31st January 2013, by Stuart Carroll
A new year, new promises. In the case of Labour and the NHS, more like a new year but the same old opposition. And 2013 is a key year for the politics of the NHS.
Along with Europe and the economy, a key electoral battleground going into 2015 will be health policy – David Cameron’s number one priority. Forever controversial and fiercely contested, the NHS remains the proverbial hot potato. As the sacred cow of British politics, the NHS provokes emotions so powerful that to simply label it political is not enough. Moreover, this is against the backdrop of the famous (or infamous, depending on your view) Health and Social Care Act (HSCA) and “cross your fingers” pledge about “no top-down reorganisations of the NHS”.
The Labour position on the NHS in 2012 followed the same linear pattern as in 2011 and 2010: oppose, oppose and oppose. You don’t need to be a statistician to work out this year’s trend. Labour’s opposition is so linear it is almost like an artificial example from a statistical text book. Y might equal mx + c, but politically this is getting boring. One man can change all of that – Andy Burnham.
Having flirted with education, the erstwhile Health Secretary was posted back to his former brief replacing the faceless John Healey (does anyone remember him?) – an obvious but unadventurous choice by Ed Miliband. As a man who loves his football, guitar music and a decent pint of ale, there is not much to dislike about the earthy Mancunian, not least given his rumoured contempt for Ed Balls (Burnham “exposed” Balls for diving in a recent Westminster charity football match!). If only the Conservative Party had more normal people like Burnham to wheel out in the news studios. With a walk slightly evocative of Liam Gallagher, the accent of Ian Brown, a hair cut blatantly lifted from Johnny Marr and an ability to talk in words “Barry and Dave” down the Burnage Arms can understand, Burnham is an asset – a human asset – in a world of smart ties and old boy blazers. Indeed, the few times I have met Burnham you can’t help but think the man is a bit of a political anomaly – he is actually very normal and likes to talk about normal things!! I am also reliably told by female friends that he is “cute” (overrated!).
The Shadow Health Secretary’s dogged and heartfelt pursuit over Hillsborough, which helped expose one of the most repugnant cover ups in modern times, points to this human touch. This was an issue Westminster village couldn’t get for decades, but one the public whiffed foul play over. In Burnham, there was a politician who got it – not in the political sense, but because of its human meaning.
If you’ve got this far, you might be thinking you’ve clicked on the wrong link and accessed the Andy Burnham Appreciation Society rather than a 2020 blog. I can assure you haven’t.
Despite these human qualities, Burnham’s problem is not one of personality or understanding the public. As important as these attributes are, his problem is far more serious than that: deficiencies in policy and emotionally driven bad judgements. Burnham’s stint as Health Secretary was hardly one to remember. The unmemorable “from good to great” White Paper, which could easily have been renamed “from wet lettuce to damp squib”, hardly exemplified the dynamism and cutting edge forward-thinking the 4th largest organisation on the planet needs. A top notch review on health inequalities by Sir Michael Marmot provided some policy cover albeit, in general, Burnham’s spell at Richmond House was pretty rank. The policy was essentially to have no policy, stick with the status quo, get tied up in knots by the BMA and other trade unions, don’t use that nasty word “reform”, and rant as much as you can about how Labour is the only party of the NHS and the Tories are Bupa covered toffs who just want to privatise everything. Good political sport, although rhetorically very boring, factually absolutely awful, and on a policy level frankly shocking.
Opposition is supposed to smooth the mind, allow for reflection and a spot of soul-searching, and moreover find a new sense of direction. It is also supposed to let you realise that more of the same won’t help you win an election when it just helped you lose one! That is why Labour’s position on the NHS remains literally incredible. The line of attack is about as credible as a BMA demand to protect gold plated pensions. Indeed, it is quite difficult for Labour to argue about real terms spending increases (however exiguous 0.4% is over 5 years) when you were committed to cutting the size of the NHS cake! To argue for direct spending cuts across the board is an honourable position (not one I agree with in the case of the NHS), but double-dealing just reeks of hypocrisy and shabby opportunism. It is even more ridiculous when you then have a pop at the Government for not spending enough! This is the preposterous position Her Majesty’s Opposition has found itself in.
On the HSCA, Labour continue to adopt the politically opportunistic strategy of attacking, criticising and fulminating over anything and everything that equals the “new NHS”; something made infinitely easier by the communications car crash of the Coalition Government. This approach may deliver some short-term back slapping and curry tribal favour amongst disaffected trade unions, although it is ultimately hollow and devoid of a constructive policy framework. There is no clear evidence that the public really has such a deep-rooted attachment with their local PCT and SHA. Also, I have not seen Andy Burnham chaining himself to one in direct protest.
For most, the architecture of the NHS is not the concern, but rather the care they receive and experiences using the NHS. Ed Miliband doesn’t need to go head-hunting in Cape Canaveral to work out that the public might actually quite like local CCGs when more direct accountability concretes the patient voice and thus more patient choice. Yes, the policy implementation remains a massively thorny task (good luck Sir David), but how can you rationally disagree with the principle? This is the crux of the problem. When asked direct what within the HSCA he disagrees with, Andy Burnham always says “the HSCA”. When pressed, he tends to offer emotional political rhetoric and no detailed critique. That is intriguing as it contains some of the things he legislated for as Health Secretary and huge evolutionary chunks of the Milburn 2000 NHS Plan. I worry that Labour has not actually read the document adopting instead a Malcolm Tucker approach to policy analysis. Also, when Milburn, Blair and so many others are in favour does this actually signify a bit of “Gareth Bale” politick (very left wing!)?
This unsatisfactory situation transcends politics and policy, or at least it should. The truth is, whatever your view, Labour is in the mix to win the next general election whether that means majority, minority or some sort of cobbled coalition. If it does, that is less than 2 years to go. Bluster and guster doesn’t equal “the NHS is safe in our hands”. And so Andy, in the words of Morrissey (it will be on your iPod), that joke isn’t funny anymore.
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