Labour needs to win big on the NHS

Labour have an important battle on their hands. Their opposition to Andrew Lansley’s terrible Health and Social Care Bill (and it is terrible, more of that later) is as much out of a need to defend their very being as it is for any ideological reasons.

The previous Labour government were wrong on the economy. This is now fact. It is irrelevant that Brown and Darling led the way in ensuring a global response to the crisis, stopping a complete meltdown in the financial sector; nor does anyone care that the Tories would have done nothing differently in the lead up to the crisis; the fact that Labour are proving to be right about the desperate need for a plan for growth to go alongside Osborne’s austerity drive is an irrelevance. History is written by the winners and Labour now have a long battle ahead to regain trust from the electorate. Important as the economy is however, nothing stirs a Labour person like the NHS – we created it and we love it as you would love a child. Lose the battle here and there seems little point getting out of bed in the morning.

So to the bill – and it is a shocker. The flagship policy is the creation of GP-led commissioning. Out go Primary Care Trusts and Strategic Health Authorities. In comes a single national health board and hundreds of small GP commissioning consortiums – reducing bureaucracy and making healthcare more responsive to local needs. It is doomed to failure.

GPs have zero track record in commissioning, they do however have a very good track record in clinical care. They also have full to bursting appointment books. Why, when the average consultation is already only just over 10 minutes in length, do we want them to spend less time seeing patients? The reality is they will delegate the commissioning powers to someone else. Who, I hear you ask? The very same people who have just been made redundant from the defunct primary care trusts.

Any suggestion of a cut in bureaucracy is a fallacy, the new structure has just as many levels as the old one, the simple fact is this is a major restructure that will cost billions of pounds and even in the long-term the exercise will cost money rather than save it. That the new system may be more responsive to local needs could well be a fair one, though whether this will come back to haunt the coalition is another matter – people crave consistency and a perception of equality. How long until the phrase ‘postcode lottery’ comes back into fashion and we start to see a re-centralisation of services?

The rest of the bill includes increasing how much private work a trust can carry out and laying out a timetable for all hospital trusts to gain foundation status. The former is there to increase potential revenues (though risks further impacting on waiting times for those who can’t pay), the latter will, in theory, help increase competition and therefore standards. (But also runs the risk of hospital trusts effectively being bankrupted, with all the associated political fallout).

Labour’s response needs to be robust, the NHS is in pretty good shape and they they have much to be proud of from their time in office – increasing spending to be in line with the European average, then using the money to decimate waiting lists, improve survival rates for those suffering from cancer, heart attacks and strokes and created a fairer pay and reward system, allowing the best health professionals to stay treating patients. The much maligned targets helped to ensure all this happened – as soon as the coalition sidelined them waiting times started to increase again.

What Labour didn’t manage to do is carry staff with them. Staff morale is arguably at its lowest ever, and is still falling. This impacts both on clinical care and the public’s perception of the NHS. Secondly, they didn’t make any in-roads into customer service – which, in my experience has tended to be appalling. It sounds a small issue, but most people’s first contact with the NHS is with a non-clinician and, if the quality is poor so is people’s first impression of the whole organisation. Any changes in the above will come, not from legislation, but from a change in culture and leadership. This is what Labour should be calling for.

Ed M and his team have had a good couple of weeks after a pretty disastrous start to the year, but this is yet another big test. Labour cannot afford for their record on the NHS to go the way of their reputation on the economy.


What Labour should be saying about Higher Education

You probably shouldn’t read too much into the news that University applications are down almost 10%. True, it sounds shocking and creates an easy stick for which to beat the coalition with, but if past evidence is to go by, give it a year or two and those numbers will bounce right back up again. That doesn’t make the coalition policy right though, far from it.

Our view of Higher Education is seen through the narrow prism of individual benefit. Put simply, those who go to University earn significantly more on average than those that don’t. University should be seen as investment – like property, or gold. What’s more, if your investment doesn’t pay off (i.e. you don’t earn lots of money) you don’t have to pay your fees. Bonus.

But what if you look at Universities another way? Perhaps argue that they exist to benefit everyone in society, not just those who have the privilege to study at them? Some of the arguments are obvious, nurses and doctors for example all repay society a hundred times over every time they save a life. Some are more abstract, how do you begin to quantify the wider cultural and societal benefits of a more educated population?

We live in a global marketplace, where companies pick and choose their suppliers from anywhere. A call-centre in India, a factory in China, a creative agency from the US. A better educated country is a more flexible country and the more flexible it is the more productive it becomes. This doesn’t just benefit graduates, it lifts salaries and living standards for everyone.

