Tag Archives: Party

The NHS “reforms” break an implicit election promise – and do not go nearly far enough


Cast your minds back to the days of the last election. All the talk was of cuts and the campaign was curiously short on optimism. Nick Clegg rocketed to popularity because of his outsider status and a rare ability to sound slightly hopeful about the odd issue. Cameron and Brown battled over grim details, tainted by all that had gone before. One of the few rays of hilarity to shine out of the darkness was the very British ridicule of one of our current Prime Minister’s key policies and publicity stunts.

I’m referring, of course, to Cameron’s notorious airbrushed poster campaign. The abnormally clean image of the old Etonian presented on billboards everywhere to the entire nation, took the Tory drive for renewal to the laughable extreme. Dave was not wealthy and out of touch, merely handsome and approachable. As funny as the image and tactics themselves were however, it’s the snappy quoted message alongside his shiny face coming back to haunt the Prime Minister now.

I certainly do not pretend to even partially comprehend the reforms to the NHS this Conservative led government is proposing. Indeed the lack of understanding from its own ministers seems to be a large part of the problem. And it’s no secret the Conservatives have long planned a shake-up, fuelled by the steadfast belief of their long serving top dog on health, Andrew Lansley. However whilst the faults and flaws of the plans that are becoming clear are extremely important, in terms of political capital and strategy for Number 10, they are in many ways besides the point when it comes to that infamous election promise.

“I’ll cut the deficit-not the NHS” translated for voters to “This is a new kind of Tory party that treasures the NHS above all else. We will not mess with it anyway.” Cameron will argue his promise did not say he wouldn’t change the NHS and that it needs modernisation for the better. But he knew the implication of his promise and the votes it would win him. His protestations about the benefits of his reforms will therefore mean little to those his promise swayed.

It’s also especially hollow given that the Prime Minister has since watered down and diluted that concrete pledge, which formed the symbolic heart of his campaign, again and again and again. First it became merely a safeguard for frontline services and then promised improvements, like an increase in the number of midwives, were scaled back and ultimately scrapped altogether, with even plans to maintain current numbers reversed. Fears about privatisation which the reasonable man might have attributed to overzealous, sensational leftist press, are now emerging to have hard evidence behind them. 50,000 jobs are set to be cut. How exactly is this not cutting the NHS?

If the workers within the system themselves were in favour Cameron would have a much stronger argument. But countless GPs have written to newspapers, as well as other types of professional, warning against the changes as unnecessary and damaging. The Prime Minister continually insists that locals have the right to opt in our out, but what are those that oppose and don’t sign up to the scheme meant to do? Even in my quiet rural area GPs feel overworked and many local people distrust the vested interests of certain doctors. Is handing over the biggest budget in the country to them really a good idea and what people want? It’s doubtful if the new system will even be able to produce what the public need.

Another argument constantly wheeled out by the Tories is the pressing need for modernisation and reform, which make it necessary. There is nothing necessary about these plans though. Whilst the health service has its flaws, the current system leads to a mostly positive service. There are undoubted challenges in health care such as an ageing population and emerging drugs, which often seem insurmountable. Government proposals do not do enough to ease the burden and according to many that know, they actually complicate the fight. For a leadership so keen on cutting the deficit, you would think that such costly, ideological plans could wait for better times.

 It would also do more good in the long run, and reduce the deficit substantially, to work out some realistic spending priorities centrally. Vital areas and treatments need to be protected nationally and things the NHS can’t afford to provide should be phased out. The private sector does have a role but it should grow independently of the NHS and take up the slack for treatments it shouldn’t be wasting resources on. Taxes and other initiatives should encourage healthier living. Devolving decisions to GPs is no magic pill, no silver bullet and it doesn’t even equip the NHS for the critical, worsening challenges it will face in the future. It would be a far more sensible decision for the government to begin a nationwide debate about what we expect, want and need from our NHS now. It would fit with the “new politics” of plural cooperation and potentially produce actual solutions.

Perhaps the main reason the government looks less likely to bow to pressure from the public on this issue is the Prime Minister’s ego and pride. He’s been happy to recognise the weaknesses of coalition and concede on issues like the forests and sport in schools. But the NHS plans are too inextricably linked to Cameron’s personal brainchild; the Big Society. Its philosophy of localism and choice in the community over centralised solutions marries nicely with Lansley’s ideas for health. The health reforms open the way for the sort of community cohesion and interaction, fuelled by voluntary, charity involvement, that Cameron wants to see. He genuinely believes it’s the path to a social recovery for Britain that’s sustainable and empowers government to do what it does best, as well as liberating people from the state. He’ll continue to be blind to all the irreversible wounds the “reforms” will inflict on the NHS itself and his popularity with the people as long as it remains tied to his vision. His recent attempt to re-launch the initiative demonstrates his huge commitment; it cannot afford to fail.

