Category Archives: Politics UK

Reflections on general political developments and ideas in the UK

The Coalition wrong-foots Labour on its (lack of) NHS policy

Labour’s plan for winning the General Election in May has a special NHSplace for the NHS. They are seeking to “weaponise” it, and promote themselves as the only party that can be trusted to run this great British institution. And yet their NHS policy has deep flaws. Now the Conservative/Liberal Democrat coalition government has come up with a plan to integrate health and social care budgets in Greater Manchester. To maintain the warlike metaphor, this looks like surgical strike on Labour. In fact the story arose from a leak in the negotiation process, and seems to be the brainchild of Simon Stevens, the politically neutral head of NHS England. But the policy poses serious questions for Labour.

The details of yesterday’s news are a little vague. The Coalition had already announced plans to devolve more powers to Greater Manchester, working through the local councils (mainly Labour, but with Conservative and Lib Dem ones too) and an elected Mayor. And integration is everybody’s favourite reform idea for the NHS. It refers to merging the health budget with that of social care (currently controlled by local authorities), so that the policies for the two can be coordinated properly. This is important because one of the main problems at NHS hospitals is that they cannot release patients to social care beds. Integration of this sort is already being piloted in such places as Torbay. This looks like a pilot on a grander scale.

As a reform idea, the Manchester proposal looks entirely sensible. Sarah Wollaston, a Conservative MP who is a doctor, and no government stooge, offered a knowledgeable and effective advocacy on Radio 4 yesterday lunchtime. Integration has been one of Labour’s big ideas. But Labour can’t bear to give the government any credit for policy on the NHS – as this undermines their weaponisation plan. So their spokesman, Andy Burham, rubbished the idea. He attacked it as undermining the “National” in the NHS, because it was a localised solution rather than being dropped from a great height from Westminster. He also suggested it would be another “top-down reform”, which the government had promised not to do.

And yet both these lines of attack expose weaknesses in Labour’s own NHS policy. In the first place, if they are serious about promoting NHS integration, how on earth are they planning to do it? The quid-pro-quo of an integration plan is surely more local devolution – otherwise you simply create a monstrous bureaucracy, and a feeding frenzy of large consultancy firms proposing over-engineered implementation plans (er, like the last Labour government’s reform of NHS commissioning). And secondly, are Labour or are they not planning a top-down reform all of their own? Their proposal to scrap the government’s Health and Social Care Act suggests just that. And if they intend to  implement integration across the whole country at once… well, that just proves it, doesn’t it?

Which highlights the real problem for Labour. Their plan is to ride the tide of anger amongst NHS insiders over the government’s record on the NHS. They headline attempts to outsource some services as an NHS “sell-off” or privatisation. This is vastly exaggerated – no major hospitals are being outsourced (private businesses would be mad to take them on) and GP surgeries, er, have always been private businesses (a fact that confused the hell out of a save-the NHS campaigner that called on me a couple of months ago). But any plan to reform the NHS in any serious way involves taking on these insiders. The idea of integration to insiders is popular probably because it is seen as a way of hitting the ball into the long grass: the setting up of some toothless committees of professionals who purr about “collaboration not competition” and achieve very little except requests for yet more money. The more serious and specific Labour gets about reforms that promote efficiency, the more dissent they will get from their core supporters, and especially the trade unions. The hard fact is that Labourare proposing to dismantle the Coalition’s health reforms at the moment they are starting to show some promising results, like this devolution initiative.

Now the public probably don’t think much of the Coalition’s record on the NHS, but they surely accept that reforms will be needed to make the organisation more efficient. And if Labour appear not to be serious about that, then their line on the NHS is undermined, and their line on tax-and-spend, already weak, gets shot through. With enough pressure this weakness will become more and more apparent – and there will be a greater and greater risk of dissent in Labour ranks. They are offering just bluster. Far from trying to avoid the NHS as a campaigning issue, the coalition parties have the opportunity of a devastating counterattack, especially if Labour persists in opposing the Greater Manchester plan.

All of which shows how fatally bad is Ed Miliband’s leadership. He has valued party unity over making serious political choices. He has chosen sound and fury over policy substance. He hoped to craft clever policy positions that cover the cracks in his own party while providing credible ideas for saving the country. Alas serious policies mean taking on vested interests in your own ranks, not just the usual villains. The unity of silence in Labour ranks  is not a token of assent – it is a token of denial. Labour’s most vocal supporters, and the providers of the bulk of their funding, do not think that Labour is serious about public sector reform and austerity. As Labour is pressured by the coalition parties the greater it is in danger of falling apart just when unity is most important. It is a political strategy put together by policy wonks and campaign tacticians – and not those with serious nous about taking on political responsibility.

The Coalition parties have their own weaknesses of course. These may yet save Labour. But a meltdown for Labour cannot be ruled out on this form.

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Can any of Britain’s political parties break the deadlock?

The rise of fringe parties takes British politics into a whole new era. and yet the outcome of the election due on 7 May 2015 seems strangely predictable. The parties seem to be stuck in a deadlock where none can win. What are the chances of one of them breaking free?

Britain’s electoral system (misleadingly referred to as “first past the post”) is capable of producing dramatic swings in the balance between the parties. But a plethora of constituency polls allows pundits to make some quite stable predictions this time. The main features are these: the Liberal Democrats will lose up to 30 seats of their current 57. The Scottish Nationalists (the SNP) will pick up a similar number, or perhaps more, giving them 30-40 seats overall. The new insurgent parties, Ukip and the Greens, will only pick up a handful of seats, and the latter maybe none at all. Overall Labour will advance, and the Conservatives will fall back. The main debate is whether Labour will be able to overhaul the Conservatives to become the largest party. Interestingly, the fortunes of both major parties will be largely determined by how well they do against the smaller parties rather than each other. But neither party will win enough seats to form a government with one of the smaller parties; they will need to do a deal with each other to form a stable government. This is the outcome nobody (except the SNP perhaps) wants.