Higher Education however is struggling, funding is much lower per head than in the US (and the rise in fees does nothing to improve this – they merely help replace the £1billion funding cut from central government), what’s more we are suffering the beginning of a brain-drain. An unintended consequence of tuition-fees is that students have started shopping globally for their education, with many of our brightest young people opting to study elsewhere. The same is true of our academics. Outside of Cambridge (which still proudly sits at the top of global rankings) our institutions are beginning to fare badly against the global competition – not just from within the US but increasingly from Asia, particularly China.

Labour’s record on higher education is mixed – whilst in office it’s 50% target helped dramatically improve access, particularly to those on lower incomes. On the debit front they were the ones who brought in tuition-fees in the first place. In opposition they have, as so often, plumped for a ‘coalition-lite’ policy – where students will pay less, but not by much. It is both intellectually and politically lazy.

Central to Ed Miliband’s political philosophy is ‘the promise of a generation’ – the deal whereby you provide the next generation with more opportunities than you had yourself. I would love to see a higher education policy that reflected this philosophy. One that accepts the wider society benefits of a good education, and with it the costs. Universities too should take more responsibility. Learning from their US cousins, they need to become much better at commercialising the significant intellectual property they own and invest in more sophisticated Alumni programmes. In fact the only people who should be worrying less about university financing are the students themselves – they, after all, should have other things on their mind.

A Welfare Cap is the right way forward – but not in isolation.

Tonight it is all about the Welfare cap – so let’s start with the facts –
What is being proposed? – That no household can claim more than £26,000 per year in state benefits (That is the equivalent of an annual salary of about £35,000).

Who does it affect? – The Department of Work and Pensions calculate it will affect 67,000 households, or 90,000 adults and 220,000 children. Obviously there is a sliding scale here – with 45% losing up-to £30 per week, 26% losing £50 to £100, 12% losing £100 to £150 and 17% losing over £150 per week.

How much will it save? – DWP figures suggest it could save upwards of £120million per year.
What about the why? – The coalition government offer two reasons. First, to help cut the deficit. Secondly, to bring fairness back into the benefits system.

Let’s deal with dealing with the deficit first – £120milion might sound a lot, but it is not even pennies, when it comes to the nations finances. Assuming every bit of the projected saving is made (which is unlikely) they will reduce the budget deficit by less than 0.0008%. Put this in the context of the 133,000 children who are at risk of being moved below the poverty line as a result of this measure and it doesn’t feel anywhere near enough of a saving.

So that leaves us with fairness as the real driver for this change. Certainly at first glance it seems fair – why should those people who are not working be able to live in a way that many ‘hard-working’ families simply cannot? It is a compelling argument. More so when you think it is those same families whose taxes are paying for others not to work. As an aside – in 1958 Social Security spending equalled 6% of national income, in 2010 it was 11.9% (though it actually peaked at 13.1% in the dying days of the last Tory government) – this kind of upward trend is simply not sustainable, regardless of where your political allegiances lie. So, it turns out I agree with a cap at some level. Progress indeed.

The next question is how much? The median household income in 2011, after tax, was £24,000 – so again the government figures look broadly fair. My problem is that it is just too general. Mean household income in London is 50% more than in the North East. Average rental for a 3-bedroom house in Buckinghamshire or Essex is double that of Cumbria (London is, on average 6-times more expensive). With the major household cost fluctuating so much, how can it be fair to introduce a UK-wide cap? Why not an overall cap on all other benefits, with regional allowances for housing benefit? That is something I could definitely sign-up to.

We have a cap, we have made it fair – so what about exceptions? Take two civil servants, with a school-age daughter, living and working in London on a total household income of about £35,000 per year. They are managing OK when disaster strikes – thanks to swingeing government cuts they are both made redundant. Their ‘generous’ severance package keeps them going for a few months, but it is now 3 months on and there isn’t much work for former faceless bureaucrats. They live in a modest 3-bed semi in an average part of London – it costs £3000 per month just for the rent. Even with regional adjustments the housing benefit doesn’t cover it – do you want to tell them they have to move, or shall I? With fairness should also come patience – these people surely come under the ‘hard-working’ banner, so my suggestion is that we give them a year’s grace to find their feet, before slowly starting to reduce their benefit down to below the cap. This gives them time to readjust, potentially re-train and also ensures their daughter has the home and educational stability that is so important in terms of her development.

So, there we go – this blog has done its job. I am much clearer on what I stand for:
– An overall benefits cap, broadly in-line with the government proposals.
– It should be both index-linked and the housing benefit should be regionally adjusted in line.
– There should be a grace-period of 12months to ensure that those newly falling out of work can continue to live in their current house whilst seeking work and/or re-training.

