of the Labour Party in parliament to go out and act as advocates for it. It turns out that many of the proposed policies in private polling have turned to be very popular. And yet the Labour Party in parliament have shot themselves in the foot. And, having declared war so publicly on the membership in the last leadership election, the Labour Party find themselves with ground troops who do not feel supported. The same footsoldiers get a sick taste in their mouth when they receive an email from Ian McNicol asking for money for the party, when they themselves have been denied a vote in the leadership election. Yes, the second one where Jeremy Corbyn won again.
It’s worth deconstructing the term ‘sneering liberal Élite’ for the moment. Just look at how a closet cabal of box office journalists from the Guardian reacted to an article from one of their own, Decca Aitkenhead, about Steve Hilton, psychedelic pant wearing guru of David Cameron in a former life. I agree that it was a well written article containing an abrupt ‘killer question’, in the same elegant way the kill was delivered by Sam Coates and Rachel Sylvester – the kill in question which put to bed Andrea Leadsom’s leadership chances. But one is left wondering what the point of the article was, apart from to belittle Steve Hilton in some way. I don’t suppose Steve Hilton with his lavish lifestyle particularly cares, though my advice to anyone “dishing out” group sneering is to never underestimate the problems people never talk about. Did it produce any valuable insights on how globalisation had brought about inequality, and that both were being rejected in a populist way despite purported advantages? Hell no.
The word ‘sneering’ is, in my opinion, very well deserved. Under the general uber defence of the declining print circulation figures, there has been easy attack that all political bloggers are illiterate and have no formal journalistic qualifications – and so they can be easily dismissed. They haven’t ‘done their trade’ working for Paul Dacre at the Mail or for Jason Cowley at the New Statesmen. I have to say, however, the tone is very much of “sneering”. Rather than engage with any of the ideas you write about, the general approach of the ‘mainstream media’ is generally to ignore political opinion from elsewhere. The definition of ‘sneer’ in the Oxford English Dictionary is “a contemptuous or mocking smile, remark, or tone argument, contemptuous in tone”; the sneer is that most people supporting Jeremy Corbyn don’t want a Labour government or are completely incompetent Momentum T-shirt wearing types. The term ‘liberal Élite’ is, of course, a contradiction in terms. The ethos of ‘live and let live’ is of course not alive and well amongst the majority of journalists who, quite frankly, want to crush Jeremy Corbyn and the current Labour Party. The Élite word though represents faithfully the authoritarianism twang of this type of liberalism – which saw Tony Blair convert NHS hospitals into debt laden PFI poodles of the private sector for years to come, or Gordon Brown to detain suspects without trial.
Unsurprisingly, I have now been blocked by many liberal left-leaning journalists, or Labour supporters. I have always voted Labour for all of my adult life, and this includes at every general election since 1992 after the nadir of disgust at years of Margaret Thatcher. I was, as it happens, living in London at the time. Since about 2010, I had been a paying member of the Fabian Society, but I relinquished my subscription last month. The stunt where one leaflet written by Andrew Harrop, meant to be a free-thinking, independent and not necessarily representative pamphlet, was plastered all over the media designed to be the Fabian Society criticising Jeremy Corbyn was the final straw. I can handle all the conspiracy theories about Bretton Woods, and ‘wolf in sheep’s clothing’, on the other hand.
I could have written a public letter to Andrew Harrop, like you see from failed Labour MPs to Jeremy Corbyn in the blogosphere, but quite frankly I couldn’t be bothered to write it, and he certainly could not have been bothered to read it. The Fabian Society for me was not the hotbed of egalitarian, democratic, intelligent debate it could have been, but a group of people where inadvertently the tone had been one of aggrandisement and self-entitlement. I didn’t want to be a member of a finishing school for entrants to the Labour Party, though good for people who have successfully followed that route.
Jeremy Corbyn is not the first person to have ideological problems with the European Union. Lord David Owen himself set out articulately the traditional arguments against the European Union ahead of the Brexit vote. Tony Benn’s views, often running in parallel with Enoch Powell’s, were well intended and clearly set out (for example, wanting to have the power to get rid of officials). There are, inevitably, problems if there are operational difficulties in activating state aid monies in an economy for a steel industry failing partly due to Chinese ‘dumping’ of steel in international markets. Hugh Gaitskell famously warned that to join the “Common Market” would mean the end of 1,000 years of history. The lack of ‘opposition’ to Theresa May is a collective failure of the majority of Labour MPs, and the ‘sneering Liberal Elite’ who are unable to articulate the arguments for building a better future for the UK. I think this vacuum in direction can be seen prior the formation of the Coalition government in 2010 where David Cameron became heir to Blair. It can be seen in the lack of substantial policy contributions from either the Fabian Society or Progress following the decline of Blair. And for all the talk of the toothless Corbyn opposition, I don’t need to remind you of the mass abstention on the welfare cuts, do I? Or the ‘jump? how high?’ response to the savagery and cruelty of the NHS ‘efficiency savings’?
The lack of intellectual drive within Labour means it’s become easy ‘copy’ to sneer at suboptimal local election results with a ‘told you so’, never mentioning the months of relentless rubbishing of the Labour Party brand. It means that well meaning tweeters can remind you of the meme why you should not vote Liberal Democrat, as they gave you Conservative policies in coalition. This completely ignores the fact that some Labour and non-UKIP oriented Conservative voters will want actively to vote Liberal Democrat to prop up a Lib Dem-Conservative coalition. It’s an open secret Tim Farron MP loathes the Corbyn arm of the Labour Party, and would like bosom up to followers of Tony Blair while being scathing of the Iraq War simultaneously.
Personally, I am finding the lack of support amongst some in the Labour Party totally demoralising. Whilst I support Jeremy Corbyn as leader, as indeed I have supported all leaders since 1992, I find it completely dispiriting how so many find themselves unable to offer constructive solutions on burning issues such as disability quality of life, social housing, the NHS, social care, the ‘gig economy’, tax avoidance, school and university education, cost of living, and so on. There are still millions of people who need a Labour government, and the sneering simply cannot go on. To attack people like me who support Jeremy Corbyn without being Corbynite will achieve nothing.
There are some ‘rules’ of politics which generally go unchallenged – to some extent. “Everyone likes choice” – and the “yeah but…”, you have to be given the correct resources to exercise this choice. Some people have more choice than others.
That Jeremy Corbyn has produced such powerful resentment in certain groups of people is of interest, in that people who dislike Corbyn might be expected to let choice to run its course. But even before he had won his second leadership election, voices in the mainstream media and the parliamentary Labour Party had already drafted his obituary. I can’t pretend to agree with all of what Jeremy Corbyn says, but I feel there is a disgust by some Labour voters at Corbyn which would be better directed at themselves.
