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There’s no point striving for economic integration if we’re sustaining political and social disintegration
When Margaret Thatcher spoke on the steps of Downing Street, about to escalate eleven years of unforgettable government, a New Jerusalem was pictured of a country at ease with itself. Not reliant on any sense of collectiveness, but a group of individuals who could seek and achieve success.
And indeed her star pupil, Tony Blair, was the best product from this era for Thatcher. Ed Miliband later proudly admitted that he ‘believed in’ the sense of aspiration to be inherited from the late Baroness.
Except this nirvana was anything but heavenly. Far from liberalising people, the Hayekian market enslaved working people who did grew further apart from the fruits of their productivity.
Inequality ‘never had it so good’ in governments during Thatcher and beyond. Ed Miliband in his recent speeches for the Labour Party conference has had to refer to ‘responsible capitalism’, citing specifically how consumers’ bills have rocketed due to energy suppliers almost acting like a cartel.
The fact that Rupert Murdoch was backing the ‘No’ campaign was therefore bound to cause disquiet, as was the backing by BP. It seems that all the multinational corporates know which side their bread is buttered on, having been given a strong lead from Barack Obama.
So therefore the idea that Scottish citizens were rejecting the privatisation of the English NHS was a profound embarrassment for the Westminster parties. All parties, especially the current Coalition parties, have vehemently denied that there has been any privatisation in recent years.
The current Government adamantly state that the percentage of private provision in the NHS has gone up from 5% to 6%. Critics of section 75 of the Health and Social Care Act (2012), argued to turbo-boost the outsourcing of NHS contracts through competitive tendering, are continually told about New Labour’s drive towards the growth of independent sector treatment centres.
Tony Benn left people thinking that it did not as such matter which party you now voted for, as they all effectively have become frontmen for globalised multinational corporations. That nobody actually votes for the World Bank or the European Commission legislators led Benn to do a pilgrimage to Strasbourg which he proudly hated.
For Benn, it was more important that a citizen could achieve influence through a single vote in democratic socialism, than to buy influence as part of a lobbying organisation. And of course we see a profound failure of democracy in the springing of the Lansley Act and the “hospital clause” from nowhere.
The spectacle of Miliband, Cameron and Clegg marching up from Westminster to Glasgow made many of my Scottish friends to vote “Yes”. But for them their solidarity has been a reaction to a different ethos being inflicted from above.
Whatever the appearance of economic integrity there might be in the United Kingdom, even with the use of the Pound Sterling in Scotland, or Eurozone avoiding a currency crisis, the victory appears somewhat Pyrrhic if there has been in fact been decades of social and political disintegration.
If Scotland votes to be independent, Labour could end up losing MPs who instead become ‘foreign nationals’. Ed Miliband has a relatively united party behind him, but it is likely that many in the Conservative Party will want to get rid of him.
This is especially likely if Cameron’s party enters the farcical situation of wanting to opt out of Europe having lost Scotland. David ‘Little England’ Cameron would then, even beyond the Labour Party, would become the worst Conservative Prime Minister to have ever existed.
But, if Scotland votes no, then it is possible that the UK general election will occur ‘on time’, i.e. early May 2015. The truth is that, even if Scotland votes yes, it possibly is too much hassle to shift the date of the election pursuant to the Fixed Term Parliament Act.
Then it might become business as usual, where the UK Labour Party promise to halt the privatisation of the NHS. The Conservatives have adopted the position where they wish to deny absolutely any existence of privatisation of the NHS, completely unlike their position on the utilities or Royal Mail. So, presumably, if the Conservatives win the election, the ‘non-privatisation’ of the NHS will continue.
But, in addition to the goal of economic integration, an incoming Labour government does have a hope of political integration with an albeit devolved Scotland. The greatest challenge will, nonetheless, be an England at ease with itself, which does not have different groups of people pitted against each other.
There is much work to be done in English health policy, including review of PFI, the purchaser-provider split, abolition of the Health and Social Care Act (2012), exemption from TTIP, a properly funded health and social care system, and fair pay for NHS staff, as well as implementation of “whole person care”.
If, on the other hand, Whitehall organises a painful ‘conscious uncoupling’ of Scotland and England, that could take up a lot of effort which might be better used up elsewhere.
