The second most important point about democratic elections (the first is, of course, winning them) is that they provide the winners with a democratic mandate which provide them with a set of tools with which they can govern.
A serious manifesto, therefore, does not only win the election, it must also provide the cabinet members with the tools to govern the country in the way in which they want.
It is that reason why a manifesto based upon the policy that the Labour party loves the NHS more than the Tories will not be good enough to save the NHS.
The picture to keep in your mind is the first meeting between the new Labour secretary of state for health and the permanent secretary of the Department for Health sometime in mid-May 2015.
The permanent secretary will have prepared an outline of the problems facing the NHS for the new secretary of state.
In May 2015 this will be a very difficult picture. Over the next five years this picture gets more and more difficult. The rising demand for health services from an aging population will mean that the model of hospital-based healthcare that was suitable in 1948 when the average male life expectancy was 66, will have become unaffordable.
Given this greater demand the only way the basic principle of the NHS – a health service with equal access for all free at the point of need – will be possible will be to have much more care for sicker older people taking place in people’s homes and not emergency beds in hospital.
This is an enormous change which most leaders in the NHS recognise is a bigger change than in the last 60 years. To bring this about over the next five years a new secretary of state will need powerful leaders of reform.
Therefore in May 2015 the new secretary of state when they hear this picture from the permanent secretary, reaches into their manifesto bag of levers for change and finds at the top of that back a pledge for an extra £2.5bn per annum.
They will lay that on the table and say to the permanent secretary ‘This extra £2.5bn will sort it out’. She of course, having read the manifesto, will be ready for this. First she will point out that since this is consequent on passing the mansion tax legislation, this money will not start reaching the Department of Health until the beginning of the financial years 2016-17.
At that time this sum will come in very handy at that time because it will match almost exactly the deficit that the NHS will have in its spending in the year 2015-16.
So the new money will be really useful in going straight into the deficit that an unreformed NHS will be ratcheting up.
Back in our meeting of May 2015 the chastened secretary of state will reach further into their bag of manifesto promises and scrabbling around for further levers for change will come out with a phrase that says ‘We love the NHS more than the Tories’.
The permanent secretary, as a professional, will of course say ‘That’s very good to hear, secretary of state, but what I need to know is how the this love is going to help you radically change the NHS model of care and to help all these sick older people.’
The main job of any Labour secretary of state for health is to ensure that a health service with equal access for all and free at the point of need is safely handed on to the next generation. Over the next few years to safeguard that principle they will need levers of reform of the NHS that go way beyond deep affection and involve very great reform of the way in which the NHS works.
Love can work wonders but to change the world it sometimes needs better politics than itself alone.
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Paul Corrigan was a health adviser to the last Labour government. He tweets @Paul_Corrigan
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Listen to this, broadcast last year – http://www.bbc.co.uk/programmes/b01ptbx2. It is only half an hour long, but it packs an awful lot in.
Devastating. Absolutely devastating.
Paul Corrigan, husband of Hilary Armstrong and architect of Blair’s marketisation of the NHS which is now being completed by Cameron, speaks frankly of having been a Communist Party parliamentary candidate in a Labour seat in 1979, and of the Eurocommunist roots of the whole idea of foundation hospitals among other aspects of the Blairite doctrinaire anti-statism that is still in power and which Charles Leadbeater defines as the Communism to which he has always adhered, right up to the present day.
Corrigan confirms that “I am still a Marxist” who understands the world in terms of dialectical materialism. Thus speaks the man who designed Blair’s health policy, and whose wife was Blair’s Chief Whip, including at the time of the vote on the Iraq War.
Some of us always knew this. But we never expected to hear it from the horses’ mouths on Radio Four.
Blairism (in all parties) is not only the intellectual heir of Eurocommunism, but also the actual, monetary heir of the Moscow Gold: the Communist Party became Democratic Left, which became the New Politics Network, which became and remains Unlock Democracy. Legally and financially. Directed by a Lib Dem, Unlock Democracy is still occupying the same premises, which were bought with money from the sale of property that had in turn been bought with money given by Lenin.
Tony Blair wrote for Marxism Today, setting out his whole agenda in black and white as early as 1991. Yes, you read aright. Before the 1992 Election.
The whole idea that there was even any need for a New Labour was effectively dreamt up by Eric Hobsbawm. Demos (although it is far better now) was founded out of the ruins of the Communist Party and of Marxism Today, with Tony Blair as the only politician at its first meeting. Even I did not know that last one. Keep reading it over until it has properly sunk in.