Can any of the parties break out of this stalemate? Sudden changes of fortune can happen. Two stand out in recent history. The first was in 1992, when John Major’s Conservative government suddenly overhauled Labour in the last week of the election campaign to win a comfortable majority, under the slogan “Labour’s Tax Bombshell”. The second was Cleggmania in 2010, when the Liberal Democrats surged forward after the performance of their leader, Nick Clegg, in the first of the television leadership debates. The surge faded, but the party avoided the drubbing they were heading for, defending their record result in 2005.

Such sudden surges are entirely possible this time. No political leader dominates the scene as Margaret Thatcher  did in the elections of 1983 and 1987 or Tony Blair in 1997, 2001 and 2005. As in 1992 and 2010, political leadership is weak, and so things can be more fluid. Public frustration with politics is high.

To understand that we only have to look at Scotland, where the SNP have surged forward after last year’s referendum on independence (or, more precisely, they are consolidating their spectacular gains in the Scottish Parliament in 2011). Labour, who are defending 40-odd seats at the election are in serious trouble. That surge, however, is already built in to the forecasts. The surprise might be if the anti-SNP vote rallies and votes tactically. That’s a real possibility, though – and it would mainly benefit Labour (whose majorities are generally big), and might stem some of the Lib Dems’ anticipated losses. It would be particularly satisfying if the Lib Dem candidate Christine Jardine is able to hold off former SNP leader Alec Salmond.

What of the English insurgents, Ukip? They won the European Parliament elections as recently as last year. But their support has sunk to 15% (less than the Lib Dems achieved last time) and it is too thinly spread. Their novelty is wearing thin, and there is quite a strong anti-Ukip reaction, visible in their leader’s negative approval ratings in polls. The press, who often set the news agenda, found it convenient to boost them, but they  are now poking fun at them. Yet they are well-funded and in some regions (along the south and east coasts especially) they might yet hit the zeitgeist, and pick up a few more seats than the pundits expect. There is a more remote possibility that they do well in northern urban Labour strongholds – but this looks too high a hurdle for them this year.

How about the other insurgents, the Greens? They have done well in the polls this year, catching up with the poor old Lib Dems quite often. They have picked up the “none of the above” vote that dislikes Ukip. They have the possibility of repeating Cleggmania and advancing into teens of %age of votes, if not better. But they could suffer if they come under scrutiny. They have a rather mad collection of policies and their leader, Natalie Bennett, struggles to break out of fringe appeal. There is a challenge for the party. If they could dump Ms Bennett as their figurehead and replace her with their only MP, the impressive Caroline Lucas, and if they ditch most of their silly policies as “aspirations”, with a more mainstream manifesto – then they might be in business. It would be a big moment of growing up – but, my sense is that they can’t. Too many activists would see such a move as a betrayal. A further difficulty is translating an advance in the polls into seats, as their vote is thinly based. They seem to do well where Labour are already strong – and they lack the time and organisation to marshal a stronger vote in particular seats.

Could the Conservatives repeat their feat of 1992, and break through to an overall majority? They have an impressively disciplined campaign. They could even repeat the tax bombshell line of 1992 line with some justice (Labour’s instincts are free-spending); and Labour’s leadership is seen as not up to it, again as in 1992. Their leader, David Cameron, may not as impressive as Mr Blair or Mrs Thatcher, but he is more convincing than John Major was. But. But. I just think that the Conservatives are on the wrong side of history and will find it impossible to extend their appeal enough. Back in the 1980s they were the party that broke the unions (which most people saw as a good thing) and made the country self-confident again. Mass affluence broke out – even if a lot of it was through the false wealth of rising property values.  Now we seem stuck; the rich do well, but few others. Even increasing property values are seen as double-edged, forcing youngsters from even affluent families back onto “the bank of Mum and Dad”. In the 2000s the Tory brand became toxic; they haven’t done enough to reverse that.  Tactically they are in a bind too. They need to win back Ukippers with sour policies on Britain’s international role and immigrants – while at the same time as appealing to more optimistic, liberal voters. I just can’t see a breakout. Their only hope of a breakthrough comes from the collective weakness of everybody else – which remains possible.

How about Labour? They have the opposite problem. They are much more in tune with the popular zeitgeist. They understand a lot of what people feel is wrong about society. But their narrative is chaotic. They look like a coalition of grumpy protest groups rather than a coherent government in waiting. I am reminded a little of Labour under Jim Callaghan in 1979: when they try to make a clear stand on a policy, one of their number undermines it. Tough on immigration? Protests from London MPs. Stop any serious reform of the NHS (which they call “saving” it) – yes one moment, no the next. The current awkwardness is on a promise to reduce university tuition fees. They want a headline policy to whack the coalition with (especially to consolidate former Lib Dem voters) – but how to do so without damaging universities or giving a gift just to the richer students? It seems as if the party has lost the discipline of the New Labour era. But the party does have some strengths – in particular an army of younger canvassers, especially in London, and probably the strongest central organisation of any UK political party.

Like the Tories, the main hope for Labour seems to be the weakness of others: the Lib Dems, the Greens, Ukip and the SNP. On the other hand, it is easier to foresee some sort of implosion by Labour than it is for the Tories. A public rift on economic policy could be the cause: the tension between their trade union backers and the more realistic parliamentarians is palpable. There is rather strange paradox here. Ed Miliband has kept the party together much better than expected over the last four years. But this has been achieved by placating rather than resolving the tensions within it. Which makes the unity and discipline less easy to achieve when it is most needed.

Which leaves the Lib Dems, in my review. Their fall has been dramatic. They commonly show up with a poll rating of just 7%, compared with the 23% they achieved in 2010. In many places they would do well to get 2-3%. But they have strongholds, and a strongly focused constituency-led campaign strategy is helping to limit the damage. They are helped by Ukip undermining the Conservative vote, though they seem to have fewer defences in the minority of seats where Labour is their main opponent. In terms of popular vote it is difficult to see the party falling much further – but there is a risk that their constituency-led strategy falls apart, and they are left with very few seats indeed. But they do have upside potential. Their hope is to be seen as a sensible, liberal party, with none of the extremist politics of Ukip or the Greens. The more Labour and the Conservatives move to the extremes to face the threat of Ukip in particular, the more appealing the Lib Dems might look. There is reason for them to hope that their poll ratings will rise – though this may make surprisingly little difference in terms of the number of seats that they lose. Indeed a surge in the polls might undermine the party discipline needed to make the constituency strategy work.