But wait a minute; if we are doing this to ensure fairness, then it has to be balanced.
I don’t have time to get started on the multi-million pound bonuses of the UK’s top CEOs and senior-execs, or how the same group of people’s pay rose by 49% in the last year alone, whilst the average value of their companies dropped by 5.5%? But just some food for thought before I go to bed. The total saving of the above plans are in the region of £120million per year. Benefit fraud costs the UK taxpayer £1.5billion per year. Tax evasion (illegally not paying tax) costs us another £15billion. Tax avoidance (whereby companies and some individuals use loopholes in the law to minimise their tax burden – strictly speaking legal in the UK, but morally dubious) costs us a further £20-£25billion per year. Wouldn’t the government have more credibility in it actions if its first target were to significantly reduce these figures?

The beginning of the end for Ed?


More bleak news for Ed Milibamd this morning as The Guardian splashes with a report from Shadow Minister and ‘leading Labour thinker’ Gregg McClymont stating Labour are at risk of falling into a Tory trap and losing the next election. The story itself is pretty lightweight, but the implication that Miliband Junior is following a core votes strategy is damaging, as is the fact the paper has now led with two anti-Miliband stories in three days. Once is careless, twice might be seen as some sort of conspiracy.

The tragic thing is, if you get the chance to listen to a set-piece speech from Ed you’ll soon realise that a core-votes strategy is the last-thing on his mind. He has a clear vision of what the post-banking crisis should look like. The need for a new approach to the economy and society, a more responsible capitalism. This isn’t just about bashing bankers, it is an opportunity to put fairness back at the heart of what we do. His problem? No-one is listening.

Eddites will tell you it is virtually impossible to get the public to listen so soon after defeat at the polls. I don’t buy it. The coalition is not the landslides of 79 or 97 and the public remain unconvinced of Cameron (though considering the year he has had, he should get some credit for the current polls). The public are looking about for an alternative, the trouble is they are not seeing anything they can buy into.

Appointing Tom Baldwin as Comms Director earlier this year certainly tightened up the messaging, helping to make the outfit more tactically adept and scoring a couple of small wins in the process. What he has been unable to do is develop a narrative. For this you need an underlying strategy, and if Ed and his team have one it seems to be very underlying indeed.

So, we enter 2012, with the polls in the same place as a year ago and the public still unaware of who Ed is and what he stands for (desperate Daily Mirror pieces aside), except now we are a year on, the party is getting restless and even the most benign of centre-left papers is beginning to turn against him. The next few months are a huge test for Ed and, in particular Tim Livesey, his new Chief of Staff. Can they develop a winning narrative that resonates with the public, and if so how quickly? The question is – is it already too late?

It’s time to pipe down and support Ed

Attacking Ed has become the ‘normal’ thing to do. First the right of the party attack him for lacking direction and, well let’s be honest, not being David enough. Then it is the turn of the left, admonishing him for taking the only sensible political option and opposing the strikes, encouraging instead more negotiation and concessions from both sides. Each day as I flick though Labourlist, Labour Uncut or The Guardian the very people who should be helping shape the future direction of the party are instead wasting their time writing petty, self-indulgent pieces putting down our leader whilst offering no viable alternative.

I understand how tempting it is, indeed it is something I took part in when Gordon Brown was in charge, but then look where that got us. At best the public ignore it, making us irrelevant. At worst they find it an absolute turn-off.

I voted for Ed, though I know a lot of you didn’t. I didn’t vote for him because I thought he was a ready made PM in waiting, but because he had a vision. He spoke of a new kind of politics, he engaged thousands of young volunteers into his campaign, some of who had never been involved in any kind of politics before, and he felt like a genuine break from the past. In return for that promise I understood it might take a while for him to get really motoring. For me he is the right leader at the right time, someone to grow into the role as the party grows again out of the ashes of the New Labour era.

For this to work however he needs the best in his party lined-up behind him, not taking pot-shots from the sidelines. I want to see the great and the good going up against each other on schools, health, defence – pushing the party to go further and deliver more radical policy alternatives than ever before. Whilst we are it, let’s start really hammering the coalition. Whilst we are bitching at one another they are systematically destroying everything we hold dear, and we are letting them.

Over the last few weeks we have started to hear more about the kind of party Ed Miliband wants to lead. ‘The Squeezed Middle’ and ‘Promise of a Generation’ are beginnings of a narrative that I hope will end up in detailed policy that will resonate on the doorstep and deliver a genuine alternative to this cruel and unforgiving government.