Not everyone agrees on Israel. Not everyone agrees on Northern Ireland. Not everyone thankfully agrees on Ken Livingstone. But it is rather that some of the strongest advocates of a liberal voice have made it their wish to shut down debate on important issues. I am loath to say that Jeremy Corbyn is an analogue politician living in a digital age, as I feel that gives power to the elbow of ageism which definitely runs as an undercurrent to some of the personal attacks on Jeremy Corbyn. But as Margaret Thatcher herself said, when you resort to personal attacks you have lost the argument.
Once you peel away the misreporting of the domestic policies, which is substantial, the policies are themselves pretty sound and reasonable for anyone ‘left leaning’. It is a genuine phenomenon that the media by and large do not give the Labour Party leadership or membership a fair hearing, preferring to give a dispropotionate voice to critics within the parliamentary Labour Party.
It has long been conceded that the Labour Party represents a diversity of views. As Tony Benn famously said, “People attending Church include some Christians. Labour is not a socialist party, although there are some socialists in it.” Much of the current media talk is inevitably about Brexit, but, for most MPs, what brings the legislation, policies and regulations to life is the caseload of the weekly constituency surgery. I expect that the number of complaints about lack of social housing, delays in A&E, or working in a ‘gig economy’ far outweigh whether UK citizens travelling abroad will be given free health insurance following Article 50.
It has become sexy to talk of an existential crisis within Labour about its identity, but it is my contention that – if you believe in choice – it is unfair for Jeremy Corbyn to be criticised for wanting to implement his view of socialism. The first thing that has to be acknowledged is that Jeremy Corbyn won overwhelmingly the leadership elections of his party nationally twice. The second thing to be emphasised is that Jeremy Corbyn has held robustly the same principles since 1983 when he was elected under the famous ‘longest suicide note in history’ from Oxford first-class honours holder Michael Foot. As the famous Marx brother said, “if you don’t like my principles, that’s OK – I have others.”
If it is inappropriate to say Jeremy Corbyn doesn’t “do digital”, I think it’s fine to say he doesn’t do binary. On the face of it, both Tim Farron MP (who I hear you ask? He is the current leader of the Liberal Democrats) and Jeremy Corbyn MP hold the same views on Brexit, in agreement on free goods and services and free movement of people. But the analogue argument is important, I feel. If you assume that Jeremy Corbyn holds roughly the same views as Tony Benn, Jeremy Corbyn would’ve voted to remain in the European Union but only just. Tony Benn believed that it was only possible to believe in free movement of capital if you believed in free movement of persons – as Benn put it, “if money can have passports, why can’t people?” Benn objected to a multinational corporatocracy, which is consistent with Corbyn’s support of the EU Posted Workers Directive, preventing undercutting of wages by multinationals. Gordon Brown in 2010 had proposed the migration transformation fund to provide financial support to areas of the UK which had experienced high levels of migration, but this was rejected by the electorate in favour of the coalition of Conservatives and Liberal Democrats. That the EU referendum was held to keep together the Conservative Party, with the consequence of splitting the country down the middle, is pure and simple. For example, Jeremy Corbyn has himself reported that in his constituency non-EU families often remain split due to the current legislation which is often perceived as being discriminatory in favour of EU migration?
Where Corbyn, Tony Benn and Farage (and UKIP) are in agreement possibly is the idea that you should not give power to those you ultimately can’t take the power away from. Benn in his diaries talks about all the pain he had in the 1970s being unable to amend EU legislation even as a Minister of the Crown. Where Corbyn and Farage (and UKIP) are possibly not in agreement is that Corbyn believes that the State should be able to intervene in ‘failing industries’. To take as an example, because national policy had led NHS Foundation Trusts to become increasingly within the ambit of EU competition law, like the steel industries, the scope for ‘state aid’ became more controversial. The irony for the NHS is that the biggest threat to its existence has come internally from decades of underfunding – i.e. a deliberate ‘choice’ from a domestic government “taking back control”. Anyway – my point is that Jeremy Corbyn does not benefit from the need to portray these arguments as binary. The media wants to do binary for everything, like “Do you hate Jeremy Corbyn? Does Jeremy Corbyn bow properly? Does Jeremy Corbyn support Ken Livingstone? Does Jeremy Corbyn want to shut down your nuclear power plant?” But where we all have different views, i.e. we live in a democratic society, such an approach is in sheer defiance of democratic socialism.
Jeremy Corbyn has held views of democratic socialism, as indeed many within the Labour Party have, for years before Jeremy Corbyn became leader or before Owen Jones was interviewed for GQ magazine. I would find it impossible to believe that Jeremy Corbyn believes in any other system for the National Health Service other than where we pool risk equally, and where money cannot buy you undue influence. This is going to be of critical importance when we get into an age of personal genomics where the inheritance of certain medical diseases can be accurately predicted at birth. Tony Benn believed that the democratic vote bought you influence not money. I am quite sure that if Jeremy Corbyn is defeated at the ballot box, as so many people within the Labour Party appear to be actively looking forward to, Jeremy Corbyn will too live with that.
Jeremy Corbyn is for me the only constant in this particular scenario, which means that Jeremy Corbyn is not the one experiencing the ‘existential’ crisis. Quite the reverse. The crisis is being experienced by many of those MPs who expected to be serving in a Ed Miliband government (and who abstained on the welfare benefits cuts) and of course the all powerful Westminster lobby of journos.
Jeremy Corbyn was my first choice for leader of the Labour Party twice. I’ve always voted Labour, and I’m currently 42. I don’t consider myself a Euro-fanatic, but I voted ‘remain’ in Brexit. But I must admit when Corbyn said ‘Now the real fight begins’, I got genuinely scared – it had for me, as Emma Burnell opined, all the overtones of someone who doesn’t really believe in parliamentary democracy.
There are some people who believe that Jeremy Corbyn can do ‘no good’. I am not one of them. I have previously supported Corbyn to the hilt, and I think most of his principles in domestic policy are reasonably sound. We are both socialists. For example, I agree with Corbyn on cracking down on aggressive corporate tax a aoidance, and wishing to tackle head-on the crisis in social care and social housing. I agree that fundamentally the situation Labour finds itself is not as such Labour’s fault. I am not a ‘Blairite’ – there were some successes in the Tony Blair governments, and some failures. The history for me personally is that, in the last leadership election shortly after the referendum of June 23rd 2016, I found myself disagreeing with the views of Owen Smith MP and his supporters. I felt that that particular time was not the best time to having yet another leadership election when Corbyn had only just been democratically elected leader – and I felt that the behaviour of much of the Labour Party was pretty unconscionable. In fact, I blocked several Labour MPs on Twitter.