All of which leaves British politics in a predicament. An electoral system that used to practically guarantee a succession of stable single party governments, is now moving towards one that simultaneously disenfranchises most voters (by stranding them in seats where their vote makes no difference), while delivering a result from which it is hard to form a governing majority. And yet such is the conservatism of Britain’s politicians and public, that it is difficult to see any successful move to change it.

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Danny Alexander is the Lib Dems most successful minister. Why does he not get the credit?

Featured on Liberal Democrat Voice

The Liberal Democrat Treasury Secretary Danny Alexander’s placeDanny and George in history is assured. He is a member of the “quad” that sets the coalition government’s agenda, along with the Lib Dem Leader and Deputy Prime Minister Nick Clegg, the Prime Minister David Cameron and the Chancellor George Osborne (with whom he is pictured here). But recently there was a revealing kerfuffle, when the Lib Dems named their election “shadow cabinet” with him as the Treasury spokesman. Shouldn’t it be the more senior Vince Cable, people asked? Many Lib Dem activists fell for the bait and were suitably outraged. In fact this was a non-story – the shadow cabinet simply reflected current ministerial responsibilities with the gaps filled in. But if anybody had doubted Mr Alexander’s weak reputation, the response to the story proved it.

But more recently the highly respected Institute for Fiscal Studies (IFS) published a study of the effects of government policies on tax and benefits on people of different income bands. For the rare few voters who are interested in the facts of the coalition’s record this 30 page report is a fascinating read. The core of it is contained in this graphic:

IFS Graphic reducedWhat this shows is that the burden of the changes has fallen hardest on the top decile, but that every other decile has benefited from a reduced tax burden (i.e. the solid green bars), mainly the increase in income tax allowances. That, of course was the Lib Dem manifesto promise in a nutshell. Reductions in tax credits and benefits, however, have hit the poorer, so that as a proportion of income the overall effect on the bottom decile has been greater than the top (about 4% to 3%). The lucky 7th decile have suffered a net effect of nil. Further analysis shows that households with children have been hit the hardest, while even the poorest pensioner households have been protected:

IFS Graphic reduced 3

This represents a reversal of generous policies for families from the last government. If you take the whole sweep of policy since 1997 you get the following change:

IFS Graphic 2 reduced

Now this shows that the treatment of families overall lines up with that of pensioners – but that working age people without children have ended up with little net benefit. This may feel a bit harsh, but politicians have never suggested that their policies would do anything else. Pensioner and child poverty were the stated priorities.

And in case you are swept on by leftist rhetoric that these changes will be swamped by changes in income inequality before tax, a separate IFS study suggests that pre-tax income inequality has actually narrowed over the period of coalition. Put the two together and you get the picture of a government with a clear agenda to redress income imbalances. All this follows the policies Liberal Democrats advocated before the election.

The Treasury is also held responsible for managing the government’s overall finances, and Mr Alexander had a critical role in managing government expenditure. In 2010 the Conservatives promised to eliminate the structural government deficit in 5 years. Labour and the Liberal Democrats converged on about 8 years. Guess what? Though the coalition initially talked about the former target, it moderated when the economy struggled, and it is on course to follow the original Lib Dem (and Labour) target. Overall economic growth projections have disappointed the politicians, of course. But what, in Labour’s alternative strategy, could have led to a better overall outcome? They called for a softening of austerity and that’s exactly what the coalition did. Beyond some sound and fury over Keynesian stimulus, now irrelevant, Labour has had nothing to say about redressing weak productivity, the real reason for the lack of economic growth and real incomes. The scale of the deficit was such that it was always going to be hard going.

So Mr Alexander has, in spite of his position as junior to one of the most powerful men in the Conservative party, delivered a government record that is much more similar to what the Lib Dems had planned than the Tories had (they had planned to be much easier on the rich). Quite a record.

How does that compare with other Lib Dems? Poor old Mr Clegg’s political reforms have largely sunk without trace, and he also failed to spot the problematic NHS reforms quickly enough (as did Mr Cameron). Vince Cable was responsible for the reversal of Lib Dem policy on tuition fees, as well as the PR disaster of the Royal Mail flotation. Chris Huhne and Ed Davey battled valiantly at Energy but have had to give ground on nuclear power and fracking. Michael Moore and Alistair Carmichael at the Scottish Office have supervised a calamitous straining of the Union. All of these men, it should be added, have a string of positive achievements too, but they’ve been forced to compromise more than Mr Alexander has. There have been some impressive performers in the junior ranks (Steve Webb and Norman Lamb in particular), but their scope is inevitably narrow. Surely Mr Alexander is top of the heap?

So why are Lib Dem members reluctant to give him credit. First is a rather indifferent record on media interviews. He lacks a sense of ease and the ability to move away from pre-prepared sound-bites, unlike his Lib Dem cabinet colleagues. He doesn’t sound as if he is in command. He manages the detail rather than the big picture. And he sounds a bit Tory sometimes in the messages he gives.

But I don’t think that’s all. I don’t think that many Lib Dem members are at ease with the government’s record on tax and benefits. Those graphs in the IFS report show that the effects of increased tax allowances have not really helped the poorest, and that cuts to benefits and tax credits, especially to those with children, have squeezed the bottom half of the wealth distribution. There has been no offsetting increase in real incomes before tax. Labour have been energetically pointing all this out.

But given Lib Dem promises on tax allowances, on cutting the deficit, and on reforming pensions, cuts to benefits and tax credits were absolutely inevitable. The government has already gone after the richest 10% heavily, in increased taxes and, especially, a clampdown on tax avoidance (something with Mr Alexander has particularly championed). The only major budgets that haven’t been heavily squeezed are those for education and the NHS (foreign aid does not count as major), something Lib Dem members would support. Benefit cuts may not have been in flashing lights in the Lib Dems’ manifesto for 2010, but they might as well have been.

And this leads to a question that many Lib Dems would rather not think about. Just how much is it the state’s duty to top up low incomes with automatic entitlements to state benefits? And how much do such entitlements create dependency and a sense of victimhood from rich and poor alike? The great Liberal designer of the the welfare state, William Beveridge, was very worried about creating unconditional entitlements. Just what he would have made of the blank-cheque of the old Housing benefit we can only imagine. But modern leftist thinking takes such entitlements for granted, forever trying to raise the bar. But most of the public regards the idea of topping up incomes with taxpayers’ money with suspicion. It stinks of a freedom with other peoples’ money.