Why the ‘999 March of the NHS’ is an important statement of democracy
There is no doubt that one should fight your battles to the hilt, but it is equally true that you should pick the right battles first. Two major battles to be had are whether NHS contracts should be aggressively pimped to the private sector, and whether the NHS should be up for sale to the highest international bidder. That is not to say that other battles are not important, but fighting these battles, I feel, will be able to tell us the future direction of travel of Labour. It’s well known that the political heart of Labour is possibly social democratic, but I feel that the ‘999 March for the NHS’ shows noteworthy twangs of democratic socialism, which has rather disparagingly been referred to as ‘left-wing populism’ previously elsewhere.
Getting Labour embroiled in a turf war over semantics I reckon is an infertile ground. The history of Labour and state ownership has long been a complicated one, as evidenced by previous Labour governments under Hugh Gaitskell and Tony Blair. When it was first established, the NHS was set up on the basis of social solidarity – everyone contributed to the cost of providing the NHS through taxes, and in return healthcare was provided by the state and available for those who needed it, when they needed it. This feeling of solidarity is indeed embed in the ‘999 Call for the NHS’.
The situation in 2014 is that rail fares are rising again, faster than average earnings. Whilst perhaps somewhat over egged, there is a genuine ‘cost of living crisis’ in England, with bills far outstripping real term wages. Employment for some is a very flimsy construct, being held together by a zero term contract. But it is true that, as under previous administrations, inequality is a problem in policy, and taxpayer subsidies are being diverted towards company profits and shareholders. Far from a smaller state, we have ended up with an unaccountable outsourced state. We have had the highest fares in Europe with profits extracted to pay shareholder dividends. In 2012/13 Northern Rail, Transpennine Express and Virgin alone paid almost £100m in dividends to shareholders after receiving over £1bn in public subsidy. Evidence shows that about £1bn per year is wasted due to privatisation, and if saved, this could fund an 18% cut in fares.
Why should the ‘People’s March for the NHS’ become so popular? Is it another example of “left-wing populism”? Left-wing populism is supposed to be a political ideology which combines left-wing politics and populist rhetoric and themes. Such a narrative normally consists of anti-elitist sentiments, opposition to the system and speaking for the “common people”, including themes of anti-capitalism, social justice, pacifism and anti-globalisation, whereas class society ideology or socialist theory is not as important as it is to traditional left-wing parties. The turbo-boosting of the privatisation of the NHS and the decimation of legal aid in England have therefore been good reasons for left-wing populism to gain momentum.
Robert Peston once famously asked, “Who runs Britain?” And looking at the recent elections to the House of Lords, one wonders how certain people get to such elevated heights of power. Meanwhile, Democratic socialists believe that both the economy and society should be run democratically—to meet public needs, not to make profits for a few. For a good such as water, where there is nothing to tell the difference between one brand of water and the next, it is hard to see how a privatised utility system is of benefit other than to corporate shareholders whether here or abroad. Democratic socialists do not want to create an all-powerful government bureaucracy, but likewise they do not want big corporate bureaucracies to control our society either. And some of the private providers in running public services, whether NHS, security, or probation, or otherwise, have been a disaster.
People often criticise Labour of having lost its roots. Indeed, it is hard to see how the most loyal Tony Blair critic should think of the Jarrow March as particularly Blairite? Jarrow is a small industrial town near to the southern mouth of the River Tyne, situated six miles east of the city of Newcastle. Despite the efforts of industrialist and Member of Parliament Sir John Jarvis, by September 1935, Jarrow had lost most of its heavy industry, and unemployment stood at 72.9%. The march was to find jobs to support Jarrow men and their families. It was also a bid for respect and recognition, not only for the people of Jarrow, but for others in a similar situation all over the country. The marchers had no resources other than their own determination, and some good boots supplied by the public. The irony about keeping wages stagnant in the NHS is that this is at a time when the country’s economy is supposedly improving, and when demand for the NHS is outstripping supply.
The People’s March for the NHS will arrive at its destination in London this Saturday, 6 September 2014, when campaigners will be joined by thousands of demonstrators for the final leg from Red Lion Square to Westminster. Started by a group of working mums from Darlington committed to stopping the privatisation of the NHS, the ‘999 Call for the NHS’ march left Jarrow on 16 August and has been winding down the country for the last three weeks following the route of the original Jarrow Crusade. The Chair of the London Socialist Health Association (@SocHealthLondon), Jos Bell (@jos21) has helped with some of the organisation over The final leg of the march, which will start at 2.30pm from Red Lion Square, Holborn, in London, with campaigners gathering from 1.45pm. There will be a rally in Trafalgar Square form 3.30pm with speakers including columnist and author Owen Jones. Further details can be found here.
