The Coalition is the current face of the corporate lobbying over the NHS, but some in Labour have acted as ‘ingluorious basterds‘ too. Ironically, neglect of the NHS was a principal cause of the Conservative government’s downfall back in 1997, and was a major issue that helped New Labour mobilise mass political support for a landslide election victory.

In 2002, Professor Anthony King described the Blair government as the “first ever Labour government to be openly, even ostentatiously pro-business”. Thus, the New Labour leadership had been “converted” from tolerating private enterprise to actively promoting it; a significant political U-turn. Now in 2013, Ed Miliband has recently been in the firing line over a lack of direction or policies, with some Labour members being wheeled out of their holiday villa in Tuscany to emphasise that Miliband will win the election in May 2015. Peter Hain talks in his latest up-beat missive in the Guardian about the New Jerusalem of Labour’s flagship integration policy, which ‘joins up’ health care and psychiatric system, but this is a poor attempt at snakeoil salesmanship from an otherwise very pleasant man. It is indeed emblematic of Labour’s outright denial of the disaster that has been the English health policy over a number of years from senior politicians of all parties. People who do actually want to stand up for a comprehensive, universal, free-at-the-point-of-use, National Health Service are finding themselves struggling to get their message across, while Craig Oliver gets panicky about the media representation of Cameron’s unsightly figure on holiday.

All is not lost. The facts speak for themselves (“res ipsa loquitur“), and Labour cannot escape from its past. Ed Miliband is a ‘social democrat’, but there are plenty in the Labour Party who are senior enough to keep him in check over the NHS. Ed Miliband, despite the loyalists, is on suspended sentence with his conference speech next month in Brighton. Whatever he decides to do about social house building, his inability even to get rid of the Bedroom Tax is a sign that all is not well. Few people currently feel that he is up to the challenge of taking the socialist bull by the horns regarding the NHS policy, not helped by entities such as the Socialist Health Association superbly supine in having no material effect on the real problems that matter to most voters.

And yet all is not lost. Take for example the flagship policy of ‘equal opportunity’, championed by Monitor in lowering barriers-to-entry in a corporate dogfight over who runs the NHS. Tony Blair doesn’t especially mind who runs the NHS, as long as it’s a corporate, as his famous dictum goes. The writing was indeed on the wall as far back as , with the very influential John Denham MP, a former Health Minister, writing in ‘Chartist’ as follows in 2006:

But the Government has adopted a simplistic and ideological formula. All public services have to be based on a diversity of independent providers who compete for business in a market governed by consumer choice. All across Whitehall, any policy option has now to be dressed up as ‘choice’ ‘diversity’ and ‘contestability’. These are the hallmarks of the ‘new model public service’.

We can see this formula behind al the recent major policy rows, and its ideological nature goes some way to explain Labour’s internal opposition. But it’s not the whole reason. Plenty of MPs are willing to look at policy change on its merits, whether or not they have suspicions about its origins. And this is the second point where things go wrong.

However strongly the Government believes in ‘choice, diversity and contestability’ there is little unambiguous evidence in its favour, and plenty of evidence that points to caution. The evidence does not suggest, for example, that choice all leads to inequities but it certainly suggests that it usually does. There are services where a choice of independent autonomous providers may make sense, but the evidence suggests that health, or education, works best when this is cooperation between different parts of the system. The link between your nurse, GP, consultant and therapists is more important than competition between different providers.

John Denham MP still has a massive influence on the Labour Party as is well known, having been instrumental in the selection of Rowenna Davis in Southampton Itchen for the forthcoming General Election on May 8th 2015.

The knives were out with the Labour Grandee, now The Rt Hon The Lord Hattersley, writing in the Guardian on 7 November 2005:

“A couple of weeks ago Tony Blair told a specially invited Downing Street audience that throughout the 80s Labour had been kept out of office because it wanted to “level down”. That allegation is as absurd as it is offensive. But plagiarising Tory abuse is not so serious an offence as adopting Tory policies. Last Friday, he again attempted to make backbench flesh creep with warnings that abandoning his “reform agenda” would lead to defeat. That is not only palpably untrue, it is also not a consideration that keeps him awake at night. His policies are on the right of the political spectrum because that is where his heart is. He has happily admitted it.