Personally, I think the expansion of automatic benefit entitlements  is a blind alley. Instead we need much more intelligent and directed interventions to help people cope with poverty, and manage their way out of it, if they want to. This needs to be done in a person-centred way that to tackles the underlying problems (housing, mental health, addiction and so on) head on, instead of paying people money to go away and keep quiet.

But that’s just my view. Meanwhile Mr Alexander has implemented a liberal agenda at the Treasury and deserves more credit than he gets.

 

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The Greens. All that was wrong with the Lib Dems. On steroids.

Featured on Liberal Democrat Voice

To me it was one of the surprises of 2010. As the Liberal DemocratsGreen_Party_of_England_and_Wales_logo.svg joined the Conservatives in coalition, and their popular support promptly crashed, why didn’t the Green Party benefit? Surely large numbers of the rather leftist, protest voters that were disillusioned with the Lib Dems would migrate there? But Green support hardly moved, while Labour surged. But now many more people are asking themselves whether they should vote Green in the forthcoming General Election. Should they?

The Greens have not been idle since 2010. Perhaps they too were surprised about their failure to draw in ex-Lib Dems. To people from a relative distance two changes are conspicuous. First they reformed their leadership structure so that they elected a single leader – rather than the confusing collective leadership they previously had; that leader is Natalie Bennett. Second they changed tack on policy to push their environmentalism back in favour of “social justice” – a concern about the distribution of wealth, the workings of capitalism, and so on. Now of the three main policy stances on their (English) website “Vote for real change” only one, and the third in the sequence, refers to environmental sustainability. The first is opposition to austerity, and the second is opposition to the privatization of public services. They have become more like a mainstream political party in sharpness of leadership and messaging.

Whether or not it is a result of these changes, the party’s fortunes have improved dramatically. Now they regularly poll more than the Lib Dems, whom they beat in the European elections in 2014. They received a boost when the Prime Minister, David Cameron, insisted that they be included in the proposed leaders’ debates at the General Election. That boosted publicity and their membership has surged to 50,000, more than the Lib Dems. Their support amongst younger voters is striking.

This attention has not been entirely welcome. Their policy of a Citizens Income came under particular scrutiny and promptly fell apart, when it appeared to hit the poorest hardest. Incidentally that link (to the Guardian) has my favorite picture of the new Green  party – which I haven’t published on this page because of copyright.

It is very tempting for members of other political parties to sneer at the Greens. Their chaotic policies; Ms Bennett’s Antipodean accent; the alleged misfortunes Brighton council, which they control. That would be a mistake. As a Lib Dem  I have endured a life-time of sneering and it hasn’t changed my mind. The Greens attract support from those disillusioned with modern politics – sneering from the sidelines just reinforces that disillusionment. But voting should be a serious business; we should expect anybody asking for our vote to make sense. and here I struggle with the Greens.

Two experiences over the last year have turned me against them. The first was a computer graphic of an election poster. Unfortunately I didn’t bookmark it, and I can’t find it, so I can’t reproduce it here. It promised everything. Growth; reversal of austerity; sustainability – and more things besides. There was no inkling of hard choices. The second was hearing a radio interview with Ms Bennett. She dripped with smugness; she had pat answers to everything. When asked if the Greens would go into coalition, she said no. They weren’t interested in ministerial cars; they would enter a confidence and supply agreement. This, of course, was an attack on the Lib Dems’ readiness to enter a coalition. It’s also utter nonsense. The British government has huge executive powers, and parliamentary controls aren’t strong. The Greens would have far more scope to change things if they had ministers. Ms Bennett clearly didn’t want the responsibility that would entail.

So what? That poster disappeared without trace. Ms Bennett is just one person. The Greens’ MP, Caroline Lucas, is much more impressive. But these things foreshadow something bigger, and a visit to the Greens’ website does not reassure me. The party just doesn’t seem to be interested in making serious choices. They just want a good whinge.

To illustrate let’s look at their “mini manifesto” Real Choices. After the introductory page it starts off well enough with a page on the environment and climate change. It firmly states a commitment to reducing the use fossil fuels, rejection of nuclear power and replacement with renewables – plus some stuff about protecting the environment more generally. This is what most people think the Greens are about. Some may say it as impractical – especially the rejection of nuclear power – but I  forgive them for that. If you feel strongly that climate change is the biggest challenge facing man on this planet, then this is a perfectly respectable line to take. And so is scepticism of nuclear power. But it involves hard choices.

Which is where we run into problems. The next two pages “Building a fairer society” and “Health and education – free for everyone” move into the party’s new agenda. No to austerity – investing in a low carbon future instead; raising the minimum wage; more affordable housing; more welfare spending; bash bankers some more; stop outsourcing health services; scrap university tuition fees;protect pay and conditions of health and education professionals; stop the Academy programme for schools.  Leave aside the “oppose austerity” bit and individually there is something to be said for each of these policies; some even look sensible (the bit on affordable housing, and a low carbon future). But together they are comically incoherent. The “oppose austerity” says it all. You might think that an environmentalist party would understand that resources are limited. If there is to be a serious drive to invest in low carbon projects, while also preserving bloat in the health and education services so as not to upset their employees, then surely something, somewhere has to give. There is going to be austerity somewhere. Austerity is about ensuring that the state is financially sustainable. Pah! say the Greens.

The next couple of pages carry on in the same vein. Energy – permanently lower bills. Here the party tries to show that its energy policies won’t mean higher bills – insulation will square the circle.  And Transport – cheaper and cleaner. Apparently by nationalizing public transport and cancelling the HS2 railway project, public transport is going to be cleaner and better.

All this leads me to a very painful reflection. I am reminded of something by this incoherent set of protest responses. The Liberal Democrats. Especially the Lib Dems under its previous leader, Charles Kennedy, and its manifesto for the 2005 General Election, the party’s most successful. The present leader, Nick Clegg, reined things in a bit, but was left with policies like the abolition of tuition fees. This proved successful politics for a while, but in 2010 the party bumped into a glass ceiling. Early in that campaign the Lib Dems surged. And then the voters looked a bit harder. And they saw a party of protest and not one of government. The surge collapsed.

