Labour can no longer pose as the party of the NHS

Published by The Guardian (21st April, 2015)

There are many strange things about this election struggle. Labour poses as the party of fiscal probity; the Conservatives say they are saviours of the working class; the Greens claim their extreme profligacy is fully funded; and Ukip argue their manifesto makes sense. Nick Clegg has campaigned well, yet his party seems to be dissolving, while overshadowing everything is a Scot who is not even standing.

Then there is the health debate – or rather, the lack of a health debate. Usually this is a key battleground – the most important issue for voters, finds Ipsos Mori. Yet the Tories seem terrified to talk about this subject, despite a surprisingly strong case that could tackle a central brand defect – allowing Labour to go unchallenged on claims they alone can protect this precious service. Such claims are based on history, not facts.

Labour may have created the NHS seven decades ago, but its recent record is ropey. Yes, the party deserves credit under Tony Blair for pumping in cash to a service gasping for resources, but many problems that have stretched services and jeopardised patient care can be traced back to their 13 years in office.

Take the disastrous contract for GPs, pouring cash into their pockets yet allowing most to abandon emergency cover – a key driver of pressures on A&E, since almost a quarter of unplanned attendances are patients unable to see family doctors. Or the money-saving merger of three disparate regulators into one mega-watchdog, the Care Quality Commission (CQC), which then concentrated on registering dentists while scaling back the safeguarding of patients in care homes and hospitals. In addition, £10bn was blown on Blair’s vainglorious computer project, and billions more on Gordon Brown’s wasteful private finance initiative schemes.

And then there was the imposition of a target culture that saw the number of managers almost double under Labour, their pay rising far faster than that of nurses, while services were distorted to meet Whitehall’s benchmarks. The legacy of such blunders was fat cat bosses, along with sordid care failures and cover-ups in two Mid Staffordshire hospitals, the Morecambe Bay maternity unit and the Winterbourne View care home. The victims, as usual, were the most vulnerable: newborn babies, elderly patients and people with learning difficulties.

Labour argues that the NHS is only safe in their stained hands. Its health spokesman, Andy Burnham, deserves plaudits for his Hillsborough campaigning, but he is also the man who, in office, colluded with the health establishment to resist calls for a public inquiry into events at Mid Staffordshire, the worst patient-care scandal in recent times. This will not be forgotten by those brave people who battled the system to expose dreadful incidents there – yet still he defends his actions.

These cases symbolised the failure to focus on safety. Indeed, Labour was so set on keeping hospital chiefs happy rather than protecting patients that it placed both the English NHS and the CQC in the hands of managers indelibly linked to the Mid Staffs scandal. Thankfully, both have since been ousted – although it was depressing to hear one of them, Sir David Nicholson, lecturing the nation on how to save the NHS last week.

Now Burnham bangs on about the perils of privatisation  – although most was unleashed by his own party, it can improve patient care, and is commonplace across European services, which often have better patient outcomes. He condemns the botched Tory health reforms that deceived voters and caused disruption – but Labour plans to rip them up just as they bed down in what the King’s Fund think tank warns will be more distracting structural changes. This is not what the NHS nor its staff need right now.

It was the Conservatives who oversaw a belated emphasis on safety after Jeremy Hunt took over as health secretary with 8,000 extra hospital nurses hired, many bad managers dismissed and 22 poorly performing hospitals put into special measures. And in this topsy-turvy election, Labour is now outgunned on health spending as the Tories pledge £8bn to meet the blueprint of Nicholson’s successor as NHS chief. Labour promises the proceeds of its mansion tax stunt, which will raise little and offers no solution to the cash crunch.

On social care the Tories deserve criticism for overloading public spending cuts on local authorities, with often dire consequences for elderly and disabled people. Yet even here the King’s Fund has praised them. ‘Arguably, the coalition has made more progress in five years than the previous government did in 13,’ said Richard Humphries, its social care spokesman, applauding the most comprehensive overhaul of legislation in this area since 1948.

The NHS struggles with a soaring number of patients in our ageing and swelling population – yet dissatisfaction is, remarkably, at an all-time low. There is no room for complacency given the huge financial questions and the continuing need to shift care into the community – and when avoidable death rates remain high, vulnerable patients are routinely mistreated, and Britain lags behind other rich nations on many indicators from cancer survival to under-fives mortality. So please ditch the corrosive delusion that we possess the world’s finest health system.

The NHS does not need ‘weaponising’ by politicians. But the Tories’ timidity on this issue is bizarre given the electoral deadlock, their perceived weakness on public services, and – according to YouGov – Labour’s 16-point lead on health. The Conservatives have a positive story to sell voters; they should not remain silent as Labour makes spurious claims to still be the party of the NHS.

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