Books of the year 2011: David Marquand

River of Smoke - Amitav Ghosh


This year, I have been extraordinarily fortunate: two fantastic books have come my way, both destined, I believe, to become classics. The first is Amitav Ghosh's River of Smoke (John Murray, £20). It is a sequel to his Sea of Poppies but can be read on its own. It is a wonderfully rich and subtle novel, skilfully written and mordantly plotted, and telling the story of a Canton-based Parsee opium dealer on the eve of the first opium war. Nothing I have read brings home more forcefully the evil of British imperialism in that era.

The second great book is Norman Davies's Vanished Kingdoms (Allen Lane, £30), a monumental history of 15 European realms, from the Visigoth kingdom of Tolosa in the 5th and 6th centuries to the Soviet Union in the 20th, all of which have disappeared from cartographic ken, and some from human memory. Vanished Kingdoms is great history and also great art. It is written with verve, passion and profound empathy. No one who cares for the past of our continent should fail to read it.

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Is anyone prepared to solve the NHS funding crisis?

As long as the political taboo on raising taxes endures, the service will be in financial peril. 

It has long been clear that the NHS is in financial ill-health. But today's figures, conveniently delayed until after the Conservative conference, are still stunningly bad. The service ran a deficit of £930m between April and June (greater than the £820m recorded for the whole of the 2014/15 financial year) and is on course for a shortfall of at least £2bn this year - its worst position for a generation. 

Though often described as having been shielded from austerity, owing to its ring-fenced budget, the NHS is enduring the toughest spending settlement in its history. Since 1950, health spending has grown at an average annual rate of 4 per cent, but over the last parliament it rose by just 0.5 per cent. An ageing population, rising treatment costs and the social care crisis all mean that the NHS has to run merely to stand still. The Tories have pledged to provide £10bn more for the service but this still leaves £20bn of efficiency savings required. 

Speculation is now turning to whether George Osborne will provide an emergency injection of funds in the Autumn Statement on 25 November. But the long-term question is whether anyone is prepared to offer a sustainable solution to the crisis. Health experts argue that only a rise in general taxation (income tax, VAT, national insurance), patient charges or a hypothecated "health tax" will secure the future of a universal, high-quality service. But the political taboo against increasing taxes on all but the richest means no politician has ventured into this territory. Shadow health secretary Heidi Alexander has today called for the government to "find money urgently to get through the coming winter months". But the bigger question is whether, under Jeremy Corbyn, Labour is prepared to go beyond sticking-plaster solutions. 

George Eaton is political editor of the New Statesman.