There was an unsaid deal that the parliamentary Labour Party would try to be more professional in experience, such as not briefing the media about offices which they should have vacated after publicly resigning, if the leadership machine communicated better with the PLP. There was an unsaid agreement that there would be at some stage much more useful detail about policies. Whilst not violently anti-Blairite, the spectacle of Anna Soubry MP and Alastair Campbell ganging up on John McDonnell (like Clive Lewis, a follower of mine on Twitter) beyond the pale.
Let’s be clear. Reversing corporation tax to fund the NHS and social care is not a policy in itself – nor is renegotiating the private finance initiative, important though that is. There is, however, an honest conversation to be had about how GPs feel themselves totally overwhelmed by the demand (and so do Accident and Emergency Departments), and, on the whole, people are living for longer with complex co-morbidities such as dementia. GPs will be the first to tell you that ‘ten minute appointments’ do not do their patients justice, and certainly insufficient for a frank discussion about psychological therapies for dementia compared to reaching for the prescription pad. The whole debate about integration has become engulfed in criticism about the sustainability and transformation plans; that there is insufficient money in both the NHS and social care is not in any dispute. On the other hand, for many long term conditions, the decision between ‘health’ and ‘social care’ is totally arbitrary and yet this has a profound impact for individuals in terms of their funding arrangements. The reality of ‘care at home’ is far from the rhetoric and yet the Department of Health is fighting its own battles such as with the junior doctors over their contract – whilst Jeremy Hunt is touring the world boasting about patient safety (neglecting to mention 20 hour trolley waits in England), and seeing if he can aggressively pimp NHS services to a New Trump US. We are all left exasperated wondering what it is that the UK is so desperate to sell to any country, dictatorship or otherwise, far flung or not.
Jeremy Corbyn’s stance is indeed ‘principled’ in that one half of the party faces one way (constituencies wishing to remain in European Union, such as Islington), and one half facing the polar opposite (constituencies wishing to leave the European Union, which as Hayes). But back to Nye Bevan’s old adage, ‘if you stand in the middle of the road, you are bound to get run over’. Corbyn’s political stance means inevitably he will end up annoying many on both sides, especially some in the 48% who oppose a ‘hard Brexit’. Whilst Keir Starmer and pals do not want to soil their lips with the words “hard” and “Brexit”, there is no other term for not being included in the single market, or giving up on the free movement of people. The ‘taking back control’ meme has become rampant, and it seems that every MP is entitled to justify voting like a robot even more on grounds of the fact that ‘this referendum result was delivered by the people’. The case against leaving the EU won’t go away, however, including the 40-60 Euro divorce fee, or the hit the economy will take when the City is not allowed to do EU passporting. But it is said that many Brexiters are prepared to take this hit. Indeed, many Corbyn voters who voted Brexit seem intensely relaxed about Jeremy Corbyn’s performance.
You’d be forgiven for thinking Britain has a bright future, despite the import inflation and problems in finding workers for certain sectors of the economy. For now, Scotland, which voted to remain in the EU largely, has been muzzled, but it will not be long before they ‘take back control’ again and ‘roar again’ as Alex Salmond put it. The Brexit vote has given fuel to Nigel Farage’s rantings on his radio show, having extra rocket fuel from the election of a bigot, sexist, and racist elsewhere. The LBC phone lines are choc-a-bloc with racist and xenophobic rantings about how the ills of the world can be placed at the feet of immigrants. But such criticisms would be to shoot the messenger of this xenophobic racist rubbish rather than the message itself. A major ‘miss’ was there not being implemented a Migration Impact Fund, or Posted Workers Directive, to give areas of high migrant population additional financial support, or legislation to stop the undercutting of workers. But the solution to all this is not Amber Rudd MP, in the same way the immigration levels sky rocketed under Theresa May MP. Without any attempt to limit proportionately migrant numbers, and without funding public services, leaving the European Union is simply a smoke-and-mirrors exercise, and you can bet Nigel Farage will have long gone by then.
I do agree very much that it’s not all Jeremy Corbyn’s fault. There are many head winds in the opposite direction to Jeremy Corbyn. For example, Corbyn daily has to deal with a vicious media and there are rarely any positive noises coming out of the Guardian or Laura Kuenssberg about him. And also, there has been a relentless focus on the ‘Labour rebels’, and the three-line-whip from Corbyn (presumably because Corbyn does not want to be blamed for obstructing Brexit), but one really has to wonder what on earth has happened to those Tory MPs who reperesnt ‘remain’ consittuencies. It is entirely possible, of course, that the Liberal Democrats will take these seats, and then the critical question for 2020 will be who is the largest party. I have a hunch this will be the Conservatives, wishing to form a coalition with the Liberal Democrats, rather than Labour and the SNP forming a coalition (assuming that there is no sign of a turnaround in Scotland’s fortunes from Jeremy Corbyn and Kezia Dugdale).
Quite frankly, these are desperately stressful times for some people who want to vote Labour. There are some people who think that Jeremy Corbyn is utterly brilliant – and all power to their elbow. But there are also different people who believe Corbyn is overseeing the suicide of the UK Labour Party. Irrespective of your views on EURATOM or the ERASMUS scheme, what are we tell close friends of ours who are EU nationals and remain as ‘bargaining chips’ in the negotiation about to happen? The reality is that we do not know what the attitude of the European Union will be – but guaranteed the hyperbolic importance of England by Nigel Farage over Brexit is not matched by the column inches devoted to Brexit in the continental newspapers. I have a declining faith in Jeremy Corbyn, but my ‘faith’ is being put to the test. I don’t see any other saviour on the horizon, and a third leadership election might make him bullet-proof as far as the membership is concerned. I would feel a lot more reassured if we had more detail on domestic policy, but I understand the problems in predicting the state of the macroeconomy particularly with Brexit and Donald Trump looming on the horizon.
And of course the 2020 general election might be a very good one to lose, if you take away the possibility of Jeremy Hunt negotiating a UK-US trade deal which would kill off the NHS entirely.
There are key differences between Theresa May and Bridget Jones.
For a start, Jones was single for a long time. And Bridget Jones always tended to look desperate.
The Labour Party is divided on Brexit – but they’re not the only ones, and it’s not Jeremy Corbyn’s fault. My late father used to tell me that there are some people who will love you whatever you do, some people who will hate you whatever you do, and some people who will always remain indifferent. Many parliamentary Labour MPs have criticised Jeremy Corbyn so much, that further criticisms of Corbyn now over Brexit would be completely hollow. To use an analogy, they have already ‘used up their lives’.
