What Brown could learn from Blair

Breakfast with the prime minister plus how not to question Tony Blair...

At today's breakfast jamboree for 10 years of the Health Service under Labour, Tony Blair was at his cheerleading best. Cajolling and charming at turns, he took a potentially hostile audience with him by talking to them rather than at them.

Gordon Brown must learn a little of this technique fast. The soon-to-be-outgoing Prime Minister couldn't resist a swipe at Brown's plans to set up an independent board for the NHS. It might just end up being a smokecreen to avoid making tough decisions, he said.

Whatever could he be referring to? He chose to repeat his doubts at the press briefing afterwards, so it was an entirely intentional dig. The best intervention came from The Guardian's John Carvel after the PM invoked Tory industrial reforms as an equivalent tough period for the Thatcher government.

Was Mr Blair celebrating the catastrophic dismantling of Britain's manufacturing industry, asked Carvel, a past master of these occasions. "No", said Blair, before admitting that it was probably a bad example.

There was a moment of tetchiness with ITN for asking whether he would ever go private for health treatment, but it was mostly a good-humoured affair. I said I hoped the PM's own health was good thanks to the NHS before asking whether he regretted overselling private sector involvement in the public services. Never ask a question with a yes or no answer. It's basic rule of journalism, Carvel and I should have known better. The answer to my question was "no" too by the way.

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The big problem for the NHS? Local government cuts

Even a U-Turn on planned cuts to the service itself will still leave the NHS under heavy pressure. 

38Degrees has uncovered a series of grisly plans for the NHS over the coming years. Among the highlights: severe cuts to frontline services at the Midland Metropolitan Hospital, including but limited to the closure of its Accident and Emergency department. Elsewhere, one of three hospitals in Leicester, Leicestershire and Rutland are to be shuttered, while there will be cuts to acute services in Suffolk and North East Essex.

These cuts come despite an additional £8bn annual cash injection into the NHS, characterised as the bare minimum needed by Simon Stevens, the head of NHS England.

The cuts are outlined in draft sustainability and transformation plans (STP) that will be approved in October before kicking off a period of wider consultation.

The problem for the NHS is twofold: although its funding remains ringfenced, healthcare inflation means that in reality, the health service requires above-inflation increases to stand still. But the second, bigger problem aren’t cuts to the NHS but to the rest of government spending, particularly local government cuts.

That has seen more pressure on hospital beds as outpatients who require further non-emergency care have nowhere to go, increasing lifestyle problems as cash-strapped councils either close or increase prices at subsidised local authority gyms, build on green space to make the best out of Britain’s booming property market, and cut other corners to manage the growing backlog of devolved cuts.

All of which means even a bigger supply of cash for the NHS than the £8bn promised at the last election – even the bonanza pledged by Vote Leave in the referendum, in fact – will still find itself disappearing down the cracks left by cuts elsewhere. 

Stephen Bush is special correspondent at the New Statesman. He usually writes about politics.