It was Aneurin Bevan's aim in setting up the National Health Service - as opposed to a series of publicly financed but locally controlled services - that hospitals and GPs should concern the highest levels of government. When a bedpan was dropped in a hospital anywhere in the country, he said, the echoes should be heard around Westminster and Whitehall. Only in that way, he thought, was it possible to "generalise the best" (a logical absurdity, as it happens, but, like many logical absurdities, a good political sound-bite).
Here, as in many other respects, new Labour is older than it cares to admit. It came to power with a firm promise to reduce hospital waiting lists. Now Alan Milburn, the new Health Secretary, sets new targets, without quite abandoning the old ones: the NHS will cure more cancers, carry out more heart operations, treat more mental health patients. Further, Mr Milburn is likely to carry forward with enthusiasm the new Labour mission to improve the delivery of public services through more targets, more monitoring, more inspection, more performance indicators. As Rudolf Klein, professor of social policy at Bath University, puts it in a forthcoming publication for the King's Fund, "if things go wrong, if standards are not achieved, if services fall short of expectations, there will be no ambiguity about who carries the blame: the Secretary of State". The same applies to education, for which Whitehall once took virtually no responsibility beyond providing money. David Blunkett, the present Secretary of State, has made the extraordinary promise that he will resign if children don't read well enough. In this sense, new Labour is not just Bevanite, but ultra-Bevanite.
Nobody should doubt the sincerity of the ministerial belief that improvements in public services are possible to achieve. But the question arises: what happens if they fail? The obvious answer is that they will perform the usual political mixture of fudging the figures, blaming someone else and hoping that the voters don't notice. But new Labour in nearly all areas of social policy - health, education, crime, transport - has raised expectations to such an extent that it will be hard pressed to pull off this trick, even if it wished to do so. Voters will look for tangible improvements, and opinion polls show signs that - at an earlier stage than might be thought reasonable - they are already becoming restless, and that only the improbability of the Conservatives doing any better keeps them from open revolt.
The most likely outcome, then, is that new Labour will be forced to face the question that it would prefer to avoid: the funding of public services. Harassed and increasingly sceptical public sector professionals will put this subject on the agenda even if nobody else does. How can we cure cancer, doctors will demand, if you don't give us the equipment? How can we teach children to read, teachers will say, if you don't give us books and paper? How can we provide the best medicine and the best education, the managers will ask, if we don't have the money to recruit the best doctors and teachers? In the past, governments could shrug all this off as public sector special pleading and mutter vaguely about excessive waste, but as ministers become more involved in the precise allocation of resources, this will become a more difficult position to sustain. A patient who had to wait for an operation while his neighbour went to the head of the queue would once accept this as a matter of clinical judgement. Now he will know that he has to wait because the government has given him and his illness a lower priority.
The fate of the public services will be new Labour's supreme test. The first great reforming government of the postwar era, the government of Attlee and Bevan, created among British people of all classes a firm attachment to the ideals of free schooling and free medicine. The second great reforming government, the government of Thatcher, Howe and Lawson, created an almost equal attachment to the ideal of low personal taxation. New Labour's mission is to square this circle, to reconcile the apparently irreconcilable. Its belief is that it can do so by improving public sector performance, by getting better value for money. If that view proves unfounded, the game is surely up and we shall know that, in this respect at least, there is no Third Way. Ministers will have to choose between higher taxation on the one hand and some form of charging for schooling and healthcare on the other. For Alan Milburn, and for David Blunkett, the stakes are as high as that.
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