The real shame for the country and even the Conservative party, is that Cameron’s election pledge could have been a clever way of dumping a responsibility and challenge for maximum political gain. His implicit promise of not touching the NHS meant it could have been left as it was, a gargantuan issue for a future administration to tackle, ticking over just fine for the time being. There are after all, enough problems for the coalition to face. If this government had done mostly nothing on health, the public would have thanked them for it, the Conservatives especially. But Cameron is so determined to be radical and appear to be so, that he will press on, regardless of the consequences. It may prove to be the well meaning project that took his remodelling of the state too far.

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A note on Obama’s rise and fall


The demise of President Barack Obama’s support in the USA, confirmed by this week’s Mid-Term election results, is a depressing triumph of pessimism over optimism. I found myself swept up in the wave of hope and positive expectation two years ago, as did millions of others across the globe. For me it was simply irresistible in a modern age in which nothing feels genuinely new and groundbreaking to be witness to true history unfolding. The first black President and one with a truly progressive agenda, felt like a huge step forward into a new era. Who knew what could be accomplished with an ordinary, sensible citizen at the helm of the world’s most powerful nation? Real change felt possible. Many will say that the capitulation of the fervour and enthusiasm that propelled Obama into office was inevitable though. They will point to the relative ease of Opposition compared to governance, the scale of the tasks Obama set himself and the harsh realities of politics. To a large extent they will be right: Obama simply could not fulfil such high expectations and his downfall acts as a warning to any politician elected on a platform of change for change’s sake, including Cameron’s coalition. But the President’s own actions and inaction has contributed to the dissipation of his popularity and can go some way still to restoring it in time for a second term.

All the talk now is of the necessity of Obama finding common ground with his newly powerful Republican foes. The advice is to consolidate the achievements of the first two years and work tirelessly on modest improvements the Republicans will support for the last two. Be a President who gets things done. However from across the pond the key disappointment of Obama’s time in office so far has been his withdrawal into work. Clearly he was conscious of the threat of his opponents labelling him as an empty orator, forever preaching but never getting his hands dirty. The danger of devoting himself completely to mammoth projects such as health care reform and securing an economic recovery though is that his enemies will have free rein on stage to belittle his accomplishments, as well as stalling them behind the scenes. And the fact is despite the huge change Obama’s health care reforms represent in the USA; they were never going to be politically profitable. Supporters of extended health care will look at the universal systems such as the NHS in this country and wish Obama had gone further, whilst conservatives view what he has already done as an act of socialism, needlessly and immorally pouring away gallons of public money at the expense of the treasured American private sector. Similarly too with his actions to prevent financial meltdown, it is difficult to prove how much worse things would have been without a giant fiscal stimulus and bailout and whether or not ordinary American workers actually benefited. There’s no doubt that America initially returned to unprecedented growth, but as this has petered out those still unemployed demand to know what is being done and the energised Republicans rant as all those on the right do globally about a ballooning budget deficit and the need for a smaller state.

Bizarrely, whilst it seemed the election of a black President had ended an era of extremism and intolerance it has actually served as a catalyst for the more outspoken Democratic opponents, mainly of course supporters of the Tea Party. It’s understandable why the President might feel paralysed and uncertain how best to fight back. In the eyes of many of the fanatics whatever he does will be wrong, and he has little evidence to hold up in defence of his first years in office. Even his supporters insist he has failed to communicate the enormity of what he has achieved already, but the problem is greater than just communication. Yes Obama must defend the good he has done but he must also spell out again the vision that energised his Presidential campaign. From here in the UK Obama’s transformation from inspirational orator with stirring rhetoric into a closeted figure focused on domestic matters, has been a massive disappointment. He had the opportunity to lead internationally on issues such as climate change, aid and terrorism, but has now spent the bulk of his political capital by becoming bogged down over health care. To restore his popularity in his own country Obama must surely begin to appear like a leader again and aim high. He must make it clear he intends to lead his nation for the long haul and that there are many challenges left to face. It may well be politically advisable to cooperate with the Republicans on some issues as he initially promised, but if this were at the expense of the idealism that catapulted him to power it would be a grave mistake. His opponents lack real backing and have merely benefited from the dissatisfaction of voters with Obama’s progress. Let’s hope that he can get back on the road and make up for a largely wasted start to the journey.

Cameron’s crafted call to arms lacked clarity and substance


David Cameron’s speech to the Conservative party conference in Birmingham yesterday was an accomplished rallying cry and an impassioned response to his critics. Of all the party leader’s speeches during this conference season there is no doubt that Cameron’s was the most polished and technically the best. He stood out as a Prime Minister and appeared like a leader, completing a transformation from head of the Opposition to the most experienced politician in Britain. He sought to counter Ed Miliband’s claim that Labour were the optimists now with his own stirring note of idealism. However in doing so he once again missed an opportunity to spell out his message clearly to the country, opting instead for reams of empty rhetoric that made excellent sound bites but often contradicted each other.