But I feel that this march is much more than a publicity stunt or an item of ‘left populism’. It for me goes to the heart of a social democracy malaise gone wrong. It is indeed true that many northern European countries enjoy tremendous prosperity and relative economic equality as a result of policies pursued by social democratic parties. Social democratic parties supported strong labor movements that became central players in economic decision-making.
But globalisation of neoliberalism can be seen as a threat as well as an opportunity. With the globalisation of capitalism, the old social democratic model becomes ever harder to maintain. Stiff competition from low-wage labour markets in developing countries and the constant fear that industry will move to avoid taxes and strong labour regulations has diminished (but not eliminated) the ability of nations to launch necessary economic reform on their own. The idea of the NHS participating in this race to the bottom, where radiology opinions are outsourced in a disruptive manner to a foreign jurisdiction which we cannot easily regulate, strikes many people with fear.
Many have long felt that social democratic reform must now happen at the international level. Multinational corporations must be brought under democratic controls, and workers’ organising efforts must reach across borders. The European Commission is currently involved in negotiating a free trade arrangement of unprecedented scale between the US and European Union (EU). This is the Transatlantic Trade and Investment Partnership (or TTIP). The process is also undemocratic as the substance of on-going negotiations is largely kept from our MPs, MEPs, as well as the public. Once the treaty is signed by negotiators, the UK parliament, like other EU member states, will only be able to vote to accept or reject the treaty as a whole: they will not be able to amend it in any way.
Many believe that one of the biggest prizes of the agreement for transnationals will be the NHS. The Health and Social Care Act (2012) and the regulations for implementing it (Section 75) have changed the fundamental nature of the NHS. By fragmenting the NHS, opening it up to competition law and turning the NHS into a market in which private companies can compete for NHS funding for patient services, the Health and Social Care Act contains a toxic tool which can put profit before people, and lead to the piecemeal destruction of the NHS. Labour has pledged to repeal the Health and Social Care Act (2012), which of course they must do to avert the biggest sale of the century.
Isn’t it time to admit failure in ‘regulating cultures’?
It is alleged that a problem with socialists is that, at the end of the day, they all eventually run out of somebody else’s money. Perhaps more validly, it might be proposed that the problem with all politicians is that they all run of other people to blame?
It is almost as if politicians form in their minds a checklist of people they wish to nark off systematically when they get into government: candidates might include lawyers, Doctors, bankers, nurses, disabled citizens, to name but a few.
Politicians are able to use the law as a weapon. That’s because they write it. The law progressively has been reluctant to decide on moral or ethical issues, but altercations have occurred over potentially inflammable issues such as ‘the bedroom tax’. Normative ethics takes on a more practical task, which is to arrive at moral standards that regulate right and wrong conduct.
There has always been a tension between the law and ethics. As an example, to prove an offence in the English criminal law, you have to prove beyond reasonable doubt an intention rather than a motive, for example that a person intended to burn someone’s house down, rather than why he had intended so. Normative ethics involve articulating the good habits that we should acquire, the duties that we should follow, or the consequences of our behaviour on others. The ultimate ‘normative principle’ is that we should do to others what we would want others to do to us.
Parliament is about to get its knickers in a twist once again over the thorny issue of press regulation. However, there is a sense of history repeating itself. A few centuries ago, “Areopagitica” was published on 23 November 1644, at the height of the English Civil War. It is titled after Areopagitikos (Greek: ?????????????), a speech written by the Athenian orator Isocrates in the 5th century BC. (The Areopagus is a hill in Athens, the site of real and legendary tribunals, and was the name of a council whose power Isocrates hoped to restore).
“Areopagitica” was distributed via pamphlet, defying the same publication censorship it argued vehemently against. As a Protestant, Milton had supported the Presbyterians in Parliament, but in this work he argued forcefully against the Licensing Order of 1643, in which Parliament required authors to have a license approved by the government before their work could be published.
