2011 is already shaping up to be a hugely important political year. We’ve had the Arab Spring and in the last couple of months alone, landscape shifting national crises in phone hacking and the riots. Coalition government is still a whole new kettle of fish that could boil over at any moment. No one’s quite sure, still, where Ed Miliband is going to take the Labour party. The Euro continues to dance with death. And Obama may have killed Bin Laden but is yet to throw his own economy a convincing lifeline.
Amidst the naming, shaming and blaming in the aftermath of England’s rioting, debates about coalition cuts and reforms have once again been lost in the robotic chanting of ideology. Earlier this year the general public mobilised in a reassuringly democratic fashion to force a pause or “listening exercise” in NHS reform. There are whispers in some parts that David Cameron and Andrew Lansley intend to ignore the concerns of the people, under the radar. But Nick Clegg, following his electoral and referendum humiliation in May, ensured us he’d keep an eye on them. Trouble is no one trusts him anymore.
What I’m about to write is more personal than political. I’ve said before that all my political writing has an element of my personality, in that I do my best to express strong opinions, beliefs or half formed ideas I’ve concocted from things I’ve read or consumed. Even professional political commentators are aware that their own preferences influence their coverage. But I’m the first to admit that, as a young man, I am often dealing naively in the abstract. My opinion on defence cuts or the symbolic importance of the Euro is rather ignorant and useless in reality. The NHS however is for all of us and can affect the quality of our everyday lives dramatically. We should all feel able to speak out about its future.
In late September I will begin university life after a gap year I probably wouldn’t have chosen to have. A couple of years ago I was very ill. I lost a lot of weight and barely ate anything. I was frequently in severe pain and unable to socialise with friends in the summer holidays. I could muster enough energy to complete school work and little else. Eventually I was diagnosed with the digestive condition, Crohn’s Disease (http://www.nacc.org.uk/content/home.asp).
After passing through various rungs of the National Health Service I found myself with a steady and capable team of staff at the Inflammatory Bowel Disease clinic of my local hospital. A variety of treatments got me through Sixth Form and I was relieved to do well in exams, unaffected by the Crohn’s. In order to continue my recovery I chose to have a gap year, although it didn’t feel like I had much choice. I simply had to get healthier.
I started a new treatment of fortnightly injections. This was intended as a longer term solution because I had been taking powerful drugs that could have harmful side effects in the future. Thankfully the injections worked and continued to do so. I could return to a “normal life” with the limitations of my condition minimised. I felt grateful to be as healthy as I could be. My worries were mostly those of ordinary people my age and I was able to grow as a freelance writer and enjoy the year.
Now though health related stress is making a comeback. With university imminent I am organising the altered delivery and storage of my treatment. And at the last meeting with my doctor a few months ago I was told that the National Institute for Health and Clinical Excellence or NICE, who are basically in charge of what doctors can spend on expensive drugs, would want to reassess my case at some stage. The guidelines say that if you’ve been well for a year you should be taken off the costly treatment. I was assured this wouldn’t happen during my transition to university but I am not naive. At some point the decision will be taken away from my doctors.
So then we come back to NHS reform. I had always been instinctively against the predominantly Conservative proposals. But my doctor said something along the lines of; if it were his choice he obviously wouldn’t even consider withdrawal of the treatment for a long while. David Cameron has constantly talked of empowering GPs and specialists to make decisions like this which could benefit patients like me. Was I against these reforms or not?
The main problem is a lack of understanding. Do you fully understand what is being proposed? I don’t. I’m betting no one, bar those involved with the actual legislation, really does. The pause has actually complicated things further. In fact even those with all the facts of the legislation can’t comprehend every little consequence in real life for real people. Letting doctors decide sounds good. But shouldn’t the bulk of their time be spent treating patients? Shouldn’t someone independent make such decisions?
My attitude towards NHS reform has taught me that whilst I lean to the liberal left or centre with my political thinking, my actual opinions can be rather conservative. Change has always stressed me out in everyday life. If something as vital as the NHS ain’t broke, don’t meddle with it, especially when the country is trying to save money. I got better eventually, that’s all that matters.
I’ve long thought that the real way to help improve standards and ensure sustainability for the future is to cut down the sprawling responsibilities of the NHS, whilst reinforcing vital areas. It seems logical and fair that treatments that aren’t essential should not be given priority. Equally those that bring about their own illnesses should come second to the more deserving and hard done by. We need tougher health based taxes to directly fund the NHS and ease its burden, doing whatever we can to discourage the abundance of drinking and smoking cases that weigh it down. Granted this view comes from the fact that I was born with asthma and have other conditions, like Crohn’s and eczema, I could do nothing to prevent. I hold a selfish view. But then everyone gets their opinions from somewhere and all I believe in is a fair, efficient health service.
Again though what I thought I believed has been turned upside down by what’s happening to me in real life. NICE are the body responsible for ensuring that the NHS spends its money wisely and on those who need it. They are also the body that could at any point in the future remove my funding and leave me without treatment. I might stay healthy or I could plunge back into an illness it will take a long time to escape from. It could be even harder to recover second time round and the injections might not work twice.
The NHS is something Britain is envied for around the world and it is a genuine reason to be proud of our country. Cameron is saying Britain is broken again and pictures of the riots have been beamed out internationally. But we can be proud of the NHS. Overall I am happy with what it has done for me but the uncertainty hanging over my future proves it’s not perfect. It can’t be. It aims to be perfect, trying to make everyone better all of the time. Because it reaches so high it can’t get it right for each individual; whatever politicians decide to do will not change this fact.
