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How a fairly standard hate campaign against Labour and Andy Burnham on the NHS went so badly wrong
Andy Burnham in Willow Park Housing Trust
I am not even a hard-core ‘activist’ of Labour, whatever that is. I do nonetheless find it highly amusing how a pretty bog standard hate campaign against Labour and Andy Burnham MP, former Secretary of State for Health and current Shadow Secretary of State for Health, went so badly wrong. Isabel Hardman from the Spectator recently remarked that Andy Burnham MP is driving the Conservatives potty. Nothing would give the Conservatives greater satisfaction than to achieve the Burnham scalp, but the fundamental problem is that the facts keep on getting in the way of this hate campaign. Burnham, unfortunately for them, has considerably more experience than his counterpart, who is currently Jeremy Hunt. Burnham does not fit the mould either of someone who looks as if he wishes to work for a private equity fund when he’s more ‘grown up’. Burnham firmly believes in the founding principles of the NHS, and ideologically he is desperate to unwind the marketisation of the NHS. He wishes to make a break from the past, and “good for him”, many will say. He is in fact one of Labour’s biggest assets in the party as a whole, and has even put his neck on the block to say constructively why Labour might need to up their game to be guaranteed of a good working majority. Labour can win a massive majority on the back of their policy in the NHS, as indeed the 1997 Blair victory, helps to demonstrate. As in all of medicine, it has to make an accurate diagnosis of the problem before putting in a coherent management plan. The argument against the markets, which can drive up shareholder dividend at the expense of patient care and which introduces a level of inefficiency and waste such that an estimated 31% of the budget will now be going on admin. and wastage (as beautifully articulated by the Himmelstein and Woolhandler papers), has been won. The need to encourage collaboration and the dignity of clinical staff cannot be underestimated. The Conservative Party have failed miserably on the NHS, and it is for this fundamental reason why they will ultimately become unstuck on May 8th 2015.
The problem with the Conservative HQ copy, regurgitated in the medical and health policy press uncritically, is that it simply does not make sense. Even worse, it is not borne out by the facts. Take the meme that “money does not grow on trees“. Even the most ardent patient safety campaigners need to acknowledge the need for safe staffing levels, which might include a basic level of nursing staffing numbers. If money does not grow on trees, how is it possible that £860 billion was found miraculously by a Labour government to fix market failure of the first global financial crash. If money does not grow on trees, how come is it that estimates of HS2 are pitched around £40-60 billion realistically? Even the £2.4 billion McKinsey ‘efficiency savings’ were returned to the Treasury, and not ploughed back into frontline care. It all fundamentally hinges on a steady stream of lies about the NHS from the Conservative Party.
Money tree
Andrew Dilnot, chair of the UK Statistics Authority, recently concluded in December 2012 that changes in NHS spending over the two years had been small and health spending was actually lower in 2011-12 than in 2009-10. He nonethlesss said the watchdog’s calculations were based on what he considered “the most authoritative source” of national statistics on the subject from the Treasury. In a letter to Health Secretary Jeremy Hunt, Mr Dilnot said: “On the basis of these figures, we would conclude that expenditure on the NHS in real-terms was lower in 2011-12 than it was in 2009-10.”
Another trick is the misuse of the term ‘sustainability’ is used by people who really have no idea what this means – sustainability clearly not be a lame excuse of stripping frontline staff of the resources they need to do their job. This all pricks the nation’s conscience which is increasingly skeptical of the ‘austerity’ blank cheque excuse to decimate public services in the name of ‘public sector reform’. It simply is a pack of lies, as Labour knows the public fundamentally has no problem with a well-funded by taxpayers state-run service, free-at-the-point of use, offering a comprehensive universal healthcare? The current Coalition vastly underestimate the public’s fundamental mistrust of money being paid on excessive CEO salaries in the NHS, especially on senior members of NHS England who repeatedly offend on the point of lack of accountability of their decisions. They do not accept the business plan that it is necessary to spend thousands or millions on redundancy payments, or compromise settlements to avoid unfair dismissal claims.