Ironically the public was wrong. Against expectations the Lib Dems entered government and proved more than ready for it. But they had to ditch the protest policies and the protest voters, and added to a public disillusionment with politicians.

The Green Party now is the old Lib Dems on steroids, but without the underlying ability to deliver effective government policies. As a voter that should give you pause.

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The SNP are on manoeuvres. Westminster politicians should be afraid.

Scottish politics is an exercise in asymmetric warfare. The Scottish Nicola SturgeonNational Party (SNP) are steeped in the nation’s own political culture, and focus on their objective of obtaining its independence. The unionist parties are more concerned with the politics of UK as a whole, and push their policies concerning Scotland and the Union into the “too difficult” pile until too late. This has been stark in the last few years. The SNP won their referendum on independence (i.e. holding the referendum, rather than the outcome, which they lost). At first Westminster politicians did not take the campaign seriously, relying on comforting opinion polls. Then, as the No campaign went awry and they woke up to the implications, they panicked. The main party leaders made an ill-thought through pledge (referred to as “The Vow”) on devolving more powers. When the referendum was over, the main party leaders could only see the issue in terms of their own struggles for supremacy in Westminster. The Conservative sought to embarrass Labour with a call for “English votes for English laws”. Labour called for a Constitutional Convention to head this off, but offered no vision of how the thought the union should be run. The SNP are now about to make both parties pay dearly for their negligence.

The SNP lost their referendum, but far from being depressed and demoralised, they have treated the affair as a sort of reconnaissance in force preliminary to a longer campaign. They have made a sharp change in strategy. First their long-standing leader, and Scottish First Minister, Alec Salmond  stepped down, to be replaced by his very capable and popular deputy Nicola Sturgeon. Then Mr Salmond said that he would stand for the Westminster parliament in the May election, meaning that Westminster would have one of the party’s biggest hitters. Then yesterday Ms Sturgeon dropped a bombshell. She said that the SNP at Westminster would happily vote on the English NHS. Until now the SNP at Westminster have stayed clear on voting on matters, like the NHS, which have been devolved to the Scottish parliament. The reason offered is that Scotland’s funding formula (“the Barnett formula”) means that their funding might be affected by England’s health policies. There is practically no aspect of devolved policy that this argument could not be applied to. The SNP are now offering themselves as a fully fledged coalition partner to the Labour Party, should the latter fail to win an outright majority. The three main Westminster Parties hadn’t seen this coming, and they are in utter disarray.

For Labour this is unmitigated disaster. The SNP’s sudden interest in Westminster politics makes a large number of their MPs in Scottish seats vulnerable. The current polling is awful; the party could lose 30 seats. Labour has taken Scots voters for granted ever since the Conservatives’ Scottish presence collapsed under Mrs Thatcher. Their ineptitude was on full display during the No campaign. They have no idea how to construct a persuasive, coherent message and stick to it: their preferred method is just crude menace.  Their campaign message so far is to threaten Scots voters with another Tory-led government. “Don’t worry,” say the SNP “if you vote for us instead we can stop the Tories too.” Labour are left with just emptiness in return. They have no vision of Scotland’s place in the union beyond panicky responses to nationalist pressure.

Intelligent Tories (there are some) should be troubled too. The purpose behind the “English votes for English laws” idea was simply to embarrass Labour in England by pointing out how much they depended on blocks of Scots and Welsh MPs. There is no coherent, workable model of a well-functioning UK constitution behind it. But it carries the risk of destabilising the Union by stoking up English resentment without offering an answer. The SNP have just made that much worse. What about the fate of England’s NHS being dictated by SNP MPs? Conservatives (mainly) support the Union. Scottish independence would be seen as national humiliation and a bitter blow. And yet they are playing into the nationalists’ hands.

Things aren’t much better for the Liberal Democrats. Their main problem is political weakness, resulting from a backlash for going into coalition with the Conservatives. This is at least as strong in Scotland as it is elsewhere in the UK. The party has thought through its vision of the UK constitution more than the other parties, and its solutions are much more robust. But its softly-softly approach to devolution within England, and rejection of the idea of an English Parliament and government, look constructed for a gentler pace of politics than is in prospect if the SNP do well. Still there are some silver linings to the very dark clouds. Labour are retreating from seats they were hoping to take from the Lib Dems, in order to face off the SNP in their own backyard. And Christine Jardine, their feisty candidate in Gordon, the seat Mr Salmond hopes to win, will be no pushover, as she rallies the anti-SNP vote.

But each of the main unionist parties need to take a step back, and form coherent ideas on how the constitution of the Union should look. It isn’t enough to call for a Constitutional Convention; each party must spell out a clear vision that looks sustainable in the face of mischief-making by the SNP. Even if such ideas have short-term political costs. The people of this United Kingdom deserve no less.

 

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We need to talk about the NHS but our political culture prevents it.

Many Britons complain that political correctness stops important issues being talked about. By that they usually mean immigration and cultural integration. Now we talk about these things all the time, and we are coming to understand why that culture of political correctness was a good idea. Pointless, nasty behaviour to immigrants and people from ethnic minorities is on the rise, while yet more rubble is strewn in the path of necessary economic development. But there are issues that are important but where there is a conspiracy of silence. Foremost amongst these is Britain’s National Health Service (NHS). This is not a good idea.

Well it isn’t that politicians don’t talk about the NHS. It has become a central theme of Labour’s election campaign, and the Green party, in their bid to harvest left-leaning voters, have jumped in too. But these campaigns challenge the very idea that the NHS should be reformed. Any suggestion that elements of the NHS should be run by private businesses, or that a local facility should be closed, is attacked virulently. The idea behind these campaigns is that the NHS is under attack, is being “sold off”, and needs to saved by a government that will let our heroic doctors, nurses and ambulancemen get on with their jobs unmolested by rapacious hedge fund managers and bankers. The government’s response to these challenges is distinctly muted – they try to deny that much is changing at all, and point out that they are recruiting more these wonderful doctors and nurses and keeping the money flowing.