But every decision they do make about the NHS will have life changing consequences for someone, somewhere in the system. For people like me
and people far worse off than me. So they should continue to think carefully
and trial new ideas before making sweeping changes. I’ve written before about
the government’s NHS plans but this article is an admission. I do not know
whether it’s best to stick or twist. All I can yelp ineffectually into the
blogosphere is that I hope the decision makers understand the gravity of what
they are doing, and that we keep doing our best to keep up and pay attention.
Two Eds really are better than one
It has been one of those weeks in politics. As well as dull but incredibly important legislative procedure on issues like voting reform and the EMA, there have been the scandalous, newsworthy, headline-grabbing stories which get everyone interested and have the potential to set the tone of debate for the foreseeable future. On Friday the big story was supposed to be the once charismatic, fallen and tainted PM Tony Blair giving evidence for a second time at a historic war inquiry. Instead both of the major parties faced employment crises that sent morale on an undulating, yo-yoing rollercoaster ride.
At the end of that ride it seems Labour, against the odds, have emerged with their heads held high and full of hope. The resignation of David Cameron’s long-term spin doctor Andy Coulson proves them right on a point they’ve been making in Opposition for months. With little policy of their own to use as ammunition against Coalition cuts, Labour have relished the niggling issue of Coulson’s shady past at the News of the World. By finally quitting Coulson has reinforced Labour’s attempts to expose the “new” politics of the coalition as the same old dishonest, elitist governance of old. Coulson may have tried to serve his employer well one last time with the timing of his announcement, shrouded as it was in theory by the gargantuan story of a Labour frontbench reshuffle so soon after the selection of the original line-up. But for the moment at least it’s Labour that are buoyed by events and the Tories feeling somewhat dejected.
Back in October I aired my views on this blog about the announcement of Ed Miliband’s first Shadow Cabinet. To me the appointment of Alan Johnson was a mistake, and far be it from me to blow my own trumpet, but events have proved my initial musings correct. Johnson went from gaffe to gaffe, showing a worrying lack of knowledge for his brief. Labour continually failed to land palpable hits on economic issues, despite a plethora of targets laid bare by Con-Dem cuts. Meanwhile Ed Balls, after a dynamic and impressive leadership campaign, languished largely unnoticed as Shadow Home Secretary. No one seemed to be pro-active enough to take the fight to the Conservatives on damaging policies in a noticeable way. Balls’ wife, Yvette Cooper, also wasted away shadowing the foreign office brief, despite widespread backing in the party and the potential for public support. The only Labour frontbencher scoring economic points was Shadow Business Secretary John Denham, and even he has left glaring gaps in his arguments and been error prone.
Alan Johnson’s sudden resignation due to personal issues so soon into his new, vital job may be a blessing in disguise for Labour and everyone wishing to see credible Opposition to Coalition cuts. Despite the mistakes, Johnson has once again proved in his short tenure his capacity to be likeable and approachable to ordinary voters. The revelation that it was in fact his wife having an affair, not him, ensures the prospect of return to the Labour frontbench in a smaller, popular role in the future. With Johnson’s static, timid fiscal presence brushed aside though, Labour can at last forge a bold new and distinctive direction on all things economic.
I praised Ed Balls during his leadership campaign for going a long way to reshape his bullyboy image. More than any other candidate, Balls looked as if he’d give Labour a truly individual position on policy. Continually described as Labour’s “attack dog” Balls will now have much greater freedom to bite at the heels of the Coalition. As Shadow Chancellor he’ll have to respond to hot, topical issues like tuition fees and bankers’ bonuses; fresh and emotive in the public consciousness. He’ll also have to start winning the argument on growth and investment vs. spending cuts.
Already though he has shown signs of defending Labour’s past record more effectively, explaining his decision to now back the plan he once opposed to halve the deficit within four years, by citing better figures driven by Labour’s spending whilst in government. He’s also been wise to already criticise the government, not for risking a double-dip recession, which looks unlikely, but for wasting an opportunity for greater growth and wider prosperity because of ideological decisions. And growth, Balls will emphasise, is the swiftest, most sustainable route to deficit reduction.
There are still those warning against the potential problems of two Eds at the top though. The primary fear is a return to the Blair-Brown standoff that came to define and overshadow New Labour. This concern adds the extra interest of a helping of recent political history to the mix of this story. Will Labour repeat past mistakes, despite Miliband’s proclamation of a new generation? Even if the new team propels Labour back to government, the same old potentially lethal questions will hang ominously over the partnership between the leader and the treasury.
However I think the doubters are at the very least premature to suspect Balls of wanting to derail Miliband’s revival of the party. Despite the fact he ran for leader, it’s no secret that the job Balls has always wanted is Chancellor. Finally in a position to seize his goal, he is unlikely to turn his fire on his own party. Much more likely is that Balls will electrify the chamber, as one Labour source believes he will, and unleash an avalanche of devastating balls of criticism at the government. He’ll add much needed guts and yes, “Balls”, to Labour’s Opposition. He’s already proved his aptitude for Opposition politics during his leadership campaign.
Balls’ wife will also have greater opportunity to play a key role, replacing her husband as Shadow Home Secretary. She’ll no doubt start picking apart government policing plans. But once again Ed Miliband showed a disappointing lack of courage with his emergency reshuffle. Already he’s failed to take climate change seriously or offer serious backing to voting reform or a graduate tax. And by handing Balls Johnson’s old job, not his wife, he once again missed an opportunity to make his generation truly a new one.
Failing with his initial selection of a cabinet though meant he simply had to give the role to Balls. Who will, I believe, do a genuinely excellent job and accelerate Labour’s journey back to power. The two Eds plan to have adjacent offices and the fears of a Blair-Brown fallout seem unfounded to me. Nevertheless they will not disappear and had Miliband boldly plumped for the equally qualified Cooper, he would have avoided the shadow of New Labour he is so desperate to escape.
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