Devastating. Absolutely devastating.
For the dullards in the aidience [moi] could you precis your above piece of, what seems to me to be, Blair-Marxist-Communist slap-down, into one line? which contains where [you] personally stand on the subject being discussed? What is devastating? where and when did the devastation occur? Also what are your personal advice[s] to our next PM [hon Ed] and his Team in Govt next May? How would you [personally] help the NHS from going down the drain – financially speaking? bearing in mind that current PM ‘DaveCam’ has said that NHS shall be ‘ring-fenced’ – explain to me if you can, what does he mean by that? according to your perceptions and understanding of a Tory mentality and track-record of Manifesto promises that were broken and VOWS not kept?[ Should we really give a hoot about this current and soon-to-be-history, Tory PM’s blather of soap-suds emanating from the rusted jowls of a decrepit Oz wizard?] but know thy enemy.
I understand important Depts {Health/NHS} {DWP/Jobs/retirement pensions}{Police and MOD} need prioritising above eg,{DEFRA} Forestry Commission’s and its ‘wide-leaf mulching’ plans for 2015/16} and finances secured to make NHS & priority Depts funcyion properly and work for the sake of all the Peoples in the United Kingdom.
But may I [dumbly] ask the writer of this article: does it really matter who is at the helm of the ship [of State] so long as he or she is a LABOUR candidate? who steers a straight, and moreover, a safe course? Their personal philosophies mean nowt – results count.
Am I missing the gist of your “Devastating, Absolutely Devastating” argument entirely?
LABOUR WILL WIN IN MAY 2015 – start making plans for it and and-mouthing former LABOUR PMs does not endear yourself to me.
UNITY IS STRENGTH : if you don’t like LABOUR and its leaders, kindly leave the room.
The NHS should be ring-fenced – like Whitehall. Any Permanent Under Secretaries should move their Walnut & Rosewood Chippendale desks and armoires to the A&E dept /Mortuary if no space up on the front desk/ from King Charles Street SW1A to the Hospitals and rural clinics up and down these green and gracious Isles. Without one’s health one is done for. One secretary of State for Health is not enough – get another 3, or 4. NHS is too important to play games with.
Allow any [willing and able] retirees and [some] of the medically unfit written off by DWP [but willing to work for basic travel/sustenance expenses paid] to offer their services to do what they can in admin’/stores/purchasing/CSS, telephone answering at a Hospital near them. This would ease up the strain on the [recruitment agencies] currently billing millions to the NHS for supply of temps etc. I can guarantee that there are upwards of at least a million [older] folk and others, who have been declared unfit to work in UK, over the age of 50, who would jump at the chance to be of service to their communities – instead of awaiting that clammy hand of the Grave to tap them on shoulder.
Just sayin’, waste not , want not. Make use of what you got to pay the bills, NHS Manadarins.
[And do a quick audit on your own salaries and perks whilst you are about it]
Paul is right. Primary care and GPs surgeries need to do much more. Expanded surgeries with proper diagnostic equipment such as X-Rays, scanners, blood test analysis would be a start. A pity the pledge was about the number of professionals, rather than outcomes such as waiting times, rapid access to GPs, mortality rates etc.
Really sensible piece. Reading this reminded me of a passage in the late Philip Gould’s book “The Unfinished Revolution” (page 45 in the edition I have). It reads “We’ve got to get away from the idea that campaigning is just about an NHS ambulance, a sticker saying ‘I love the welfare state’ and the launch of a charter”. The person quoted was Peter Mandelson and the time it was said was 1985. Nearly 30 years on it’s depressing that Paul Corrigan is saying much the same thing. There is never, ever, going to be sufficient money to meet all needs of an ageing population within something as large, complex and multifaceted as the NHS – which means there will always be tough decisions to be made.
Whilst the wider point is undeniable that the next govt needs a coherent strategy, I doubt it will be in any manifesto. Coalition politics changed the dynamic of being able to hold a party to account for their promises. Both parties have done a raft of things either that they were silent about or that contradict their stated policy (no top down reorganisation, end tuition fees). Sadly the days of the manifesto of substance seem long gone. They are sales brochures not product specifications. Never was it more true that they campaign in poetry but govern in prose. Mores the pity.