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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Jeremy Corbyn and his opponents are now locked in a permanent struggle

Labour MPs will neither accept Corbyn’s leadership nor abandon the party if he wins again.

 

In September 2003, outraged by Tony Blair’s support for the Iraq War, Jeremy Corbyn declared in the Morning Star that there should be “an annual election for leader”. Thirteen years later, in rather different circumstances, his wish has been granted. Yet the Labour leader has little cause for regret. There is no evidence that the sequel will end differently from the original.

Having failed to force Corbyn to re-seek MP nominations (a decision being challenged in court by the Labour donor Michael Foster as the New Statesman went to press), his opponents imposed other obstacles. Those who had been members for less than six months were barred from voting. Registered supporters were required to pay £25 to participate, rather than last year’s £3. Corbyn’s foes hoped that both decisions would shrink his support base, perhaps to the point of defeat.

Yet the early indications are that he has cleared these hurdles. A YouGov poll published on 19 July found that among eligible members Corbyn would beat Owen Smith with 56 per cent of the vote to his opponent’s 34 per cent. Of the 140,000 registered supporters likely to be approved, between 55 and 75 per cent are thought to be pro-Corbyn. Although the leadership result will not be announced until 24 September, ballot papers will be distributed from 22 August. Smith, the former shadow work and pensions secretary, has less than a month to overturn Corbyn’s advantage.

The last Labour leader to face a contest was Neil Kinnock, challenged by Tony Benn in 1988. Today, the roles have been reversed. A hard-left Bennite is the incumbent, while a soft-left Welshman is the challenger. No one expects a result as resounding as that of 1988, when Kinnock prevailed with 89 per cent to Benn’s 11 per cent. Smith’s team concede that they are “the underdogs”.

It was as a “clean skin”, untainted by the Iraq War and service in the last Labour government, that the Pontypridd MP was endorsed by colleagues over Angela Eagle. But his low profile has been exploited by his opponents. Corbyn’s allies have framed Smith as a Big Pharma lobbyist (he was formerly head of policy for Pfizer) and an NHS privatiser (he suggested in 2006 that firms could provide “valuable services”). The Labour leader’s social media presence, the terrain on which party elections are now won and lost, gives him a formidable edge.

Some MPs believe that Smith should have defined himself more clearly in the six months between signalling his leadership ambitions and launching his campaign. Comparisons are drawn with Ed Miliband, who allowed his opponents to fill the vacuum following his victory in 2010.

Smith has made electability his defining dividing line with Corbyn. The leader’s supporters, however, either do not conceive of his project in such terms or regard his opponent as no more capable of winning. Victory for Smith, they fear, would precipitate a rightward shift on austerity and immigration. Some share the assessment of a shadow cabinet minister who told me that the aspirant leader would be challenged if he won. “The Blairites won’t rest until they’ve got their party back,” he said.

Corbyn’s team is confident of victory and confronts the charge of unelectability. A source spoke of the campaign as a chance to “showcase our levels of organisation” and “build a movement that can win a general election”. Labour MPs concede that they are unlikely to beat Corbyn but hope to narrow his margin of victory and win among full members. This would deny him the right to boast of an “overwhelming” mandate and grant his opponents greater legitimacy.

In any discussion of Labour’s crisis, the 1980s are invoked. But the differences are as notable as the similarities. The left today controls the leadership, rather than merely the constituencies; the trade unions are no longer right-aligned; a “one member, one vote” system has replaced the electoral college. It was in less adverse circumstances, then, that 28 Labour MPs joined the break­away Social Democratic Party in 1981. For this reason, the possibility of a new schism endlessly recurs in media debate. Yet it is not one that MPs intend to pursue.

Labour’s tribalists have no intention of leaving their party, while the more tactically minded see little potential for a new grouping to flourish. The electoral marketplace is too crowded to achieve power without coalitions, merely replicating present divisions in a new form. Theresa May’s economic interventionism further limits the space for a centre-left insurgency to occupy.

Rather than retreating, Labour MPs intend to mount repeated challenges to Corbyn. As one told me, “We only need to get lucky once. He needs to get lucky every time.” Corbyn’s allies are hopeful that some rebels will emulate Sarah Champion MP and rejoin the front bench if he wins. One suggested that the proposed boundary changes, which will be published on 13 September, would encourage discipline in order to prevent deselection by local activists. Still, most MPs have no intention of rescinding their opposition to Corbyn.

It is deselection by the electorate at large, rather than by members, that some in Labour fear most. Though May has ruled out an early contest (having privately assured backers that she would not trigger one), the temptation could prove irresistible. An ICM poll published on 26 July gave the Tories their highest lead (16 points) since 2009. Prime ministers are rarely stronger than when they first enter office, a lesson that Gordon Brown neglected fatally. But such are Labour’s divisions that May could conclude that she need not show haste. Until the members reflect the MPs, or the MPs reflect the members, unity will remain elusive. As Corbyn and his opponents contemplate a struggle with no obvious end, the prize that both seek is rapidly diminishing in value.

George Eaton is political editor of the New Statesman.

This article first appeared in the 28 July 2016 issue of the New Statesman, Summer Double Issue