The coalition’s NHS headache gets bigger

Waiting times reach a three-year high following the decision to relax targets.

Iain Duncan Smith recently caused the government much embarrassment when he admitted that waiting times at his local hospital had increased since last year. Now, a new report by the King's Fund shows that the picture isn't much better elsewhere.

Hospital waiting times are now at their highest since April 2008, with 15 per cent of patients waiting over 18 weeks for treatment. Given the financial pressures on the National Health Service, these figures are hardly disastrous. But the numbers are moving in the wrong direction and cannot be simply explained by seasonal fluctuations.

The news will call into question Andrew Lansley's decision to relax Labour's waiting-time targets last June. As the King's Fund chief economist, Professor John Appleby, a co-author of the report, pointed out: "In the past the two things that kept waiting down were targets and extra money. Managers got sacked for not meeting targets. And of course in the future there won't be the same amount of extra money."

They may not have been fashionable, but Labour's much-derided targets and patient guarantees produced results. Lansley's decision to "relax" targets has had the reverse effect.

One of his first acts as Health Secretary was to pull back on the four-hour Accident and Emergency target, which has since been scrapped entirely. The result is that the number of patients waiting more than four hours has risen from 176,522 to 292,052, a 65 per cent increase and the highest level in five years.

At a time when the coalition is struggling to convince the public that the health service is "safe in its hands", a rise in waiting times is politically toxic. History teaches us that once governments lose trust on the NHS, they rarely win it back.

George Eaton is political editor of the New Statesman.

Getty
Show Hide image

Labour must unite idealists and nativists to beat Ukip

The party has no coherent economic policy, says Labour donor John Mills. 

The heart of the dilemma faced by Labour is that, by and large, its working-class supporters think that you should look after your own first and everyone else afterwards, while its more idealistic middle-class supporters don’t share these nativist views. Add to this the fact that the Labour party nowadays is more middle class, more internationalist, more public sector-orientated, more metropolitan, more intellectual and less interested in winning elections than it has ever been before, and you can see why Ukip is a huge potential threat.

Ukip started by attracting mainly disaffected Conservative voters who thought their party was weak on the EU and who didn’t like David Cameron’s liberal approach to social issues. More recently, especially during the EU referendum, Ukip picked up a huge amount of Labour support. Of the 9.3m people who voted Labour in the 2015 general election, close to 3.5m of them voted for Leave – and half of these people say they are not going to vote Labour in future. Where are they going to go?

The crucial issue is whether Ukip, having gone through all its recent traumas, will get its act together to scoop up these footloose voters. Up to now, the glue which has held Ukip together has been hostility to the EU and distrust of the political establishment. It has lacked coherent policy. This leaves Ukip still essentially a protest operation rather than as a potentially governing party. But this could change. 

With Labour now increasingly idealistic rather than nativist, Ukip may pull together a string of policies that promise support for working-class solidarity, immigration restrictions, social conservatism and a reindustrialisation plan – very much the platform which won Donald Trump the US presidency. Such a manifesto could attract sufficiently widespread working-class support to make large numbers of Labour seats vulnerable. Ukip came second in 120 constituencies during the 2015 general election. There doesn’t have to be a very large swing for Ukip to start picking up enough seats to make the prospect of a future Labour government more and more remote.

Faced with this prospect, what can Labour do? Three key strategies suggest themselves. One is to avoid alienating potential Labour supporters by trying to persuade them that they should have voted Remain. On the contrary, the party must clearly accept the referendum result, and fight hard and constructively towards getting the best possible Brexit deal. 

Second, Ukip is weak on economic policy. It is all very well to promise reindustrialisation and better jobs, but how is Ukip going to fulfil them? Populism shades very easily into protectionism. There is a principled case for open markets to produce more prosperity - but this may only be possible if there are also changes to monetary and exchange rate policy to avoid unmanageable commercial competition. Ukip may, like the Labour party, find this a hard case to make.

Third, Labour needs to change its tone. There needs to be less talk of abstract universal values and more of concrete steps to improve people’s lives. Labour must celebrate working-class attitudes to self-help, trade unionism, mutual support, patriotism and solidarity. The party must build on the huge influx of members, not least because they are the cadres for the future, but it also must avoid alienating old supporters with many years of experience and commitment. It is up to the party leadership to create such a change.

As it stands, too many Labour people are still trying to derail Brexit. The party has no coherent economic policy and it still looks too London-centric, divorced from its working-class roots. Not a good place to be if Ukip pulls itself together. 

John Mills is a businessman and a Labour donor. He founded the group Labour Leave ahead of the EU referendum and has recently published the pamphlet "Why Trump Won"