Let me pin my nails to the mast. I am in my early 40s, and was opposed to Brexit for the purposes of the June 23rd 2016 referendum. I don’t think this makes me a ‘remoaner’. I was always a bit concerned about the domestic abuse of the UK governments in state aid rules, and this is clearly of concern with the pre-meditated drastic, severe and chronic under-funding of the National Health Service and social care. I was similarly concerned about whether the EU en bloc with the US would become embroiled in TTIP, a transatlantic trade agreement, which would make it much easier for ‘free movement of capital’ ownership of ‘our NHS’. But I am told by various loud voices that what concerned many, stereotypically outside Scotland and London, was a free movement of workers, many unskilled, undercutting ‘home grown produce’. Unfortunately, some of this genuine concern got transformed into outright racism and abuse, as can be clearly seen in some of the vitriol aimed at Gina Miller.
I get the fact that there are some Labour MPs who represent constituencies representing populations who wanted to remain in the European Union. I also get the argument that you wouldn’t want, ideally, to sell your house, and make yourself homeless, and have nowhere to go to. But the idea that we will know much of the detail of the negotiations this early on is pie in the sky on the whole. Clearly, if it were the case that the European Union demanded forced repatriation of British citizens living in Europe, there would be a strong case not to start the chain of events culminating in us leaving the European Union; but this is quite unlikely, if only we don’t have a clear idea of which EU citizens are living in the UK for a start. It is pretty likely that, in the absence of strong free trade agreements elsewhere, our domestic economy would take a big hit if the UK was not included in the EU single market, but at this point this is a prophecy, and coud be right or wrong like every single other economic prediction.
I understand the need for Labour MPs to make it public that they cannot comply with a 3-line whip set by Corbyn, when their ‘conscience’ will not allow it (and nor will their local membership). We are where we are, however. The referendum, we all know by now, was only legally advisory according to the relevant Act of parliament, but unfortunately it is also the case that the non-binding yet forceful words dropped into every letterbox in the land: “that the Government will implement whatever you decide.” The case for re-running the referendum in some form of other on account of the outright lies is weakened by the fact that every single UK election has had a big degree of lying (remember ‘no top reorganisation of the NHS’ by Cameron prior to the 2010 general election?) Whilst a referendum is not the same as an election, it was David Cameron’s decision to put the issue to a referendum in his famous Bloomberg speech to defuse grumblings in his own party. What this inevitably has done has exposed a split opinion in the country at large, and it would be nonsense to believe that the splitting of opinion is simply confined to the Labour Party.
Whatever you dislike about Jeremy Corbyn MP, for example his famous terrorist ‘friends’ remark, his arguably somewhat patronising tone in giving interviews, his dress sense, his purported lack of patriotism when singing the national anthem, Jeremy Corbyn is in no way responsible for the split within the Labour Party on Brexit. Many of his MPs represent constituencies who do not see the ‘benefits’ of immigration. Many of his MPs represent the polar opposite viewpoint. In as much as the only certainties are ‘death’ and ‘taxes’, one thing is pretty certain in that Jeremy Corbyn MP as leader of the Labour Party would be unlikely to make everyone happy on Brexit. This is not the same as the Labour Party appearing ‘confused’ on Brexit, as constantly levelled at Emily Thornberry MP in media interviews. Quite the reverse, the ‘three line whip’, if anything, is Jeremy Corbyn showing the ‘strong leadership’ or ‘real leadership’ demanded of him by Angela Eagle MP and Owen Smith MP in their failed leadership bids.
Now that the Supreme Court had decided that there is insufficient mileage in the argument that the Royal Prerogative is sufficient to trigger Article 50, a Bill predictably has been laid before parliament, longer than the Bill giving women the vote. Labour and the Conservatives, unlike the SNP and Liberal Democrats, have taken national party lines of triggering exiting from the European Union. I feel that the need for MPs to comply with national policy comes less from the convoluted arguments of Edmund Burke on delegates versus representatives, often misquoted inaccurately, but the issue that otherwise MPs would be acting as independents. There are clearly massive problems down the line, if the US Congress decide to do a trade deal with the UK massively to the detriment of the UK for the political convenience of the governing parties of the UK and US. Or, there are issues if, to gain competitive advantage, the UK feels it must lower corporation tax rates even further to stop capital migrating, say, to Ireland, turning the UK effectively into a ‘bargain basement tax haven’ was warned in unison by Keir Starmer QC MP and Jeremy Corbyn MP. It is not immediately obvious what the UK has to sell in a trade deal to the US apart from its genius – but the rich pickings that would made of the NHS is not “scaremongering” but a genuine issue which lies in the national interest.
Exiting the European Union per se is the starting gun. The current Government has previously talked about repealing the Human Rights Act (ideologically consistent with leaving the jurisdiction of the European Court of Justice). There’s no guarantee that xenophobia in some parts of the UK ‘heavily hit by immigration’ will be alleviated short of mass deportation of citizens awaiting guarantees of permanent residence, or by a ‘migration transformation fund’ promised by Labour back in 2010. There’s no guarantee that total immigration levels will fall drastically. We do, however, already know that Indian and Australian Doctors do not feel it is their duty to plug the ‘skills gap’ in the NHS, given the torrential negative perception of the NHS given by its longest serving Secretary of State, Jeremy Hunt. But it would be political suicide if Labour unilaterally came out on the side of the 52% or the 48%. We know that countries of the European Union do not see the four freedoms, in people, capital, goods, and services, as anything other than an unitary package. It’s pretty unlikely that London, even if achieved outright devolution imminently, would be allowed to gain EU passporting rights maintaining a sectoral lifeline for the City.
It’s also pretty unlikely that a small number of revolting Labour MPs, SNP MPs and Liberal Democrat MPs (#seewhatIdidthere) will be sufficient to stop the triggering of Art. 50. Jeremy Corbyn MP, meanwhile, will have to do the best with the deck of cards he’s been handed. Keir Starmer QC MP is right not to get worked up about the semantics of the hard versus soft Brexit. The approach taken by Theresa May MP is substantially one of pragmatism, even if the rhetoric and mood music are more akin sometimes to euphoric Nigel Farage. Many of us reasonably minded like-minded people (or liberal snowflakes) want to reach for the sick bag as soon as we hear about the personal relationship or special chemistry between Theresa May and Donald Trump. Likewise, Jeremy Corbyn can only try to make the best of a bad deal, but, if he is held as being downright obstructive to Brexit, all hell will break loose. I think with import inflation, the skills gap in the UK, and societal discord, Brexit will pan out to be an unmitigated disaster. But it would be wrong to blame Jeremy Corbyn for that too.
And by the way… we know what happened to Bridget Jones in the end.
Some of my best friends quite like Paul Nuttall. They think of him as a bit of a “cheeky chappy” who is pretty affable.
There’s a rule in HR (Human Resources) – that past performance predicts future performance. On that basis, that Paul Nuttall MEP failed to win Bootle and numerous other seats previously, the current leader of UKIP may continue the losing streak in getting into the UK parliament.