Even the question of the nation’s “priorities” generally runs into the buffers immediately. The public resent the idea of carers in a ‘caring profession’ by definition being put on ‘zero hour contracts’, even if the party-line from profit generating multinational corporates is that these allows staff ‘flexibility’. The arguments criticising the NHS have swung from one hyperbole to another, with the NHS having been called a 65 year mistake. And yet, this argument is unable to touch the scandal at Winterbourne in the private sector. On the issue of the nation’s priorities, can one reasonably suggest that one of the very worst things for this current Government to do was to embark on a £3bn reorganisation of the NHS with the sole primary purpose of outsourcing and privatising the NHS? As the lawyers say, “res ipsa loquitur” or the facts peak for themselves. In a 493 page Act, there is not a single clause on patient safety, which seems rather odd given everyone’s correct focus following the disasters at Mid Staffs and Morecambe Bay which Labour has every intention of remedying. The Act clearly thrusts private competitive tendering as the prime method of commissioning, which is being played out as a disaster in the legal/justice system. The Act has clearly massively increased the amount of income that a NHS Trust can make from private sources. It is an Act which fundamentally the public did not vote for, and it is little wonder that Andy Burnham MP and his team have repeatedly promised to repeal the Act. Like High Speed 2, which many do not similarly remember ‘voting for’, the costs are threatening to spiral out of control, which makes it all the more ludicrous that it is the Labour Party should be blamed for misuse of the handling of the public finances. Like High Speed 2, this policy is an outcome of intensive behind-closed-doors lobbying, and the genesis of the Act sits uncomfortably with the widely reported general issue of the Conservative Party and hedge funds.
Burnham has not sat on the fence over issues of health policy either. Despite the ‘smoke and mirrors’ of untrue fatuous claims of David Cameron, Burnham resolutely has promoted plain packaging of cigarettes, consistent with current global evidence and much to the chagrin of Philip Morris International. Burnham has also supported the evidence-led view of the Faculty of Public Health of the UK Royal Colleges of Physicians over ‘minimum pricing’ of alcohol. Burnham has said ad infinitum and absurdum that, despite the purported advantages, the ‘private finance initiatives’ need to be drafted such that the public do not lose out. Three things to say here, that the policy has been extended by the current Government under George Osborne. Secondly, it is a policy which was born under John Major’s government in the mid 1990s Thirdly, the first ‘sighting’ of this policy, which represents fundamentally a synthesis of a Conservative ‘Butskellite‘ policy, was in a 1993 policy document published by the Social Market Foundation with David Willetts MP, current Conservative minister for Universities, entitled “The Opportunities for Private Funding in the NHS”. Burnham, furthermore, has not his hid under a bushell regarding NHS 111. He has in fact accused the Government of destroying NHS Direct, “a trusted, national service” in an “act of vandalism”. According to him, “It has been broken up into 46 cut-price contracts. Computers have replaced nurses and too often the computer says ‘go to A&E’.”
Writing about the situation in Lewisham, Burnham unsurprisingly has been spitting bullets, remarking that:
“The High Court yesterday delivered a damning verdict on an NHS now being run by accountants rather than in the interests of local communities. This ruling is a humiliating blow to Jeremy Hunt. It is outrageous that he thought he could rob a community of its A&E and maternity services to solve financial problems at a neighbouring trust.Labour warned him that he was acting above the law but he refused to listen, and that arrogance has cost taxpayers dear in legal fees but has also caused people of Lewisham unnecessary worry.”
The general public resent this general sense of arrogance with which Jeremy Hunt and colleagues behave in their management of the NHS. The ‘democratic deficit’, where the public are simply not included in decisions about the NHS, makes a mockery of the ‘no decision about me without me’ mantra so beloved of NHS commissioners currently. Arguably, this is not seen any more clearly than in the sharing of confidential data without the valid consent ethically or legally of NHS patients. This was even reported in right-wing newspapers who have on occasion been strongly in favour of patient rights as follows:
“Mr Burnham said it is “absolutely essential” that patient data is safeguarded, after The Sunday Telegraph revealed David Cameron will use a keynote speech to outline far closer “collaboration” between the health service and life science companies. The Prime Minister will say that the controversial industry has the potential to be a powerhouse of Britain’s 21st century economy, but that it is stifled by excessive regulation at present. Speaking to Sky News, Mr Burnham said that while he did not object in principle to close ties between the NHS and private sector life science companies, he was concerned that “one of the patients’ groups that was on the working group looking at this issue has walked away”.”