Milton then argued that Parliament’s licensing order will fail in its purpose to suppress scandalous, seditious, and libellous books: “This order of licensing conduces nothing to the end for which it was framed.” Milton objects, arguing that the licensing order is too sweeping, because even the Bible itself had been historically limited to readers for containing offensive descriptions of blasphemy and wicked men.
England has for a long time experienced problems with moving goalposts in the law, and indeed the judicial solutions sought have varied with the questions being asked. Lord Justice Leveson acknowledged that the “world wide web” was a medium subject to no central authority and that British websites were competing against foreign news organisations, particularly in America, which were part of no regulatory system.
Leveson once nevertheless proposed that newspapers should still face more regulation than the internet because parents can ‘to some extent’ control what their children see online, while they could not control what they see on a newsagent or supermarket shelf.
‘It is clear that the enforcement of law and regulation online is problematic,’ said Lord Justice Leveson at the end of his year-long inquiry into press ethics.
An attempt at ‘regulating culture’ was dismissed in the Leveson Report largely through arguing that the offences were substantially already ‘covered’, such as trespass of the person or phone hacking. And yet it is the case that there are ‘victims of phone hacking’ who feel that we are unlikely to be much further forward than we were before spending millions on an investigation into journalistic practices. In recent discussions this week, eyebrows have been raised at the suggestion that Ed Miliband could write to senior members in the Mail-on-Sunday empire to suggest that the culture in their newspapers is awry, and to ask them to do something about it. It could be argued it is none of Miliband’s business, except that Miliband would probably prefer the Mail to write favourably about him. Such flexibility in judgments might be on a par with Mehdi Hasan changing his writing style and target audience within a few years, as the recent Twitterstorm demonstrates.
The medical and nursing professions have latterly urged for an approach which is not overzealously punitive. There have been very few sanctions for regulatory offences in Mid Staffs or Morecambe Bay, for example.
Robert Francis QC still identified that an institutional culture which put the “business of the system ahead of patients” is to blame for the failings surrounding Mid Staffordshire Foundation Trust. Announcing the publication of his three volume report into the Mid Staffordshire Foundation Trust public inquiry, Mr Francis described what happened as a “total system failure”.
Francis argued the NHS culture during the 2005-2009 period considered by the inquiry as one that “too often didn’t consider properly the impact on patients of decisions”. However, he said the problems could not “be cured by finding scapegoats or [through] reorganisation” of the NHS but by a “real change in culture”. However, having identified the problem, solutions for cultural ‘failure’ in the NHS have not particularly been forthcoming.
There are promising reports of ‘cultural change’ in the NHS, for example at Mid Staffs and Salford, but some aggrieved relatives of patients still have a feeling that ‘justice has not been done’. There has been no magic bullet from the legislature over concerns about bad practice in the NHS, and it is unlikely that any are immediately forthcoming. There is little doubt, however, that parliament improving the law on safe staffing or how whistleblowers can raise issues in the public interest safely might be constructive steps forward. There therefore exists how the law might conceivably ‘improve’ the culture, and one suspects that this change in culture will have to permeate throughout the entire organisation to be effective. That is, fundamentally, people are not punished for speaking out safely, and, whilst legitimate employers’ interests will have to be protected, the protection for employees will have to be necessary and proportionate equally under such a framework.
Journalism and the NHS are not isolated examples, however, Newly released reports into the failures of management at several major banks – HBOS, Barclays, and JP Morgan among them – show that some of the worst losses had roots deeper than the 2008 credit crisis. It is said that a toxic internal culture and poor management, not the subprime mortgage collapse, caused billion-dollar losses at some of the world’s largest banks
In an argument akin to that used to argue that there is no need to regulate the journalism industry, the banking industry have long maintained that a strong feeling of internal competition can be healthy for profitability, but problems such as abject fraud and misselling of financial products are already illegal.
The situation is therefore a nonsense one. There is a failed culture, ranging across several diverse disciplines, of politicians wishing to use regulation to correct failed cultures. Cultures of an organisation, even with the best will in the world, can only be changed from within, even if the public, vicariously through politicians, wish to impose moral and ethical standards from outside.
Whichever way you wish to frame the argument, it might appear ‘we cannot go on like this.’ It is a pathology which straddles across all the major political parties, and yet all the parties wish to claim that they have identified a poor culture.
Their lack of perception about what to do with these problems is perhaps further evidence that the political class is not fit for the job.