But senior NHS professionals are worried. Today it is the turn of Professor Sir Bruce Keogh, NHS England’s medical director, to speak out. He warns that without major changes to the way care is carried out the service will collapse. That means that many existing facilities will have to be cut in order to make room for more cost-effective ways of treating illness which do not involve big hospitals. You don’t have accept Sir Bruce’s prescription to understand the nature of the threat.

The first problem is demographics. The proportion of elderly people in Britain is on the rise. This is increasing the number of patients, and presenting the service with more complex cases that it is difficult to deal with adequately. It is also undermining the tax base from which the NHS is funded and the pool of workers that the NHS needs to recruit. The next problem is a change to the economics. More advanced and effective treatments cost more money. Rates of pay, especially for skilled staff, are getting higher.

These problems are well understood, even if politicians and public alike would rather talk about their implications another day. There is a third problem too. And that is management. Dealing with health issues is a very complex matter, and it is becoming clearer that the way we try to go about it isn’t really helping. Our default method is to break the task down into a series of specialisms and give each a separate autonomous organisation. Primary care is split from acute hospitals which are separate from social care, with mental health handled by yet another set of organisations. But all these things interrelate, and good patient care depends on getting the coordination right. For example the current NHS crisis in hospitals is presented as overflow in Accident & Emergency, but it has its roots in the inability to move older patients into more appropriate social care settings when the acute phase of their illness is over.

I am very familiar with this type of management problem, albeit in much simpler contexts. It was the focus in the 1990s of a management revolution that went under the name of Business Process Reengineering.  The key insight here is that one of the main obstacles is the shape of the organisation itself. Pouring more resources into it won’t help, or not help by much. If you fix a problem in one area, it simply pops up in another. That means that the shape and structure of health care has to change in order to cope with the extra pressures being thrown at it.  That in turn means politically sensitive closures and, almost certainly moves that can be described as sell-offs. It is worth pointing out, though, that simply outsourcing an element of the service without restructuring the way care is delivered is just as fallacious as pouring extra funds into existing structures. This is a point that some on the right, and in government, have not grasped.

I think this is reasonably clear; there may even be consensus about it amongst those that try to look beyond the short-term politics. But the fog then starts to descend. The problem is highly complicated, and the costs to failure very high. The way forward is not obvious. Both this government and the preceding Labour one grappled with it. Both got some things right; both have made mistakes. But it is a debate amongst a small elite of policy wonks and senior professionals, when broader engagement, to prepare  the political ground, is what is required.

Is the basic model of the NHS under threat? This is an open-ended commitment by the taxpayer to fund health care for all citizens. This has some obvious problems – there is no clear way to limit demand. Health care, it turns out, is not like the drains, where once you have fixed the basics, people forget they are there. That was what some people thought when the NHS was set up. People don’t like getting ill, so, said the optimists, that would limit demand. Alas longer life and reduced pain are consumer propositions to die for; potential demand seems endless.

This is the key to a further insight which few seem to have grasped. People often talk of high levels of health care spending being unaffordable. This is untrue. People prize healthcare above many other things, and are happy to give up these other things for less pain and a longer life. You only have to look at the enormous sums spent in the USA on health care to understand that. The problem is how, exactly, do you get the money from people’s pockets and into that of health service providers. The critical question for the future of the NHS is how much more can be raised through taxation.

Which is another area that we should all be thinking about. Could we raise a lot more through taxes if the process was more transparent and people had more confidence in it? Or should the NHS start charging for more things? Should we develop a model of “basic cover” vs “luxury cover”, and bill for the latter? And what could the latter include (anti-cancer drugs that might prolong life but aren’t deemed cost effective?). And that leads to another series of questions we would rather not ask, about the meaning of life and death.

And there’s a further problem. How much do we focus resources on where the demand is currently, or and how much to where we think the areas of greatest need are. The last government talked often of rectifying “health inequalities”, and started a process of shifting resources to poorer areas with worse health outcomes. That put facilities in areas with high current demand, but less actual poverty, under pressure. Most of the NHS’s big disasters, like the failure of Mid-Staffordshire Trust, occurred in areas that had high demand, especially from elderly residents, but which were not classed as being in poverty.

If we don’t fix the NHS, a parallel private health system will build up beside it and undermine it. Something like this has already happened with dentistry. We have little chance of a serious, mature political discussion this side of a General Election. But the sooner that the public demands their politicians address such issues the better. Rejecting the facile slogans of Labour and the Greens would be a good start.

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Charlie Hebdo – time for cosmopolitans to show leadership

As the dust settles from the Charlie Hebdo shootings in Paris, an ugly picture emerges. The consensus that holds society together is breaking down. We may all agree that murder is wrong, but we disagree on how to combat extremists, how to live with foreign cultures and, indeed, the scope of free speech. The cosmopolitanism that prevails amongst society’s elite is challenged. And yet the only solution is to embrace cosmopolitan ideas yet further.

On the one hand we have the Islamic extremists themselves. We haven’t learnt much new here. Their alienation is such that they feel at war with western (and not just western) states, and they have ceased to see their opponents as human beings. The Paris assailants drew a distinction between “civilians”, whom they should not attack, and others, including journalists and Jews, whom it was OK to kill. This will no doubt aid the process of self-justification in their own circles – but the contradictions are too obvious to everybody else. The extremists appear to have momentum, especially led by the success of the Islamic State in Syria and Iraq. But their attacks, and their revelling in the power of life and death, should alienate them from the rest of society, outside the failed states in the Middle East and Africa.

We could take comfort from that if it wasn’t for dark forces working within the rest of society. Foremost amongst these is the rise of nativism in Europe and America. Nativists are intensely suspicious of any foreigners in their land. As we come to the end of the era of easy economic growth, and as technology destroys swathes of stable, clerical and factory jobs, faith in the idea of progress wanes. Nativists hark back to an earlier age that seemed simpler. They blame immigration for its undermining. Islamic immigrants have become a particular focus of suspicion. Ideas of a clash of civilisations, even a war, take currency. Nativism seems particularly strong in places with small immigrant communities, such as Clacton in England or, on an altogether larger scale, Dresden in Germany. But large, unintegrated ethnic minority communities provoke similar fears in neighbouring communities too. This accounts for the rise of perhaps the most important nativist movement: the National Front in France.

