Clegg hits out at Cameron over NHS reforms

Deputy PM attacks Cameron for undermining the NHS while declaring that he loves it.

He may once have boasted that the government's NHS reforms were in the Liberal Democrat manifesto, but Nick Clegg is now chipping away at Andrew Lansley's masterplan. The BBC has obtained a copy of a Lib Dem policy document signed by Clegg which demands that Monitor, the health regulator, should have a duty to promote NHS colloboration rather than competition.

The document states: "We cannot treat the NHS as if it were a utility, and the decision to establish Monitor as an "economic regulator" was clearly a misjudgement, failing to recognise all the unique characteristics of a public health service, and opening us up to accusations that we are trying to subject the NHS to the full rigours of UK and EU competition law."

It's a demand that has been echoed by the British Medical Association and by the independent-minded Conservative MP Sarah Wollaston, and one distinctly at odds with Lansley's original vision of a market-based NHS. In his address to Lib Dem MPs and peers last night, Clegg said:

There must be no change in the way competition law operates in our NHS. No to establishing Monitor as an economic regulator as if health care was just like electricity or the telephone, and no to giving anyone in the NHS a duty to promote competition above all else.

But it's Clegg's coded criticism of David Cameron that is most striking. He is reported to have said:

People get confused when one day they hear politicians declare how much they love the NHS and the next they hear people describing themselves as government advisers saying that reform is a huge opportunity for big profits for health-care corporations.

The Deputy PM doesn't mention Cameron by name but it's clear who he has in mind. After all, it was the Prime Minister who declared in a speech on Monday: "[I]t's because I love the NHS so much that I want to change it." And it was his adviser Mark Britnell (recently appointed to a panel of senior health policy experts by Cameron), who told a conference for health-care corporations:

The NHS will be shown no mercy and the best time to take advantage of this will be in the next couple of years.

One legacy of the AV referendum campaign is that Clegg now feels liberated to speak out. Cameron's failure to block the vociferous attacks on his deputy by the No to AV campaign means that Clegg is a lot less willing only to air his grievances in private.

George Eaton is political editor of the New Statesman.

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Morning after pill: It's time to say no to the "ultimate sexist surcharge"

A new campaign aims to put pressure on the government to reduce the cost of emergency contraception.

The British Pregnancy Advisory Service recently launched its Just Say Non! campaign to highlight the fact that British women pay up to five times more for emergency contraception than women on the continent. The justification for the UK price of up to £30 – and the mandatory consultation with a pharmacist – is that otherwise British women might use the morning-after pill as a regular method of contraception. After all, you know what us ladies are like. Give us any form of meaningful control over our reproductive lives and before you know it we’re knocking back those emergency pills just for the nausea and irregular bleeding highs.

Since BPAS announced the campaign on Tuesday, there has been much hand-wringing over whether or not it is a good idea. The Daily Mail quotes family policy researcher Patricia Morgan, who claims that “it will just encourage casual sex and a general lack of responsibility,” while Norman Wells, director of the Family Education Trust, which promotes what it calls "traditional values", fears that “there is a very real danger that [emergency contraception] could be misused or overused.”  

The Department of Health has indicated that it has no intention of changing current policy: “We are clear it is only for use in emergencies and we have no plans to change the system.” But why not? What is the worst that could happen? Wells argues that: “The health risks to women who use the morning-after pill repeatedly over a period of time are not known.” This may be true. But do you know what is known? The health risks to women who get pregnant. Pregnancy kills hundreds of women every single day. There are no hypotheticals here.  

The current understanding of risk in relation to contraception and abortion is distorted by a complete failure to factor in the physical, psychological and financial risk posed by pregnancy itself. It is as though choosing not to be pregnant is an act of self-indulgence, akin to refusing to do the washing up or blowing one’s first pay packet on a pair of ridiculous shoes. It’s something a woman does to “feel liberated” without truly understanding the negative consequences, hence she must be protected from herself. Casually downing pills in order to get out of something as trivial as a pregnancy? What next?

Being pregnant – gestating a new life – is not some neutral alternative to risking life and limb by taking the morning-after pill. On the contrary, while the UK maternal mortality rate of 9 per 100,000 live births is low compared to the global rate of 216, pregnant women are at increased risk of male violence and conditions such as depression, preeclampsia, gestational diabetes and hyperemesis. And even if one dismisses the possible risks, one has to account for the inevitabilities. Taking a pregnancy to term will have a significant impact on a woman’s mind and body for the rest of her life. There is no way around this. Refusing to support easy access to emergency contraception because it strikes you as an imperfect solution to the problem of accidental pregnancy seems to me rather like refusing to vote for the less evil candidate in a US presidential election because you’d rather not have either of them. When it comes to relative damage, pregnancy is Donald Trump.

There is only a short window in a woman’s menstrual cycle when she is at her most fertile, hence a contraceptive failure will not always lead to a pregnancy. Knowing this, many women will feel that paying £30 to avoid something which, in all probability, is not going to happen is simply unjustifiable. I’ve bought emergency contraception while conscious that, either because I was breastfeeding or very close to my period, I’d have been highly unlikely to conceive. If that money had been earmarked to spend on the gas bill or food for my children, I might have risked an unwanted pregnancy instead. This would not have been an irrational choice, but it is one that no woman should have to make.

Because it is always women who have to make these decisions. Male bodies do not suffer the consequences of contraceptive failure, yet we are not supposed to say this is unfair. After all, human reproduction is natural and nature is meant to be objective. One group of people is at risk of unwanted pregnancy, another group isn’t. That’s life, right? Might as well argue that it is unfair for the sky to be blue and not pink. But it is not human reproduction itself that is unfair; it is our chosen response to it. Just because one class of people can perform a type of labour which another class cannot, it does not follow that the latter has no option but to exploit the former. And let’s be clear: the gatekeeping that surrounds access to abortion and emergency contraception is a form of exploitation. It removes ownership of reproductive labour from the people who perform it.

No man’s sperm is so precious and sacred that a woman should have to pay £30 to reduce the chances of it leaving her with an unwanted pregnancy. On the contrary, the male sex owes an immeasurable debt to the female sex for the fact that we continue with any pregnancies at all. I don’t expect this debt to be paid off any time soon, but cheap emergency contraception would be a start. Instead we are going backwards.

This year’s NHS report on Sexual and Reproductive Health Services in England states both that the number of emergency contraception items provided for free by SRH services has “fallen steadily over the last ten years” and that the likelihood of a woman being provided with emergency contraception “will be influenced by the availability of such services in their area of residence.” With significant cuts being made to spending on contraception and sexual health services, it is unjustifiable for the Department of Health to continue using the excuse that the morning-after pill can, theoretically, be obtained for free. One cannot simultaneously argue in favour of a pricing policy specifically aimed at being a deterrent then claim there is no real deterrent at all.

BPAS chief executive Anne Furedi is right to call the price of Levonelle “the ultimate sexist surcharge.” It not only tells women our reproductive work has no value, but it insists that we pay for the privilege of not having to perform it. It’s time we started saying no

 

 

Glosswitch is a feminist mother of three who works in publishing.