But these are different times – where there are no facts or truth, and anything goes. For example, nobody really cares whether Paul Nuttall holds a Doctorate or not. It’s very rare for somebody to be elected into parliament on their academic prowess. Enoch Powell and Tristram Hunt both went to Trinity College, Cambridge, and both hold doctorates from the said University, but that did not make them into election-winning infallible machines.
Looking at the idea of targeting people for particular seats, one can see the logic of trumping up a LibDem candidate in a parliamentary seat such as Richmond in London which is predominantly anti-Brexit. Similarly, the constituency in Stoke is largely pro Brexit, so if there is someone in with a chance it’s Paul Nuttall MEP. When you add to this that Tristram Hunt only just won his seat, having been parachuted in with the help of senior Labour grandees, only just beating UKIP, the high risk strategy of Nuttall might indeed pay off.
Why is it high risk of Nuttall to go for this seat? It’s a very public fight. If he wins the seat, this could be a landmark victory for UKIP in a post Brexit vote or post Trump inaugural era. It may be now ‘acceptable’ to vote for Nuttall. There could be a plethora of shy Nuttalls, who aren’t ‘racist’ but who feel that immigration is out of control. They aren’t opposed to immigration per se, but can’t stand people from Eastern Europe stealing their jobs or living together in houses of ten.
To this extent, Paul Nuttall MEP is behaving exactly like a ‘disruptive innovation’. Typically a product, a disruptive innovation comes along, which, if adopted, offers some feature or value the other products don’t have. It’s easy to obtain this product, and completely scoops up the market. We’ve seen in roads in disruption from, say, the Apple iPod or Uber taxis.
The interesting thing is that with this added value, say the ‘beautiful’ design of the iPad or iPod, people are prepared to overlook the lack of certain other features (e.g. no record deck or minidisc). Paul Nuttall’s unique selling point is that he can plug into this sentiment that nobody cares about getting immigration levels down. And to that extent no amount of memes about his wish for certain types of capital punishment or privatisation of the NHS are relevant.
And the other thing is that, once Nuttall gets his foot in the door, nobody will ever look back – people will be hard pushed to imagine a market without iPods, iPads or Uber taxis. Similarly, we’ll all wonder how on earth we ever managed without UKIP in mainstream politics.
There are also externalities which might act in Nuttall’s in favour. One of them is the sheer effort and tenacity with which the parliamentary Labour Party has put into rubbishing the brand of the Labour Party, whether this involves criticising Jeremy Corbyn personally, or criticising his personal stance over a wide variety of issues (e.g. the pay differential, Trident etc.)
The Labour Party is like the country divided. The membership is said to be soaring, and yet certain MPs are thought to be seeking alternative employment ahead of the next general election (like Jamie Reed for example). The MPs are genuinely divided on a lot of policy, such as Brexit and Trident, but are generally well disposed to criticising with an united voice the crisis, humanitarian or not, in the NHS and social care.
Past performance is meant to be a predictor of future performance. Whilst it is roughly true that the one day of Trump as a president has been largely the same as Trump as the candidate, we know the Republican Party were loath to support Trump and Trump’s poll ratings are terrible.
So, the difficult transpires how we will know whether Labour will have a chance in Stoke or Copeland. If you take heed that nobody has ever come back from such terrible poll ratings, Jeremy Corbyn politically is already dead and buried. But he did also defy convention to be elected leader of the Labour Party twice, the second election being a ‘back me or sack me’ scenario.
The truth is that the Labour Party in parliament have limited options in rubbishing their brand, and some of it depends whether voters think they’d rather try a new political party rather than one of the incumbents. There may also be, unlikely though it is, shy Corbynites who will never admit to voting for Corbyn, a bit like fans of the pop group Bros, but who will go out and vote for him as it’s better than voting Tory.
It may be that despite all the faults people will vote for Labour or Nuttall whatever, in the same way that the sexual peccadillo or showering habits of Trump are not game changers. But these are strange times. If Nuttall wins, it could be, as Blair put it once, ‘a new dawn has broken’. But if he loses, as UKIP leader, the accusations will come thick and fast that UKIP have peaked, and that with the Brexit negotiations, this is ‘no time for a novice’.
Nuttall’s approach to be that, apart from a sense of libertarianism thinking the NHS could benefit from more privatisation making it more efficient, the ideology is sufficiently broad brush to appeal to anyone who hates immigration. But if he wishes to slay the sacred cow that is the NHS, especially at a time when the NHS is in crisis, it’s debatable about whether voters like him enough to make Nuttall an official member of the House of Commons? Is it beyond contempt to criticise the NHS as a member of the ‘working class’ (a broad category of people), or is Nuttall ‘seizing the moment’?
It could be that Paul Nuttall is not ‘the man of the moment’, but, as the Thick of It hold out, the “man for the moment”.
The ultimatum that Jeremy Corbyn should step down if Labour’s fortunes do not improve appears to have been handed down by somebody considered to be a loyal supporter of Corbyn – Len McCluskey, possibly one of the most well known ‘Union barons’.
Part of the problem is that we will not known for certain if Labour’s fortunes have improved. The Corbyn camp normally draw attention to the huge mass membership of Labour, attributed to a personal popularity of Corbyn himself, citing that Labour is at least one of the largest socialist parties in Europe. But we know that metrics can be unreliable. Donald Trump came to win ‘from behind’. He was even lagging in polling terms at the beginning of the night of the US election itself. Pollsters in the UK have likewise had a run of bad luck, in not being able to predict reliably the outcome of the 2015 general election (on the whole) and the EU referendum. But there were, arguably, runes to be read. For example, the wipeout in Scotland, which predates Jeremy Corbyn and which appears untouched by Kezia Dugdale, was expected. Likewise, a revival of Labour’s fortunes in Scotland in the next general election is not widely anticipated by many.
The traditional explanation of Corbyn’s bad poll ratings has been a protracted effect of the ‘coup’ that never was, or the ‘honeymoon’ experienced by Theresa May as a new Conservative Prime Minister in office. Or it could be the lack of support of what has boringly become the ‘mainstream media’ as a term of abuse, invariably sponsored by Rupert Murdoch in some form. And there is possibly some truth in this, in that the Labour Party visibly imploded, and appeared proud at doing so, in broad daylight in the aftermath of the referendum. Whatever the reasons are, apart from local rallies, or on Twitter, Jeremy Corbyn does not appear to be getting his message across with the longstanding Labour voters who have switched to UKIP.