Socialism is either the doctrine of public ownership or the gospel of equality. The first Tony Blair (now) rightly rejects. The second he openly wants to replace with a commitment to meritocracy – the survival of the fittest at the expense of the less fortunate and less gifted. That proves his intellectual consistency. No prime minister since the second world war, including Margaret Thatcher, has believed so devoutly in the economic healing powers of the market. Meritocracy is a market in which human beings compete with each other for wealth and esteem. Markets always produce losers as well as winners.

The “choice agenda” requires competition for places in what are called “the best schools” and beds in the most efficient hospitals. Unless there is a surplus of secondary schools with small classes, highly qualified teachers and exemplary results, some parents will be forced to accept what others have rejected. The same rule of winners and losers will apply to hospitals. No genuine Labour leader would allow the self-confident and articulate section of society to elbow the disadvantaged and the dispossessed out of the public service queue.”

The mutant DNA is still to be found in Labour’s current NHS policy, sadly, except these are not lone trace fragments by any stretch of the imagination. We’ve been before though, and Labour has fundamentally been frightened to do the right thing. At the 2005 the Labour Party Conference a resolution was passed that attacked the Government’s move “towards fragmenting the NHS and embedding a marketised system of providing public services with a substantial and growing role for the private sector”. It was left up to Michael Meacher MP to put the writing back up on the wall in an article in March 2007 in Tribune, explaining what Tony Blair should do, if he should win the 2007 General Election:

“Domestically, I would reverse the “new” Labour obsessions of replacing the public service ethos by the market. Equity, equal rights according to need, public accountability, a professional standard of care and integrity are being replaced by targets, cost cutting, PFI top slicing of public expenditure, a service fragmentation by private interests. This is the case of health and education housing, pensions, probation, rail, the Post Office and local government. There are even threats against public service broadcasting. Privatisation of our public services should be stopped and reversed.”

Stuart Hall, Emeritus Professor of Sociology at the Open University, argued that whilst the Labour Government has retained its social democratic commitment to maintaining public services and alleviating poverty, its “dominant logic” was neo-liberal: to spread “the gospel of market fundamentalism”, promote business interests and values and further residualise the welfare system. It now falls to Jon Cruddas in the current policy review to stop the rot in Labour, but his words from his article “How New Labour turned toxic” in the New Statesman on 6 December 2007 ring ever true:

“After years in opposition and with the political and economic dominance of neoliberalism, new Labour essentially raised the white flag and inverted the principle of social democracy. Society was no longer to be master of the market, but its servant. Labour was to offer a more humane version of Thatcherism, in that the state would be actively used to help people survive as individuals in the global economy – but economic interests would always call all the shots. Once the Blair government took power, the essentials of its approach became clear: from the commercialisation of public services to flexible labour markets, on through soaring executive pay and on in turn to party funding, big business and the politics of the market had taken pole position.”

Labour is a leopard which hasn’t changed its spots at all. Hence, apart from Debbie Abrahams virtually, Labour appears to be giving tacit support to a current Government policy which appears to be sympathetic to the World Trade Organisation’s (WTO) General Agreement on Trade in Services (GATS), which aim to opens up service provision like health and education, (which account for approximately 15% of GDP in most European countries) to direct multinational competition and ownership, This, in fact, is despite a statement in 2002 from the UK Government that it would not take on WTO commitments that would compromise public service delivery via the NHS. This represents a major U-turn in healthcare policy and it is therefore important to understand from a historical perspective how and why this happened.

Labour is currently involved in a massive con-trick with the electorate, colluding with the Conservatives and the  Neoliberal Democrats, and it won’t be long before real voters spit in their face in response to their claim that, “Labour is the party of the NHS.”

Further reading

Hall S. (2003) New labour’s double shuffle, Soundings.

King A. (2002) ‘Tony Blair’s First Term’ in King A (ed.) (2002) Britain at the Polls.