I first spoke with Andy Burnham after one of the leadership hustings in 2010 at the Methodist Central Hall. I liked him as a person, and I was really struck by the sheer passion he genuinely had for an integration of health and social care pathways, even long before the political shennanigans of the Dilnot Review which were delayed because of the Health and Social Care Act. This was further embellished in a seminal speech to the King’s Fund in January 2013:
“For 65 years, England has tried to meet one person’s needs not through two but three services: physical, through the mainstream NHS; mental, through a detached system on the fringes of the NHS; and social, through a means-tested and charged-for council service, that varies greatly from one area to the next. One person. Three care services. For most of the 20th century, we just about managed to make it work for most people. When people had chronic or terminal illness at a younger age, they could still cope with daily living even towards the end of life. Families lived closer to each other and, with a bit of council support, could cope. Now, in the century of the ageing society, the gaps between our three services are getting dangerous. The 21st century is asking questions of our 20th century health and care system that, in its current position, will never be able to answer to the public’s satisfaction. As we live longer, people’s needs become a complex blur of the physical, mental and social. It is just not possible to disaggregate them and meet them through our three separate services. But that’s what we’re still trying to do. So, wherever people are in this disjointed system, some or all of one person’s needs will be left unmet.”
I feel that nobody could have worked harder than Andy Burnham for the NHS on a range of issues, such as nursing staffing levels, the lie about the NHS budget being protected, the sharing of confidential patient data, the Lewisham decision under appeal, minimum pricing of alcohol, standard packaging of cigarettes, the repeal of the Health and Social Care Act (2012), and PFI. He has also worked extremely hard in exploiting his ‘first mover advantage’ over health-and-social integrated care and ‘whole person’ care. Labour is consistently trusted by the voters on the NHS ahead of the other parties, and this is not particularly any surprise when you consider that many employees of the NHS receive more balanced information about the actual situation of the NHS from their Unions of which they are a part. There is no doubt that the toxic memes of “competition” and “choice” are here to stay, totally bastardised by health policy wonks who have never set foot on a busy NHS ward in their life. Andy Burnham MP can do no worse than to maintain the reputation of and trust in the medical and nursing professions and the NHS. After years of the Coalition rubbishing the NHS, it is definitely time for a change, and we can’t go on like this.
@Ed_Miliband’s speech on the Unions and party funding, 9 July 2013 [full text]
Ed Miliband MP, Leader of the Labour Party, said:
Let me start by saying how pleased I am to be here at the St Bride’s Foundation. Only a few hundred yards from where the Labour Party was founded over a century ago. And especially to be here with so many community organisers and Labour Party members from right across the country.
I am here today to talk about how we can build a different kind of politics. A politics which is truly rooted in every community of the country and reaches out to people across every walk of life. That is what I mean by One Nation. A country where everyone plays their part. And a politics where they can. It is about a politics that is open, transparent and trusted.
Exactly the opposite of the politics we’ve recently seen in Falkirk. A politics that was closed. A politics of the machine. A politics that is rightly hated. What we saw in Falkirk is part of the death-throes of the old politics. And the reason why Falkirk is so damaging is because it comes against growing mistrust in politics. People thinking politicians are in it for themselves. Not to be trusted. Not to be believed. And every time something like Falkirk happens, it confirms people’s worst suspicions.
And as the Labour Party – the party of working people – we have a special responsibility to stand for a better politics. So I want to build a better Labour Party. A better politics for Britain. And that is what we will do. And we will do so by shaping a Party appropriate for the twenty-first century not the twentieth century in which we were founded. Understanding we live in a world where individuals rightly demand a voice, where parties need to reach out far beyond their membership and where our Party always looks like the diverse country we seek to serve, representing the national interest.
Building a better politics starts by building a Party that is truly rooted in every community and every walk of life.
