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The electoral arithmetic potentially could turn out good for the NHS



abacus

Be in no doubt. This is a very complicated UK general election.

It’s pretty likely that the SNP will gain a huge number of seats in the Westminster parliament. Many of us sadly forecast this. Jim Murphy and Kesia Dugdale were not the people to inspire the Scottish electorate to a good representation.  At the time, it was pretty clear that many would go back to their constituencies and prepare for a hung parliament.

The situation is this. Ed Miliband wants a coalition with the SNP over his dead body. He has ruled out ‘a deal’, although this does not exclude lots of mini-deals to get a minority Labour government legislation through. A critical test for a Labour minority government will be whether the SNP can support a Labour government on a case-by-case basis. The economy clearly presents a problem, but many people feel that Ed Balls is ‘the weakest link’. Allowing for eased austerity and boosting consumer confidence and demand might be good for a weak recovery in the UK, and certainly the Green Party and the SNP should like to establish this.

The Liberal Democrats clearly fancy themselves as tempering the Government on preventing a lurch to the left or right. However, the credentials of the current Government are not much to brag about. National debt has gone through the roof. With the Coalition’s policies, a ‘fair society’ is not evidenced by the decimation of English law centres (aka access to justice). If Nicola Sturgeon becomes the Deputy Prime Minister of the United Kingdom, she is exercising her democratic right to be a force within UK politics, given that it was also an exercise of democracy that Scotland did not become independent.

Both the Green Party and SNP talk the talk on wanting a public-run NHS, and the proof of the pudding is in the passing of legislation. Both political parties are expected to be keen to reverse the Health and Social Care Act (2012), getting rid of the toxic sections 75 and 76 which makes competitive tendering a must if there’s more than one bidder. Given that Nick Clegg is keen to apologise for tuition fees, it is possible that Norman Lamb, if given a rôle in government as an experienced care minister, might support integration. Integration is a ‘must’ to make Andy Burnham’s “whole person care” work, bringing together a national health and care service, with pooled budgets, integrating physical, mental and social care. There are potential advantages in having a Liberal Democrat influence on health and care policy now, parking aside previous differences, on securing funding for the future for 2015-20 and giving prominence to mental health and parity of esteem.

In terms of personalities, it is going to be incredibly tough. But you can bet your bottom dollar that Nick Clegg will want to leave the scene, as there is animosity between him and Labour, and the feeling’s entirely mutual. Many Labour members also want him to lose his seat in parliament to a very good Labour candidate in Sheffield Hallam. Nick Clegg might not want to be physically there if Ed Miliband is Prime Minister, and Miliband takes the lead in scrapping the Bedroom Tax and the Health and Social Care Act (2012).

The alternative is pretty dreadful – of a Conservative government propped up by any party which wants a referendum on Europe, i.e. UKIP. Another toughie is going to be Trident, but it is likely that the majority of the Conservative Party, Labour Party and Liberal Democrats will vote against others such as the Greens or SNP on such a vote, whipped or not.

The structure and function of a possible Labour minority government is complicated, but there is actually a possibility that the relationship is a more meaningful relationship that the current Coalition. The electorate, strangely enough, might be producing a best possible outcome.

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