Most strikingly Cameron again tried to explain what he meant by the “Big Society” and again failed catastrophically to render it a reality accessible to voters. In his haste to counter the new Labour leader’s charge of pessimism, Cameron swung dangerously into the realms of wild over optimism. In the speech he simultaneously claimed that his coalition government was both realistic about what it could achieve in power and optimistic about what government could achieve in partnership with the people. In principle this all sounds lovely of course. Of course government should concede it cannot solve everything by decree and ask cooperation from its people, whilst also setting high standards of achievement. In reality though Cameron has no credible claim to the titles of both realist and optimist. He must choose one or the other to define his leadership. He let the tone of his speech tip into an unrealistic optimism, probably due to that desire to stop the Labour revolution in its tracks. He blasted the “cynics” who would pour scorn on his “Big Society” rhetoric and indeed it was a clever ploy from the Prime Minister to call on the people to come to the aid of the nation, with grand, fluffy, empty rhetoric, and offer nothing concrete. Those who criticise Cameron’s speech for its lack of substance will be easily labelled as non-believers, as statists who do not trust the brilliance of the British people. Cameron therefore tried to lay a trap for opponents of the “Big Society”. But there is a reason I continue to put the “Big Society” in inverted commas, and it’s the same reason voters and indeed Conservatives distrust the policy; good idea in principle, but it’ll never work in practice.

Again Cameron failed to articulate what the “Big Society” would actually mean in terms of government policy, besides him praising voluntary organisations in speeches and urging everyone to go out and get involved. Rhetoric and the lifting of restrictions alone will not drastically change people’s behaviour and therefore the country. The kind of society Cameron claims to want, one that rewards contribution and discourages excessive consumption, simply cannot happen without at least some prompting by central government. It is also confusing that Cameron should place such an emphasis on contribution and consumption, areas that would be better suited to alterations in tax policy, when his government has vowed to tackle the deficit predominantly through spending cuts. On the other hand Cameron did make it clear he wanted a state that was better run, more powerful and within the means of government. Again this is sensible in principle, but shockingly for a government claiming to be the “greenest ever”, Cameron simply refused to utter the word “sustainability”.

To have made sustainability a key theme of the speech would have given it greater direction and purpose and clarity. It should also be made a more important plank of his government’s policy agenda. At the moment it is an area that lies wide open for Ed Miliband’s “new generation” to seize upon and exploit. Cameron’s deficit slashing philosophy, he was at pains to point out, was not simply ideological but a necessity. However the public is already convinced that the cuts, whichever party implements them, will be in some way driven by that party’s ideology. An ideology containing the idea of sustainability would be far easier to justify than the abstract notion of the “Big Society”.

Cameron also hinted at a promise that after the pain there will be rewards. He should have placed much greater emphasis on his long term goals and how action now would lead to sustainable rewards in future, but he was perhaps deterred by the short term nature of the coalition. He was also perhaps put off of any mention of “sustainability” because a truly sustainable recovery, that really could end “boom and bust” as Gordon Brown once rashly promised, would require substantial investment now to ensure growth, energy supplies and long lasting jobs. Cameron is simply not prepared to take the gambles required of the “greenest government ever”. His brush with the backlash of child benefits cuts this week has reinforced to him that it is difficult to justify changes of policy, particularly from those promised in manifestos, to the media and electorate. He will therefore not be seen to spend now, even if that spending is necessary because of what he has previously said. So despite the obvious passion and idealism of his speech, his actions as Prime Minister suggest that Cameron is happy for the “Big Society” to remain a vague enigma, which will inspire some, baffle many and prove largely immune to damaging criticism, as critics will remain unsure as to what it is they object to. And if the Prime Minister was truly serious about lifting the burden of debt from our children then he would also use the shield of coalition to act in the “national interest” now to avert a legacy of unalterable climate change for them to inherit.

Canny Clegg is no closet Tory


A leading article in The Observer today, linked below, argues that Nick Clegg is not simply a Conservative in disguise, adopting Cameron’s austerity drive with relish, but a pragmatic visionary with the aim of transforming British politics. On this blog I have long argued that Clegg needed to have the resolve to make the Lib Dems a serious, credible party of goverment in order to smash the Red and Blue seesaw of power at Westminster. This article in the Observer wisely points out the risks the Lib Dems face, of abandoning the bulk of their idealistic, protest vote, but also point out the necessity of a better politics, in which coaltions are effective and commonplace and policies are not beset by tribal division and disagreement. This better politics requires the Lib Dems try and seek a new wave of support, and I can only hope the British people recognise the fairness in Clegg’s vision for a political system that isn’t simply a two-sided battleground and back his party at elections. As I’ve said before Clegg and Cameron’s partnership has not brought instant honesty and reliability to Westminster, but the presence of a third party in goverment does reperesnt revolutionary, progressive change that ought to halt the worst of right-wing Tory policy and be good for fairness in the future. Nick Clegg is a political pragmatist who deserves to be admired for setting about changing his party and the country in the most idealistic and liberal of ways; by breaking an established mould. Whether his economic gamble proves right or wrong Clegg has rightly gone for the bigger prize of political regeneration, that ought to ensure the country is governed more progressively and democratically in the future.

http://www.guardian.co.uk/commentisfree/2010/sep/19/observer-editorial-liberal-democrats-conference