Such new voters tend to say their decision is not out of any love for Nigel Farage, but some of them appear to loathe Corbyn, feeling that Corbyn has nothing to say on social housing (completely untrue). But the thorn in the side of some people who voted for Brexit, part of the ‘taking back control’ meme, is that there appears to be no immediate resolution to the thunderous immigration levels. But these levels have remained high even with Theresa May as SoS for the Home Department. The narrative still remains of people from Eastern Europe undercutting local workers, and claims and counterclaims remain. But the perception is that Jeremy Corbyn is friendly to the idea of free movement of people, and there is a sense from some that even if the UK economy implodes due to withdrawal from inclusion in the single market this is a ‘price well worth paying’ to misquote Norman Lamont, if immigration levels come down. For many, there is no discussion to be had about the value of migrant populations to the fabric of society or economy of the country, in the same way there is no longer a discussion about Labour is incompetent with the economy.
If Jeremy Corbyn were not to step down, it is unlikely that the current parliamentary party has the energy or inclination to host a third leadership election much as that might seem desirable. If Corbyn refuses to move, the best the parliamentary party is to try to work with a grassroots membership to sell Labour on the doorstep. But it is hard to get away from the genuine unease of some Labour grassroots in wanting to sell, for example, a Trident policy with which they may not necessarily agree. Not all will believe in the arguments of a minimum income, for example, either. But the tragedy is that Labour call ill afford such internal troubles mean that the UK withdraws seamlessly from the European Court of Justice which would bode well for the repeal of the Human Rights Act, or let the NHS and social care further implode. There is much agreement on the need to tackle industrial scale tax avoidance or the abuse of the gig economy, but there are serious doubts whether Jeremy Corbyn is necessarily the man who can appeal to the broad range of potential Labour membership. And this is not even to touch the concerns of some on Corbyn’s foreign policy, though this could well be small fry with what President-Elect Donald Trump has to offer imminently.
The only definitive way of knowing whether Corbyn will do a Trump, snatch victory from the jaws of victory, is to put it to the test. But of course it could all end badly yet again for Labour. If Labour fails, there will be plenty of people who will claim ‘I told you so’, but there will also be plenty of people who will think the daggers were out for Corbyn from the very start. The side-effect of the second Labour leadership election is that it effectively made Jeremy Corbyn bullet-proof. Admittedly, there is a substantial number of uncertainties, such as what the current Government wish to propose as ‘red lines’ in its exit from the European Union. However, whatever the feeling of what is ‘right’ for the economy or society, there’ll be some Labour longstanding voters flirting with UKIP who might be very angry that Labour didn’t wish to support Brexit really. Corbyn is essentially in a ‘no win’ situation, virtually impossible to triangulate out of, unless he makes the 2020 election a referendum on the running of the Conservatives’ Brexit, and who knows what would happen there. The danger of course is that Labour bins Corbyn just before the election, then has to bin the new leader after losing a 2020 general election.
The starting point is here.
— Chris Hopson (@ChrisCEOHopson) October 8, 2016
In May 2016, the need for increasing funding for the NHS was mooted powerfully by one of its former chief executives.
“Ministers must increase taxes to raise new cash for the NHS, a former chief executive of the health service in England has said, warning that no developed country would be able to cope with the spending squeeze inflicted on the health since the financial crisis of 2008.
Sir David Nicholson, who served as head of NHS England until 2014, said that last week’s record NHS hospital deficit figures were a symptom of the “serious problem” of NHS under-funding. His call for a boost for NHS spending via the taxation system was echoed by a senior NHS official, who said the only alternative to increasing taxes or national insurance contributions would be deeply unpopular new charges for NHS care.”
Let’s look at the effect of these, shall we?
1. Reducing the number of strategic priorities the NHS is currently trying to deliver. Our members tell us that they are inundated with new initiatives they “must implement” ranging from seven day services and mental health and cancer taskforce recommendations to moving to a paperless NHS and a raft of new patient safety related initiatives. Whilst these are perfectly sensible individually, collectively they are impossible to deliver in the current environment;
It is already known that the NHS offers a seven day service for emergency care, and clinician have been vehement in their opposition to the ‘7 day service’ unless there are adequate resources to ensure patient safety.
The concerns are even reported to be widespread (this extract from August 2016).
“The health service has too few staff and too little money to deliver the government’s promised “truly seven-day NHS” on time and patients may not notice any difference even if it happens, leaked Department of Health documents reveal. Confidential internal DH papers drawn up for Jeremy Hunt and other ministers in late July show that senior civil servants trying to deliver what was a totemic Conservative pledge in last year’s general election have uncovered 13 major “risks” to it. While Hunt has been insisting that the NHS reorganise around seven-day working, the documents show civil servants listing a string of dangers in implementing the plan – as summarised by a secret “risk register” of the controversial proposal that has prompted a bitter industrial dispute with junior doctors. The biggest danger, the officials said, is “workforce overload” – a lack of available GPs, hospital consultants and other health professionals “meaning the full service cannot be delivered”, they say in documents that have been obtained by the Guardian and Channel 4 News.”
2. Formally rationing access to care in a more extensive way;
This has already been happening by the backdoor.
Nick Triggle writes for the BBC in 2012:
“Access to NHS care – including knee and hip operations – is being restricted, data from trusts in England suggests. The evidence, gathered under the Freedom of Information Act by GP magazine, showed 90% of trusts were imposing restrictions. The trend was blamed on cost-cutting by some, but the government says there was no justification for that assertion. NHS managers have defended the practice, saying there were instances when care had to be prioritised. Limits on cataract surgery were in place in 66% of trusts, while more than half of trusts were rationing weight-loss surgery and hip and knee operations Another survey published by Labour found similar patterns, prompting criticism of the trust’s actions from patient groups Clara Eaglen, of the Royal National Institute of Blind People, said: “People should not have to live with a reduced quality of life simply because PCTs are using arbitrary criteria to determine whether they get to keep their sight.””
Caroline Molloy, editor of Our NHS, writes in March 2016:
“Worrying news has emerged this week from the Midlands.
Cash-strapped local health bosses there have suggested that they may in future no longer fund a wide list of procedures on the NHS for many patients, including hearing aids, cataract ops, vasectomies, and hip and knee operations. Clinical Commissiong Groups (CCGs) in Wyre Forest, Bromsgrove and Redditch and South Worcestershire are currently consulting on the proposals, due to a £25million shortfall in government funding. Worcestershire CCG says baldly: “We do not have enough money to continue to buy all the services that we currently do in the same way as we have done before.” A couple of CCGs have already dipped their toe in the water of withdrawing such services – Essex announced in January it would no longer fund NHS vasectomies, and last October Staffordshire CCG started denying hearing aids for the first time in NHS history. The reductions in healthcare build on a longer tradition of short-term rationing fixes.”
3. Relaxing performance targets;
This would prevent the blushes of NHS managers missing A&E targets now virtually every month. “Relaxing performance targets” would help to cover up bad care.
Even in April 2015, the situation was known to be dire.
