Labour: NHS to be a "defining issue" at the next election

Ed Miliband turns his attention to the coalition's disastrous health bill.

Ramping up his recent attacks on the coalition's controversial health bill, Labour leader Ed Miliband today told nurses at the Royal Bolton Hospital that the NHS will be a:

defining issue

at the next general election.

He was instantly mocked for saying so by the usual suspects. I'm not sure why. As I said on Twitter this morning, it's not rocket science. The polls have Labour ahead of the Conservatives on the NHS (and the Opposition has doubled its lead over the Tories on health since the election); the health bill has so far been a PR disaster for the coalition (Cameron's "poll tax", in the helpful words of one of his Conservative cabinet colleagues); Miliband bests Cameron in PMQs every time the NHS comes up; and Cameron, of course, used the NHS to try and "detoxify" his party ahead of the last general election so there's no reason why Labour can't now use the health bill to try and retoxify the Tories.

Some on the right recognise this point. As the Spectator's Peter Hoskin observed:

If the NHS is the closest thing we have to a national religion, then the Labour leader is hoping to stir up some sectarian fervour.

And as ConservativeHome's Tim Montgomerie put it:

The NHS Bill is not just a distraction from all of this but potentially fatal to the Conservative Party's electoral prospects.

Or is it? Some have argued that the NHS doesn't win Labour general elections. That's arguable. Others say that the economy should be the "decisive issue". But, hold on, Miliband didn't say health would be "the" defining issue at the next election; he said it would be "a" defining issue. Get the difference? There's absolutely no reason why the economy (growth, jobs, living standards, vested interests, etc) and health can't both bedefining issues come 2015.

YouGov's Peter Kellner says:

It's possible the saga of the NHS could resemble that of Thatcher's privatisation: people, if asked, say they are against change, but not to the extent of switching their vote. The verdict that will matter will come after reform, when people can judge by results. If the Health Bill is enacted, patients and their relatives will be able to cast their votes at the next election on the basis of experience. If the much-maligned Andrew Lansley is proved right, and the NHS provides a better service, then there is no reason why the Tories will suffer.

However, if the Bill's critics are right, and the NHS deteriorates, then the electorate may exact fierce revenge. David Cameron has fought so hard to dispel old fears that the Tories don't really care about the NHS: those fears may come rushing back. If Ed Miliband has managed to restore at least partially Labour's reputation for competence, then we could see something that has happened only once before in the past 80 years: a Government being booted out after just one term in office.

Here's hoping, eh? And, indeed, as the False Economy website argues in a new factsheet, the health bill will lead to more bureaucracy, longer waiting times and "a postcode lottery on a scale not seen before". Good luck Dave!

On a side note, here's a link to my column in today's Independent, headlined: "Follow Obama, Ed, and get in touch with your inner populist". Enjoy!

Mehdi Hasan is a contributing writer for the New Statesman and the co-author of Ed: The Milibands and the Making of a Labour Leader. He was the New Statesman's senior editor (politics) from 2009-12.

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How to think about the EU result if you voted Remain

A belief in democracy means accepting the crowd is wiser than you are as an individual. 

I voted Remain, I feel sick about this result and its implications for what’s to come. But I’m a believer in democracy. This post is about how to reconcile those two things (it’s a bit unstructured because I’m working it out as I go, and I’m not sure I agree with all of it).

Democracy isn’t just fairer than other systems of governance, it’s smarter. It leads to better decisions and better outcomes, on average and over the long run, than countries that are run by autocrats or councils of wise men with jobs for life. It is simply the best way we have yet devised of solving complex problems involving many people. On that topic, if you’re not averse to some rather dense and technical prose, read this post or seek out this book. But the central argument is that democracy is the best way of harnessing ‘cognitive diversity’ — bringing to bear many different perspectives on a problem, each of which are very partial in themselves, but add up to something more than any one wise person.

I don’t think you can truly be a believer in democracy unless you accept that the people, collectively, are smarter than you are. That’s hard. It’s easy to say you believe in the popular will, right up until the popular will does something REALLY STUPID. The hard thing is not just to ‘accept the result’ but to accept that the majority who voted for that result know or understand something better than you. But they do. You are just one person, after all, and try as you might to expand your perspective with reading (and some try harder than others) you can’t see everything. So if a vote goes against you, you need to reflect on the possibility you got it wrong in some way. If I look at the results of past general elections and referendums, for instance, I now see they were all pretty much the right calls, including those where I voted the other way.

One way to think about the vote is that it has forced a slightly more equitable distribution of anxiety and alienation upon the country. After Thursday, I feel more insecure about my future, and that of my family. I also feel like a foreigner in my own country — that there’s this whole massive swathe of people out there who don’t think like me at all and probably don’t like me. I feel like a big decision about my life has been imposed on me by nameless people out there. But of course, this is exactly how many of those very people have been feeling for years, and at a much higher level of intensity. Democracy forces us to try on each other’s clothes. I could have carried on quite happily ignoring the unhappiness of much of the country but I can’t ignore this.

I’m seeing a lot of people on Twitter and in the press bemoaning how ill-informed people were, talking about a ‘post-factual democracy’. Well, maybe, though I think that requires further investigation - democracy has always been a dirty dishonest business. But surely the great thing about Thursday that so many people voted — including many, many people who might have felt disenfranchised from a system that hasn’t been serving them well. I’m not sure you’re truly a democrat if you don’t take at least a tiny bit of delight in seeing people so far from the centres of power tipping the polity upside down and giving it a shake. Would it have been better or worse for the country if Remain had won because only informed middle-class people voted? It might have felt better for people like me, it might actually have been better, economically, for everyone. But it would have indicated a deeper rot in our democracy than do the problems with our national information environment (which I accept are real).

I’m not quite saying ‘the people are always right’ — at least, I don’t think it was wrong to vote to stay in the EU. I still believe we should have Remained and I’m worried about what we’ve got ourselves into by getting out. But I am saying they may have been right to use this opportunity — the only one they were given — to send an unignorable signal to the powers-that-be that things aren’t working. You might say general elections are the place for that, but our particular system isn’t suited to change things on which there is a broad consensus between the two main parties.

Ian Leslie is a writer, author of CURIOUS: The Desire to Know and Why Your Future Depends On It, and writer/presenter of BBC R4's Before They Were Famous.