A hundred years ago the Trade Unions helped found the Labour Party. Decade by decade, from Neil Kinnock to John Smith to Tony Blair, we have been changing that relationship. And in this generation, to build the new politics, we need to do more, not less, to make individual Trade Union members part of our Party – the three million shopworkers, nurses, engineers, bus drivers, construction workers, people from public and private sector.
The problem is not that these ordinary working men and women dominate the Labour Party. The problem is that they are not properly part of all that we do. The vast majority are not members of local parties, not active in our campaigns. We have to turn that round. Working people should be right at the heart of our Party.
Our relationship with individual Trade Union members needs to change. Trade Unions have political funds for all kinds of campaigns and activities as they choose. These funds are governed by law, passed in the 1980s, and there are arrangements where their members can opt-out from that fund if they do not want their money spent on political activities, activities covering a whole range of campaigning issues.
We do not need to change that law on the right of Trade Unions to have political funds. But I do want to change the way individual Trade Unionists are affiliated to the Labour Party through these funds. At the moment, they are often affiliated automatically. I do not want any individual to be paying money to the Labour Party in affiliation fees unless they have deliberately chosen to do so. Individual Trade Union members should choose to join Labour through the affiliation fee, not be automatically affiliated. In the twenty-first century, it just doesn’t make sense for anyone to be affiliated to a political party unless they have chosen to do so. Men and women in Trade Unions should be able to make a more active, individual choice on whether they become part of our Party. That would be better for these individuals and better for our Party. It could grow our membership from 200,000 to a far higher number, genuinely rooting us in the life of more of the people of our country.
I have a message to the millions of Trade Union members currently affiliated to the Labour Party: with this change I invite you to be at the centre of what this Party does, day in day out, at local level. Together, let’s change our communities and change our country.
Moving to this system has big and historic implications for both the Trade Unions and the Labour Party and they need to be worked through. But I am clear about the direction in which we must go. I have asked Ray Collins, former General Secretary of the Labour Party, to lead work on how to make this a reality and he will look at the other Party reforms I am proposing today as well. So a new politics starts with the vibrancy of our Party.
And it also needs candidates for election who are properly chosen and truly representative of our country. That is what we are doing as a Party. It is why we have taken steps over the last few years to seek more candidates from backgrounds that are under-represented. It is why I have put an emphasis on also getting more ordinary working people as candidates. It is why we have All Women Shortlists which have transformed the representation of women among MPs, now at 33% Labour and rising.
I am incredibly proud of so many brilliant candidates who have been selected for the Labour Party. Those who have served in our armed forces, our health service, successful entrepreneurs, school teachers, shop workers, all selected for the next election to represent Labour. People from almost every walk of life. But we need to make sure that every selection process happens in the fairest way. That’s not what we saw in Falkirk.
So we will have a new code of conduct for those seeking parliamentary selection. Observing this code of conduct in the selection process will be a condition for moving forward to being a parliamentary candidate for our Party. Also as a Party which believes so strongly in equal opportunity, we cannot have any part of the Party being able to stack the odds in favour of one candidate over another simply by the spending of money. We will not allow this to happen. That is why we will also urgently agree new spending limits for Parliamentary selections to include for the first time all spending by outside organisations. And the same goes for future selections to the European Parliament and future leadership contests.
So a new politics involves a diversity of candidates, from all backgrounds, selected in a fair way. It also involves ensuring trust in Members of Parliament. Just as I am proud of our new candidates, so I am proud of our Members of Parliament. All of them serve their local parties. All of them owe their allegiance to their constituents and to our country. That is the way they behave.
Many constituency Labour parties also have agreements with Trade Unions. These agreements help local parties campaign on issues that really matter to local, working people. I want it to be absolutely clear that there is a proper place for agreements like these, enabling people to campaign locally from everything from violence against shopworkers to promoting apprenticeships. They help keep our Party connected to the needs of working people. What a contrast to the Conservative Party that stands for a few out of touch people at the top. But these agreements need to be properly regulated. So henceforth, the Labour Party will establish standard constituency agreements with each trade union so that nobody can allege that individuals are being put under pressure at local level.
