Saturday, 11 February 2012

Win Or Lose On The Bill, The NHS Is Still In Danger

Well, we seem to have got the enemy on the run! Like in those stories of the battles of old, their allies are fleeing, their lines are broken, and their household elite have formed a circle round their imperilled leader.
I suppose we’ll see in the next few days if they are prepared to fight to the death for the particular piece of nonsense which is the NHS Bill.

The Labour Party, by contrast, is euphoric. Andy Burnham is a god! Ed must be sleeping easier.
Instead of all that ‘not-so-far-nor-so-fast’ and ‘we-agree-in-principle-but-are-going-to-vote-against-it’ stuff, Labour has at last learned to OPPOSE. The simplicity of simply #dropthebill has won over the public.
Either way now, the ConservativeHome website suggests, Labour wins – either it forces the government into a humiliating withdrawal, or the Tories get the blame for every setback in the NHS from now till 2015.

There are flies in the ointment, however.
Burnham seems to have realised (at last) what his shadow cabinet colleagues have not – that opposition is different to being in government. You only need to oppose ... to find fault … to mobilise the opposers. You don’t need to say what you would do instead, because you are not in government and are not (certainly at this stage) going to be called upon to DO anything.

But the Tory rebels are not rebelling because they have come over to our side – they are only furious because of the PR damage #dropthebill is doing to the Tory Party. They are angry with Lansley and Cameron, not with the Bill.
Fraser Nelson in The Spectator yesterday bemoaned Lansley’s hubris, and charged that ‘his inept handling has blackened the name of NHS reform’. Why, asked Nelson, had Lansley not (as Gove in education) simply ‘fit rocket boosters to a very good Labour reform’.

And there’s the rub, of course. Because – despite the simplicity and effectiveness of Burnham’s #dropthebill – Labour could well have fought yet another of those impotent ‘we-agree-in-principle-but-are-going-to-vote-against-it’ campaigns … because Labour, too, believes that the NHS needs reforming.
And – moreover – when the Tories eventually recover their composure and begin to challenge Labour’s position, they are going to reveal that Labour’s stance on the NHS is not all that different to their own.

Because the principle which lay behind most of New Labour’s suggestions for public service reform was the principle of the state as commissioner, rather than as provider, of public services … that the state should PAY for public services, but should contract them out to private providers. This is the process which New Labour started in the NHS – including, catastrophically, PFI – and to which the Tories merely wish to ‘fit rocket boosters’.

What the Labour leadership who are enjoying their moment of victory need to realise is that the public opponents of this Bill do not want a ‘not-so-far-nor-so-fast’ alternative – they are opposed to the whole principle of ‘commissioning-not-providing’ reform. They want the NHS to be PROVIDED, not just paid for, by the state.

Last week, in PMQs, Cameron made a huge error, which has gone hitherto uncommented.
Pressed by Ed Miliband on the Bill, he lashed out at Labour’s record on the NHS: “we’ve still got private finance initiative agreements where we pay £300 every time someone changes a light bulb”.
Now this is true, and it is outrageous, but the point is that the Tories have pushed on with PFI, and that their NHS Bill would see more, not fewer, ruinous private contract agreements like this where – half-a-dozen years down the line – we will come to realise we were ‘done’ and that we cannot afford to pay them.
The public who are fighting this Bill are doing so because they oppose, not just the detail or the implementation of the Bill, but the whole principle of devolution of services to the private sector. That is the weakness of the Tory Bill – but, ultimately, it is Labour’s weakness too, because I wonder whether Labour’s stance on this is sufficiently different to the Tories’.

Into the Abyss
I started by reporting the suggestion that, on this matter, either way, Labour had won.
I’m going to finish, however, on a much less hopeful note.

Fraser Nelson was furious with Lansley because, as Secretary of State, Lansley could have implemented most of the ‘reforms’ in the Bill without legislation: ‘You can just imagine Cameron shouting at the TV screen: then why didn't you?’

It won’t take the Tories long to catch on to this.
They may decide to press ahead, and force the Bill through.
The danger is, however, that even if they ‘pause’ again, or declare a moratorium, or emasculate, or drop the Bill … they will go ahead and quietly implement its provisions anyway.

Either way we, the people, lose.

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