“Commenting on the latest NHS England figures published today (Tuesday) showing that the A&E waiting time target hasn’t been met for 26 consecutive weeks, UNISON Head of Health Christina McAnea said:
“Week in week out, for half a year now, the waiting times target has been missed. It’s bad enough that some sick and injured people were having to wait for more than four hours in the depths of winter – a time when demand on the NHS was at its peak. But for that still to be the case now that spring is here shows just how stretched A&E departments have become. Sadly this is where we are after five years of Tory mismanagement of the health service. The NHS, its patients and its staff need and deserve better.””
4 Closing or reconfiguring services;
This has already surfaced to public discourse.
This for example comes from August 2016:
“Plans are being drawn up that could see cuts to NHS services across England. The BBC has seen draft sustainability and transformation plans (STPs) which propose ward closures, cuts in bed numbers and changes to A&E and GP care in 44 areas.
There have been no consultations on the plans so far. NHS England, which needs to find £22bn in efficiency savings by 2020-21, said reorganising local services is essential to improve patient care. But the Nuffield Trust think tank said while STPs could lead to “fundamental changes”, many of the plans do not meet the financial targets set by the government and will face a “dauntingly large implementation task”.”
Also that month the Guardian carried further details:
“NHS England has divided England into 44 “footprint” areas, and each was asked to submit a cost-cutting “sustainability and transformation plan” (STP). The Guardian has seen the detailed plans for north-west London, while 38 Degrees, a crowdfunded campaign group, commissioned the consultancy Incisive Health to collate and analyse proposals from across the rest of England.
The picture that emerges includes:
In the Leicester, Leicestershire and Rutland region, there are proposals to reduce the number of acute hospitals from three to two.
In the Black Country region of the West Midlands there are proposals to reduce the number of acute units from five to four and close one of two district general hospitals.”
“There are also serious concerns that cost-cutting on the scale envisaged under the plan could damage patient care. Jennifer Dixon, the chief executive of the Health Foundation thinktank, said the strategy risked a repeat of a care scandal of the scale of that seen at the Mid Staffordshire NHS Trust between 2005 and 2009. “Getting the balance right between carrot and stick is critical, as history tells us,” she said. “The Francis inquiry, published only three years ago, describes how radical steps by one NHS hospital – Mid Staffordshire – to improve its financial position had terrible consequences for patient care.””
5. Extending co-payments or changes;
The effects of copayments are well known, see for example here Colin Leys and Stewart Player:
“What has already occurred with dentistry, physiotherapy, podiatry and other services will start happening across the board. ‘Top-ups’ and ‘co-payments’ will become standard. Some treatments will cease to be available freely on the NHS and have to be paid for – if you can afford it. ”
Co-payments (and personal budgets) have the effect of rationing care at the individual level, making cuts much easier to get away with.
“By the use of direct payments and/or ‘personal budgets’14 for an increasing range of conditions – patients are given a fixed sum to buy their healthcare themselves, from either the NHS or private providers. Personal budgets have been trialled since 2009 and are now being rapidly extended. By 2014 they will be rolled out to all patients receiving NHS continuing care. The experience from social care personal budgets here and healthcare in other countries is that risk is passed down to the patient, and state health providers can go under. Budgets often get progressively cut, leaving the individual to top up from their own pocket, or via insurance, if they can afford it.”
6. Reducing / more explicitly controlling the size of the NHS workforce which accounts for around 70% of the average trust budget. But, clearly, controlling the size of the workforce would have to be linked to some form of reduction in what the NHS is being asked to deliver.
The King’s Fund comments:
“Between 2000 and 2010 the nursing and midwifery workforce in the NHS in England grew by 26 per cent, an average of 2 per cent per year, the result of a concerted effort to reverse nursing shortages in the previous decade by increasing training places, improving staff retention and active international recruitment. However, the number of nurses on the Nursing and Midwifery Council’s UK register of all practising nurses, began declining in 2008 and continued to fall in the following three years, while the headcount of qualified nursing staff working in the NHS in England only began to reduce after reaching a high of 375,505 in 2009.”
“The Government has suspended NICE (the National Institute for Clinical Excellence) from producing further guidance on safe staffing levels in the NHS and this is a cause of great concern.
Simon Stevens, Chief Executive NHS England says he has requested Jane Cummings, Chief Nurse NHS England, to incorporate nurse workforce planning into the 5 year forward plan initiatives. This is a serious backward step as NICE were commissioned to provide an independent review on safe staffing levels based on research and expert advice from the healthcare field. NHS England is not in a position to provide an independent view and the outcomes will be fragmented across its various initiatives with no standardized approach to staffing levels resulting in a serious risk to patient safety. (It is of interest that on the same day of the suspension, NHS Wales voted unanimously to pass a safe staffing to its second stage.)”
“Healthcare services and its professionals are “heading into an extremely difficult autumn”, the Royal College of Physicians (RCP) has warned as the latest workforce survey from the RCPCH revealed widespread staff shortages and rising rota gaps in the field. The survey, which has been collecting evidence since 2009, found that more than one in four general paediatric posts at senior trainee level are now vacant, with over half of paediatric units not meeting recommended staffing standards. To keep services running, consultants are increasingly providing unplanned cover in addition to covering their own roles. Perhaps even more worryingly, four out of five, or almost 90%, of clinical directors are worried about how services will cope in the next six months. Doctors argued children’s services are “at a breaking point, sustained by existing junior doctors and consultants struggling to plug vacancies”.”
The problem with NHS Providers putting so much effort into laying out these disastrous options is that they begin their negotiations from a starting of point of (unintentionally) destroying the NHS? They should emphasise at all times this will only be solved by proper funding to both NHS and the social care.
The “zombie policies” keep on coming up again and again.
Caroline Molloy again, this time from 2013:
Reform acknowledge that the last major review of NHS funding found that charges were “inefficient and inequitable” and that taxation was the most effective way of paying for healthcare, just as NHS founder Nye Bevan insisted when he dismissed means-testing, charging and insurance, saying:
“The means of collecting the revenues for the health service are already in the possession of most modern states, and that is the normal system of taxation.”
Taxation is – Reform admit – still the model of NHS funding “preferred by the public”.
But these days it’s surprisingly rare to hear a politician explicitly defending this core principle of the NHS. Cameron’s appointee as new NHS Chief Executive, former United Health chief Simon Stevens, wrote an essay for Reform last year that appeared to problematise the “the NHS’ tax-funding mechanism”.
There are other think tanks prepared to help Reform do the political dirty work – or ‘heavy lifting’ as it’s now known – to try and shift the public away from their commitment to a tax-funded comprehensive NHS towards one based on charges and insurance.