And there is another issue that all parties must confront if we are to rebuild trust in politics. And it is time we talked about it again. That is the pursuit of second outside jobs, sometimes paying higher salaries than the job of an MP itself. Decades ago being an MP was often seen to be a second job. The hours of Parliament starting in the afternoon, so people could do other jobs in the morning. We have changed that. But there remains a problem, as recent episodes involving lobbying and outside interests have shown. The vast majority of all MPs have performed their duties properly within the rules. And raising this issue casts no doubt upon that. But we should question the rules. The question of MPs second outside jobs has been discussed but not properly addressed for a generation. The British people expect their MPs to be representing them and the country not anyone else. They understand that Members of Parliament need to keep connected to the world beyond Westminster and will always write articles and give speeches. But can it be right that the rules allow MPs to earn hundreds of thousands of pounds from private legal practice while they are supposed to be an MP? Or from outside corporations without any real form of regulation?
We will change things in the next Parliament. That is why I believe that at the very least there should be new limits on outside earnings, like they have in other countries and new rules on conflict of interests too. The British people must be reassured that their MPs are working for them. Being an MP should not be a sideline. It’s a privilege and a duty. And the rules must reflect that. And I urge other party leaders to respond to this call for changing the system.
So we will do everything we can to have diverse local parties, candidates selected in a fair way, and we will make clear that MPs’ allegiance always being to their constituents and our country. But as we make these changes, we must also recognise that a new politics must always reach out to more people. We live in a totally different era than when the Labour Party was founded. People in Britain today are less likely to join political parties. They are more likely to focus on single issues and they are rightly demanding an open rather than a closed politics.
That is why Labour is increasingly becoming a community organisation, leading and participating in individual campaigns, from the living wage to library closures to campaigns against legal loan sharks. I know so many of you here today are pioneering that work and I applaud you for it.
As we reshape our Party for the future, we must always value the role of Party members. And I do. But valuing Party members cannot be an excuse for excluding the voice of the wider public. Since I became Labour leader, we have opened up our policy making process and opened up the Party to registered supporters, people who do not want to join Labour but share our aims. But I want to go further. If we are to restore faith in our politics, we must do more to involve members of the public in our decision making. We must do more to open up our politics. So I propose for the next London Mayoral election Labour will have a primary for our candidate selection. Any Londoner should be eligible to vote and all they will need to do is to register as a supporter of the Labour Party at any time up to the ballot. And Ray Collins will examine how to pioneer this idea elsewhere too.
Such as in future Parliamentary selections where a sitting MP is retiring and where the local party has dwindled, and a primary could make for a more properly representative selection process. I want to hear what local Labour parties think about this idea because we all know there are parts of the country where our Party could be reenergised as a result.
To build trust, we also need to change the way that our country’s politics is funded. I repeat my offer that as part of a comprehensive set of changes we should set a cap on donations from individuals, businesses and Trade Unions. I urge the other party leaders to reopen talks on how we can clean up the way we finance our politics and if they won’t, the next Labour government will start that process anew. What I have proposed today are big changes in the way we do our politics. There is no place in our Party for bad practices wherever they come from.
I am determined that we have a Labour Party that operates in a fair, open, transparent manner. I am determined we uphold the integrity of our Party. And that reaches out to the country.
These reforms though are not just putting right what has gone wrong in our Party. It is about much more. Political parties are too often seen as remote from people’s lives. As somebody who deeply believes that the Labour Party can be a force for good, we must change that. We must change it with a Party not of 200,000 but of many, many more. We must change it with candidates from diverse backgrounds, accountable to their constituents. And we must change it by reaching out at every opportunity to the people of Britain, including through primaries. These changes are about making it possible for us to change Britain for the better. All of our history shows that change does not come just from a few people at the top. It comes when good people come together to demand change. But to make that happen we need those people in our Party and we need to reach out to others outside our Party too, to genuinely build a movement again, a movement that makes change happen in communities across the country, and a movement that changes Britain.
That is what I believe. That’s what the founders of our Party knew. That is what these reforms are about. That is the Party I want us to build. That is how we will make Britain One Nation again.
