Tag Archives: promise

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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Belated thoughts on tuition fees: The ball is in Labour’s court


I feel a tremendous guilt for allowing my political articles to dry up over the last few months. It is not as if there have not been issues to debate, dissect and confront. In fact the coalition’s spending cuts have energised the public’s political opinions more than any other topic in recent years. Whether their policies are right or wrong, this government has shown a willingness to listen to its people and even a tendency to undo unpopular decisions when faced with a sufficient backlash, albeit over relatively minor issues like free milk, sport in schools and reading initiatives.

 I have also not stopped writing about politics due to a loss of interest or lack of activity; in fact the opposite scenario is the case. I’ve welcomed the Lib Dem achievements gained in power. I have joined a number of campaigns against government policies I believe to be destructive and misguided, such as plans to sell off Britain’s woodlands, and marched on several student protests. Hordes of people to seem feel that the gravity of what the coalition is doing demands opposition and not only this but that the very nature of coalition politics makes democratic protest unusually effective.

Why then the failure to articulate reasoned and persuasive arguments against the cuts? In particular why the lack of output in relation to tuition fees? An issue directly relevant to my immediate future and the strength of the party I voted for, now branded as the great betrayers. After all as I’ve already said, it is not as if I would think my actions completely hopeless. Even though the motion passed in the Commons, the foundations of the government’s majority were shown to be extremely weak when great pressure is applied, with both Conservative and Lib Dem MPs refusing to back their leaders. If I added my voice to the online chorus it might not do much but it could do no harm in adding to the ever rising volume of argument.

I suppose I felt compromised. So swept up was I in passionate outrage, camaraderie and the excitement of genuinely doing something historic, that I could not write in a sufficiently detached, analytical manner. The issue was simply too close to home and tied up with too many emotions for me to rationally look closely at all sides of the debate. That is not to say I don’t have opinions I believe to be well supported and accurate about the issue, just that whenever I tried to express them they would sound weak and as if they were merely scratching the surface of something so vitally important to economic recovery, the future of our country and my own education. Of course I managed to write up my experiences of protest but whatever I said sounded inadequate and I felt incapable of getting across how strongly my fellow marchers felt and how justified I believed them to be.

Now though I am finally going to attempt to air my views on the issue, if only for my own personal relief and satisfaction. By keeping them simple and focusing on where the debate goes from here, I hope they can cut through all the complexity to the heart of the matter.

Firstly a note on Nick Clegg and his ministers’ eventual decision to back the plans. I completely understand why he chose to vote in favour of the proposals. He worked hard to inject fairness into the legislation and went above and beyond the safeguards suggested in the Browne report, despite the fact he was unavoidably still engineering a policy that upped the fees he’d promised his party would fight to keep down and if possible, abolish altogether. I think Clegg genuinely believes that despite the rise in fees, the modifications he secured ensure the new system will be fairer, especially for disadvantaged students, than the previous one. However it was still a grave mistake for Clegg not to utilise the clause in the coalition agreement allowing his party to abstain. He may have worried that had the motion not passed universities would have faced a funding crisis and the coalition would have splintered. Or behind the scenes he may have only gained his concessions in exchange for his supporting vote. Nevertheless if the option for him to abstain was truly there, he was foolish not to take it. Or, ironically given the savage demonization of him as a treacherous liar, he is simply too honest to not back a plan he was a partial architect of and believes in. Even after this crisis I am still of the opinion that Nick Clegg is a bold and truly progressive politician, bravely securing real change through compromise. I may disagree with his decision to back the change to tuition fees and stand aside for other Conservative policy, but this is the reality of coalition, and if he had had a majority government (in a dreamy alternate world) he would’ve squeezed the budget elsewhere.

At the height of the protests Clegg desperately tried to champion his hard won tweaks for fairness and criticised the marchers drumming up unfounded fears about the new system. Here he made another catastrophic political error, essentially labelling the protestors, vast swathes of which probably voted Lid Dem, as ignorant. If he’d listened to the prevailing, dominant chant at the protests he’d have understood that the marchers weren’t ignorant and that whatever modifications he offered as sweeteners collapsed under one fact: “NO IFS, NO BUTS, NO EDUCATION CUTS”. Just like everything else the coalition was facing opposition over, these protests were primarily about cuts. The NUS and others had made the mistake of focusing on the rise in fees in their criticisms; perhaps because the thought of paying more would inspire more students to turn up. But in reality it would be several years before the higher fees would come in and some real help had been hardwired in for poorer students. The arguments that a burden of debt would be a huge deterrent, that there would be no proper help for middle income families and that students would choose their university on price not quality, were all valid, but not as clear and convincing as the cuts.

The cuts to teaching and all aspects of university funding were big and would hit the standard and availability of university education immediately. Ideologically what really irked people was that fees were rising to plug the gap from a drop in government investment, thus sparking accusations of a shift to a privatised system predominantly paid for by students directly. Logically the coalition’s insistent argument that the rise in fees was a necessary evil to secure Britain’s world class higher education system long term, also fell apart because of the deficit driven cuts. All the reports say universities need more money to remain competitive. But the government was actually reducing investment and making up the shortfall with a huge hike in fees which might even jeopardise the current quality of education, let alone increase it. Perhaps most bafflingly of all, the government plans, with all Clegg and co’s little alterations for fairness, would still require expenditure and make absolutely no impact on the size of deficit, the coalition’s Holy Grail.

The leaders of campaign groups rant and rave that, as with Thatcher’s Poll Tax, protests will continue despite coalition success in Parliament, until the act is undone. However it looks unlikely that anything other than a hardcore will continue to mobilise on this issue. Unless, of course, a real alternative can be found to march for. This was always the Achilles heel of these protests, and marchers discussed it, wishing someone would get their act together. The ball is now in Ed Miliband’s court, with his new generation of Labour players. Labour must offer a practical but popular vision for higher education, sooner rather than later, if the fight is not to be lost. Of course Miliband’s team needed time to get it right and may need more, but the clock is ticking.

It will be a difficult balance to strike for Miliband. Understandably as a new, fresh leader of the Opposition, he jumped on the bandwagon of protest, stopping short of joining one, but regularly singing the praises of a graduate tax. Ultimately this progressive leap forward may prove unworkable and in any case his chosen Shadow Chancellor opposes any such measure. But if Labour focus on the cuts to higher education they can still offer a fairer, point scoring alternative. Growth is the coalition’s weak spot and Labour should highlight the decisions of other major economies to boost education investment and therefore jobs and tax revenues. A world class university system should drive a sustainable economic recovery. Restore investment and throw in a drop in fees, whilst retaining some Lib Dem additions, and Labour would not only be doing the right thing but keeping alive an issue that could break the coalition, with a credible, sensible alternative.