Reform cite a recent Kings Fund report to back their assertion that “attitudes to charging have begun to shift in recent years”. In fact the Kings Fund’s focus group strongly rejected NHS charging and preferred increased taxation if necessary. Only after two days of being brow-beaten with the “inevitability” of the NHS’s financial “crisis”, did attendees reluctantly concede that if they absolutely had to accept charging, they would prefer it applied to less vital procedures and to more irresponsible patients.
Reform also try to claim that GPs and the British Medical Association are shifting towards supporting charging – an attempt at co-option roundly rejected by both the BMA and the Royal College of GPs. Dr Chaand Nagpaul, chair of the BMA’s GP Committee said yesterday:
“This proposal undermines the core value of our NHS: universal access based on need, not ability to pay. If a charging system is introduced there’s a risk it would deter patients from seeing a doctor and getting the treatment they desperately need.””
Accidentally destroying the NHS with parliament’s permission?
It would be a disaster if Chris Hopson going into his negotiation had effectively given up on the notion of funding the NHS properly, and suggested effectively only a route for destroying NHS as a comprehensive and free at the point of use service.
Remember the ‘sustainability and transformation plans’ which have wrought widespread concern?
Chris Hopson again:
“We strongly support the current sustainability and transformation planning (STP) process to enable local health and care systems to chart a path to sustainability by 2020/21. But the problems the NHS faces are immediate. Trusts and CCGs must develop immediate plans that close the larger gap they will face from April 2017. Failure to do this now means the NHS will be unable to livewithin its 2017/18 budget.”
The original Hobson choice is described as following:
Or to bring up to date, Hopson’s choice, destroying the NHS with the permission of parliament?
I am certain Chris Hopson doesn’t intend this, to be clear.
It was a ‘badge of honour’ for some to remark ‘Never heard of him’ in response to Jon Ashworth MP’s elevation to Shadow Secretary of State for Health.
But if it’s any consolation – I doubt he’s heard of you either.
Whisper it gently, but there’s more to life in the health and social care services than the pages of the Health Services Journal or the lecture theatres of the King’s Fund.
His campaigning work on mental illness, breaking down stigma and prejudice, has been inspiring.
But he is no ‘yes man’ – he railed against the mischievous use of slogans (a campaigning strand for Owen Smith MP over the summer for the Labour leadership).
From this starting point, I think Jon has form in being able to speak his mind, but withstand having his political career assassinated. He potentially might act as an important bridge for Corbyn’s “socialism for the twenty first century” and the halyçon days of “New Labour”.
When Tim Farron MP, leader of the Liberal Democrats, says like the Stone Roses he prefers the earlier work of New Labour, he presumably is referring to how when Labour came to office and power in 1997 the NHS was on its knees. Radical surgery had to be taken to the NHS, including Milburn’s NHS Plan.
The aim was also to put in real investment to the NHS – which worked – and to tackle burning issues of poor infrastructure.
Alan Milburn himself has said the tendency when you first come to the post of Secretary of State for health is ‘to want to do everything’, but as time passes progress slows down.
Tragically, Jon Ashworth MP is inheriting the NHS in a state of chaos and turmoil, but there are huge problems bequeathed by the current leadership of Jeremy Hunt: viz, inadequate monies to run the services, backdoor insidious rationing of services, morale of NHS staff (excluding management) at rock bottom, crippling PFI debts, a small number of NHS Trusts in ‘special measures’, widespread financial deficits, social care funding on its knees, A&E targets comprehensively missed, an IT programme which is badly behind, problems in recruitment in some specialties of the NHS, drastic cuts in mental health services, leaders of the NHS who refuse to quit despite catastrophic performance, disasters of outsourcing where nobody appears to wish to take responsibility, junior doctors repeatedly on strike with an imposed contract officially seen as not ‘imposed’, problems in recruitment, retention and workload of general practitioners, and so on.
And yet despite this, Theresa May MP, in my opinion probably one of the most dangerous Conservative Prime Ministers ever, insists ‘nothing to see here’.
But, without pointing the finger of blame at the latter Blair years, the list of policy misfires is substantial, including unsafe staffing and rush to regulation which contributed to the Mid Staffs disaster, explosion in new PFI deals (PFI has continued under subsequent governments) with extremely poor value for the taxpayer, the consolidation of the market in the NHS and social care, the introduction of the ‘purchaser provider split’, moves to use of private sector due to failure in planning (termed euphemistically as ‘building capacity’) such as privatisation of NHS logistics, legislation such as the National Health Service Act 2006 and the Public Contracts Regulations 2006 which laid the foundations for the catastrophic Coalition Health and Social Care Act 2012. The 2012 Act saw turbo boosting of outsourcing and transfer of services to the private sector (aka “privatisation”). New Labour started to embed the notion that competition between providers would not only bring down costs but also improve quality, which was never borne out in other monopoly behaving industries such as the utilities – and this was a disastrous hangover for the Coalition Years 2010-2015 with the Conservatives and the Liberal Democrats finding synergy in free movement of capital. This all had paved the way for greater consolidation of competition economics governing the NHS from EU membership, as well as the threat of TTIP investor protector clauses.
And Ashworth needs to insist that the NHS and social care to run a decent service, when the current Government is using #Brexit as an all round ‘get out of gaol’ card. Without this money, Simon Stevens cherished ‘Five Year Forward View’ will run into deep problems. Governments and opposition parties have been shroud waving about integrating health and social care for decades, but progress on this has been generally poor apart from some islets of promise. Parity of esteem does not appear to be a reality, as even Andy Burnham MP had recently sloganised. Delayed discharges or delayed transfers of care, or ‘bed blocking’ as affectionately known in the predominantly right wing anti Corbyn media, have got worse under Jeremy Hunt’s watch too, breaking both the NHS and ASCOF outcomes for patient experience.
But Ashworth is an effective campaigner – and he needs to put those skills into good use, for example against the unconscionable poor value for money PFI deals, the catastrophic current operational performance of the NHS, and the disastrous funding situation of social care, the need for much better mental health services.
Simultaneously, Ashworth will have to convince the public of the long view of the need of a comprehensive, properly funded, NHS free at the point of use. A similar National Care Service has been the vision of many in the past, but never got off the drawing board. Maybe the Shadow Treasury will have some idea about prioritising this now, given the change in monetary policy from the current Government? Clinicians and patients/users converge on a desire for care planning and continuity of care. We know the Government has done its best to show wage restraint in some areas not others (e.g. of nurses but not of NHS managers), but addressing the funding gap will need to see an intelligent use of technology – not aggressive pimping and rent seeking to the private sector – and changing especially for the elderly, where polypharmacy and multi morbidity can be big issues, the direction of the supertanker towards being a ‘National Health and Care Service’ not a ‘Fragmented Health Service’.
Jon Ashworth MP definitely has his work cut out. It’s a monumental task where he does need to build up some momentum.