In Britain the rise of nativism is led by Ukip. Originally  Ukip focused on Britain’s membership of the European Union, but it struck electoral gold when it shifted to opposition to immigration. The mainstream Conservative and Labour parties started to panic as Ukip ate into their core support, giving nativism further impetus. Tabloid newspapers stirred things up. As a result public attitudes to ethnic minorities have soured in much of the country. The idea of “freedom of speech” is now used to defend the open expression of Islamophobic views – though the idea that such freedoms should extend to the expression of Islamist or anti-Semitic views is not aired.  The outcry of the Charlie Hebdo killings has given such nativists and their prejudices a real fillip.

Which makes matters worse. The entire Islamic community finds itself under attack. People say that all Muslims are to blame for extremists, and should apologise for them. Now the Muslim communities must face up to some important questions about how they are to progress and integrate into a modern world – questions that many are reluctant to confront. But ignorant prejudice serves only to alienate them, and prolong the sense of grievance on which the extremists feed.

And so we face the prospect of an unravelling.  Globalisation is integral to the western way of life. Just think of the rise of the British Empire and the cities that have been built on the back of the African slave trade in the 18th Century if you think it is anything recent. Large immigrant communities are simply a continuation of that process, in an actually much more benign way. Denying globalisation is as futile as Britons denying that their country is European. Nativism is a road to nowhere, or rather a road to poverty and conflict.

Instead we must embrace the values of cosmopolitanism. These are articulated most clearly by the Ghanaian-born author Kwame Anthony Appiah (as in Cosmopolitanism – Ethics in a world of Strangers). We must accept that our culture is the product of many cultures melding together in a process that has being going on for millennia, and which is destined to continue. There is no such thing as cultural purity, and no point in trying to defend it. This is not the same as relativism, which backs away from defining any kind of right or wrong ethical values. It means embracing ethical values which accept that all the globe’s inhabitants are part of an “us”, even though we recognise stronger affinities with some rather than others. People of different cultures should enter conversations with each other, and accept that their outlooks may change as a result.

Cosmopolitanism has always been embraced by elites, especially in the west after the nightmare of Fascism, which showed the futility of its opposite. That accounts for the many cosmopolitan aspects of our institutions. But now it is vital that it is taken up by all of society: amongst working class communities and ethnic minorities too. Here in London, perhaps, this process is quite well advanced, though hardly complete (I’m afraid that Islamophobic attitudes remain commonplace). Different communities are forced to mingle. We go to school together; we work together; increasingly we have children together. Elsewhere, though, we have just taken a backward step.

But I remain hopeful. The young are more cosmopolitan than their elders. Our cultural and business leaders, by and large, remain firm. At a time when elites are under attack for being out of touch, it is time for them do what elites should: to show leadership.

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Cameron lets the cat out of the bag. The election isn’t a two-party contest

Last night David Cameron, Prime Minster and Conservative Party leader, announced that he would not take part in the proposed leadership debates this year’s UK General Election. Or rather, he wouldn’t unless the Green Party was also invited alongside Labour, Lib Dems and Ukip. This was after Ofcom, the media regulator, suggested that the Greens were not a major party, but that Ukip and the Lib Dems were.

In the petty tactical thinking that so dominates thinking amongst Westminster’s political elite, it is easy to understand Mr Cameron’s move. Two birds can be killed with one stone. First the Greens have emerged as a thorn in Labour’s side, as they are promoting an unambiguously leftist policy platform, and also attract Lib Dem defectors, who are central to Labour’s electoral strategy.  They do not trouble potential Tory voters though. The second aim is that Mr Cameron is not much interested in taking part in the debates anyway. These debates were an innovation in 2010, and greatly expanded political engagement, especially amongst younger voters. But the conventional Tory wisdom were that they were a mistake, assisting the Lib Dems at their expense. And this time Mr Cameron has more to lose than gain. Especially if Labour’s Ed Miliband turns out to be much less of clump than the Tories are portraying him to be.

The announcement was also an opportunity for Mr Cameron to sneer at his coalition partners, the Lib Dems. His claim for the Greens to be a major party was that the Greens beat the Lib Dems in last year’s European elections. But the Lib Dems have 57 seats and record in government to defend, compared to the Greens’ single seat. Mr Cameron’s voice dripped in sneering condescension in a way that only upper class Brits can do.

But it’s a strategic mistake, for all that. Along with the Labour party, the Tories claim that they are the only parties that matter in the election. Electors must choose between these two; everybody else is a waste of time. They dream that a few days before the election, electors will come to their senses and return to voting for the two establishment parties. But now Mr Cameron has painted a picture of a multiparty leadership debate, rather like those we saw on the Danish TV series Borgen. Yet this idea is toxic to the two-party vision. If he had said that he would only debate with Mr Miliband, it would have had strategic value.

All of which reinforces a general sense of Mr Cameron’s weakness as a prime minister. Too clever for his own good. Ever after gaining a tactical advantage, but with no idea of his, or his country’s, strategic interests.

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Good and bad news about the Lib Dems NHS funding pledge

Today the Liberal Democrats announced and eye catching policy toNHS improve NHS funding by £8bn a year by 2020 (in England).  This matches the figure asked for by NHS England chief Simon Stevens – so it isn’t plucked from thin air.

How is this to be paid for? First £2bn extra is already planned and accepted by the other parties (Labour want to add another £0.5bn). A further £1bn comes from more taxes on the wealthy. The rest will be gradually added as the economy grows. The Lib Dems say that public expenditure should keep pace with national income.

There are good and bad things about this new policy. First the good thing. The £8bn funding figure is entirely credible, given the direction of demographics. Mr Stevens is no lefty. He knows that the NHS can be more efficient and has plans to make it so. But that only gets you so far. Any party that promises to keep the NHS within its current scope and free has to address this gap. This moves, or should move, the debate on the NHS out of the area of gimmicks and into serious choices.

Except that it doesn’t. They’ve made the whole thing look to easy. Tax some other people a bit more and the rest comes from growth. If it’s that easy the other parties can do it too. This is not different in substance to what Labour are offering. It is more of a challenge to the Tories who want to use the proceeds of growth to fund tax cuts.