In the meantime I would love to read more about policy and less about Ed’s leadership – let’s get behind him, campaign as one against the coalition and build a party ready to take power again.

Time for a Bennite Revolt?

I should admit right at the outset that I have a bit of a rose-tinted view of Tony Benn. My views on the great man have been flavoured less on the 80s firebrand and more on elder statesman, diarist
and conscience of the party. After retiring as MP so as to concentrate more time to politics, he is now leading a call for “ordinary people” to revolt against “the most savage spending cuts since the 1930’s. It is easy to dismiss Tony Benn as a figure of a bygone era, a rabid left-wing politician that has no place in the post-ideological political age. But that is to do him, and his campaign, a huge disservice.

The proposed spending cuts have the potential to destroy livelihoods. Although the coalition remain steadfast that “we are all in this together” the reality will be very different. Increases in VAT, an £11billion cut in the welfare budget and 25% reductions across government departments will all hit the most vulnerable the hardest. It is not millionaire business leaders or bankers that will feel the pain but single mothers, the disabled and their carers. And it is not just service users that will be affected. Internal Treasury documents estimate 1.3million public and private sector job losses over the course of this parliament, all piling more pressure onto whatever services remain.

Policies that have such a negative impact on so many people’s lives must be resisted. Organising communities, holding public meetings and taking to the streets should be embraced by the left, with local Labour parties sitting at the heart of these protests. But protest alone is not enough, if you believe the coalition government, and huge swathes of the media, there is simply no alternative to cuts. The responsibility of all those vying for the Labour leadership is to prove this statement untrue by articulating a viable alternative.

We cannot allow ourselves to get into a situation where as a party we accept the premise of cuts but then argue against them on a one-by-one basis. It does not sound credible and will just further shrink the publics trust in politicians, with Labour as the principal leader. Instead we need to deliver a positive message for change – an alternative and fairer way of doing business. For me Ed Miliband is currently the one best articulating this. Slower deficit reduction, more onus on progressive taxation and support for small business are all key platforms of an alternative economic plan and these, along with a campaign for the living wage, are the central themes of Ed’s campaign. I urge you all to support him.

In the meantime however rather than looking inwards, local Labour parties need to be taking the fight to the government – this means getting on-board the ‘Bennite Revolt’. Whilst our potential leaders slug it out, we need to organise within our communities and deliver our future leader (whoever that maybe) a vibrant grassroots movement willing to fight for an alternative to the vile campaign of cuts being proposed by this government.

Tory plans keep me awake at night – but where is the opposition?

So here I am sitting on a train that is currently winding it’s way to London from Glasgow. I should really be catching up on sleep but every time I start to doze an uncomfortable thought jolts me back to reality. The thought? That the Tories are in complete control of the political agenda, they are already drawing up the battle lines for the next election and by the time the other parties wake up to the threat it may be too late.

The dominant Conservative element of this coalition government are determined to learn from the mistakes of the 1997 Labour Government. Not for them a timid first term, patiently fighting one battle at a time whilst all the while keeping one eye on the polls and focus groups. We are witnessing an object lesson in the exploitation of power by a party that sees the last 13years as an aberration, a temporary lapse in the electorates collective judgement.

Crippling cuts in public expenditure, the effective decoupling of education from LEA’s, the largest overhaul of health provision since the inception of the NHS. Promises of prison reform and welfare reform, not to mention a proposal to significantly reduce the size of the House of Commons and of course a referendum on AV. All this, and it is only August. Once Parliament returns from the summer recess it is time for the spending review and that is when the real fun begins. Don’t let yourself fall for DC’s easy charm – this government is working with an ideological zealotry that Thatcher would be in awe of. Under the cover of ‘necessary cuts’ we are about to witness a dramatic and permanent cut in the size of the state, with those on the margins of society hit the hardest.

And what of the other parties? Nick Clegg and his band of Lib-Dems have gambled all on an AV referendum, ceding all power and voice in an attempt to make progress on their most treasured policy. I fear for a party that now has no identity beyond the coalition itself and could suffer a catastrophic demise at the next election. Regardless, they are in no position to do anything but offer tacit support to the Tories for now. As for Labour, could there really be a worse time for a long drawn out leadership battle that is struggling to maintain interest from it’s own membership let alone from the wider electorate? What we need are Labour’s biggest and best minds working together to build public campaigns, raise the level of debate and hold this un-mandated government to account.

The Tories and their agenda have stolen a march and currently there is no one to stop them. That thought alone is enough to keep me from sleeping.