Milburn's challenge to Labour on NHS reform

Former health secretary argues that Labour should take up the mantle of radical reform.

The Tories lack the public trust needed to radically reform the NHS, so Labour must. That's the striking message of Alan Milburn's essay in tomorrow's New Statesman. Tony Blair's former health secretary argues that Andrew Lansley's bill, "riddled with complexity and compromise", means the Tories have "forfeited any claim to be the party of NHS reform."

He writes:

Obsessed with policy tinkering, Lansley ignored the politically inconvenient truth that the Conservatives simply did not have enough public trust on the NHS to inflict change within it. The baggage they carried of being ideologically obsessed with privatisation weighed them down once they hit a wave of opposition to their health reforms. They are drowning as a result.

From here, he urges Labour to take up the mantle of reform. The left has the opposite problem to the right, Milburn argues. While it has the permission to make change, it lacks the volition. He writes:

Too often the left in Europe has shied away from such an apporach. It has adopted a protectionist rather than a reformist approach to the public services. The left's default position has been to stand up for producers, not consumers. Defending the status quo in a world of such rapid change has proved to be a recipe for electoral disaster. In France, Germany, Italy, Spain, even Sweden, the left has suffered consecutive election defeats where until recently it could lay claim to be the natural party of government. As New Labour proved, it is not by being protectionist but by being reformist that the left is able to win.

He urges Labour to embrace reforms that "empower patients, financially incentivise outcomes, increase competition, improve transparency and devolve accountability to local care organisations."

If that sounds remarkably similar to Lansley's vision for the NHS, it's because it is. Milburn's objection to the coalition's approach isn't a principled one but a pragmatic one. In his view, only Labour, the party that founded the NHS and restored it to health, has the political trust required to introduce Lansley-style reforms.

It's a message that sits uneasily with Labour's current approach. As David Cameron rightly noted at today's PMQs, it was Ed Miliband's party that first introduced private competition into the NHS in 2008. For now, with Cameron on the ropes, Labour is in no mood to reflect on this fact. But Milburn's essay will reignite the debate about what the party is for, rather than merely against.

George Eaton is political editor of the New Statesman.

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Would you jump off a cliff if someone told you to? One time, I did

I was walking across the bridge in Matlock park, which is about 12 feet high, with a large group of other kids from my year, in the pouring rain.

Ever heard the phrase, “Would you jump off a cliff if they told you to?” It was the perpetual motif of my young teenage years: my daily escapades, all of which sprang from a need to impress a peer, were distressing and disgusting my parents.

At 13, this tomboyish streak developed further. I wrote urgent, angry poems containing lines like: “Who has desire for something higher than jumping for joy and smashing a light?” I wanted to push everything to its limits, to burst up through the ceiling of the small town I lived in and land in America, or London, or at least Derby. This was coupled with a potent and thumping appetite for attention.

At the height of these feelings, I was walking across the bridge in Matlock park, which is about 12 feet high, with a large group of other kids from my year, in the pouring rain. One of the cool girls started saying that her cousin had jumped off the bridge into the river and had just swum away – and that one of us should do it.

Then someone said that I should do it, because I always did that stuff. More people started saying I should. The group drew to a halt. Someone offered me a pound, which was the clincher. “I’m going to jump!” I yelled, and clambered on to the railing.

There wasn’t a complete hush, which annoyed me. I looked down. It was raining very hard and I couldn’t see the bottom of the riverbed. “It looks really deep because of the rain,” someone said. I told myself it would just be like jumping into a swimming pool. It would be over in a few minutes, and then everyone would know I’d done it. No one could ever take it away from me. Also, somebody would probably buy me some Embassy Filter, and maybe a Chomp.

So, surprising even myself, I jumped.

I was about three seconds in the air. I kept my eyes wide open, and saw the blur of trees, the white sky and my dyed red hair. I landed with my left foot at a 90-degree angle to my left ankle, and all I could see was red. “I’ve gone blind!” I thought, then realised it was my hair, which was plastered on to my eyes with rain.

When I pushed it out of the way and looked around, there was no one to be seen. They must have started running as I jumped. Then I heard a voice from the riverbank – a girl called Erin Condron, who I didn’t know very well. She pushed me home on someone’s skateboard, because my ankle was broken.

When we got to my house, I waited for Mum to say, “Would you jump off another cliff if they told you to?” but she was ashen. I had to lie that Dave McDonald’s brother had pushed me in the duck pond. And that’s when my ankle started to throb. I never got the pound, but I will always be grateful to Erin Condron. 

This article first appeared in the 25 August 2016 issue of the New Statesman, Cameron: the legacy of a loser