And growth cannot be guaranteed. There are severe economic headwinds, from demographics, from changes to technology, from changes to world trade – to name but three. To say nothing of the legacy of piles of household and state debt.

To be distinctive, the Lib Dems needed to make it look harder. Which in practice means raising taxes – income tax, national insurance or VAT. Remember Paddy Ashdown’s promise of 1p income tax for education?  This would have made the promise more credible, and got a real debate going.  It would then be Labour who would be forced to mutter promises about future growth, which the public are likely to discount.

Instead this looks like another politician’s promise that is less than it seems. What a pity.

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The Lib dems – successful in government, unrewarded by the public

2015 is here at last. For British politicos this is the  endgame – the year of the General Election and the verdict on the politicking of the current parliament, elected in 2010. That election remains very open, but for the Liberal Democrats it is fair to say that things have gone disastrously off script.

The party languishes at 5-10% in the polls, compared to the over 20% it achieved in 2010. This has shown no sign of improving as the election approaches, and there have been plenty of real life elections to show that such dismal ratings are not just inaccurate polling.

This follows the party’s entry into coalition government in 2010, a ground-breaking event both for the party and for British politics. This government has been pretty successful all told. It inherited an utterly unsustainable government deficit that demanded cuts to both public services and benefits – “austerity”. It struck a fairly prudent course between extreme austerity, and using the relative ease of government borrowing to postpone the pain. For all the political sound and fury over the sense or otherwise of such austerity, there has been little difference between the main political parties on its scale.

There have been failures. Benefits had to be cut, but many of the reforms to the benefits system were misconceived.  The centrepiece reform of Universal Credit might be a nice idea in theory, but its dependence on unobtainable real-time data make its demise only a matter of time. Many attempts to sub-contract government services to the private sector have proved misconceived too. Reforms to the NHS were well-intentioned but it would surely have been more sensible to build on the previous government’s reforms incrementally. Reforms to immigration were popular but unhelpful to the nation’s economic and social health.

But there have been many sensible reforms along the way. A lot of bureaucratic over-engineering from the last government was dismantled. The management of schools is more sharply focused, with a welcome emphasis on the progress of pupils from more challenging backgrounds – and a search for performance measures that can be gamed less easily. Reforms to university finance have improved accountability and spread the financial burden more fairly. The burden of taxation has been shifted to a more progressive and redistributive pattern, not least with a spectacular crackdown on tax avoidance by the very rich. This has helped stem a rise in inequality – though I don’t think the statistics are conclusive as to whether inequality has actually been held in check. overall.

Many (or even most) of these sensible reforms have Liberal Democrat fingerprints on them. The party has proved good at the exigencies of being a governing party – including the discipline of its parliamentarians. A lot of small scale policies have been implemented that Lib Dems have spent years campaigning for (like being able to declare pubs as community assets). Previously characterised as being chaotic lightweights, Liberal Democrats have proved to be up to the job.

There have been major disappointments for Lib Dems in the area of political reform. A referendum on changing the voting system to the Alternative Vote just gave an opportunity for the rest of the political establishment to gang up on the party. Plans for an elected second chamber collapsed in the face of hostility and indifference from Conservative and Labour politicians. Ironically these disappointments may help the party’s fortunes. With the current state of public opinion AV might well have  helped the Conservatives and Labour more than the Lib Dems, allowing them to scoop up Ukip and Green votes. And the strong presence of Lib Dems in the House of Lords immeasurably adds to the party’s heft in any negotiations in a hung parliament – something the SNP, for example, cannot offer. In the PR elections the party wanted for the Lords (or rather, its replacement), it would almost certainly have been nearly wiped out, and surely behind Ukip, the SNP and perhaps even the Greens.

But Lib Dems had expected better rewards from the electorate. It is commonplace for governing parties to lose popularity in the middle of a parliament, but then they are meant to recover. The Liberal Democrats hoped to present themselves to the electorate as a credible coalition party, firmly rooted in the political centre – having put to rest any doubts that it was incapable of achieving practical political power.  Even as Labour and the Conservatives seem to be vacating the political centre, few centrist voters see the Lib Dems as a respectable alternative.

What went wrong? The first problem is that the party has disappointed many of its supporters. In 2010 (and earlier General Elections, come to that), the party set itself up as standing for a new brand of politics – and a break from the lies and cynicism of the other parties. But what the public saw was just another established party wheeler-dealing like the rest of them, and enjoying the prestige of ministerial office. Reforms to university finance may have been an elegant compromise in practice, but it involved reneging on a very categorical election pledge.

A further problem is that many of the party’s supporters were Labour defectors, who saw teaming up with the Conservatives as betrayal. The impact of austerity and reforms to the benefits system and the NHS hardly reassured these voters. That the party was in practice no worse than Labour wasn’t really the point; they hoped for better. The Tory brand remains as toxic as ever.

But all is not lost. The party has upped its game in the seats it holds, and constituency polls show that its candidates there are much more popular locally than the party itself. And their opponents are distracted by the need to keep Ukip, the SNP and the Greens at bay. The public may yet give the party more credit, especially if it gets its messaging right. The liberal centre is not close-fought territory – it is notable that activists have never found the alternative parties less appealing than now.

But a job needs to be done to define better what the party stands for, and communicate this to the public. The party is confident of its core liberal values, but these are not producing sharp, distinctive policies for the more practical issues that bother voters – the economy and the NHS in particular. That’s a shame because some interesting thinking has come up through the party’s policy making machinery – but these ideas need to be turned into something much sharper. This week has not been particularly encouraging. The party has joined in the excessively negative slagging off of other parties – as have all the other parties, mainstream and fringe. Wouldn’t it be better to set out a stall of distinctive policies, on the economy, taxation, the environment and public service – and damn the other parties with faint praise? The public get that small parties can make a difference in coalition – but they need a better idea of what that difference might be in the case of the Lib Dems.

The party has to go through the final act of its years in coalition, and endure the outcome. After that though, the party needs a period of deep reflection, whether or not it re-enters government. But the country does need a liberal party, and there are no others challenging for that space.

 

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