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.

Photo: André Spicer
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“It’s scary to do it again”: the five-year-old fined £150 for running a lemonade stand

Enforcement officers penalised a child selling home-made lemonade in the street. Her father tells the full story. 

It was a lively Saturday afternoon in east London’s Mile End. Groups of people streamed through residential streets on their way to a music festival in the local park; booming bass could be heard from the surrounding houses.

One five-year-old girl who lived in the area had an idea. She had been to her school’s summer fête recently and looked longingly at the stalls. She loved the idea of setting up her own stall, and today was a good day for it.

“She eventually came round to the idea of selling lemonade,” her father André Spicer tells me. So he and his daughter went to their local shop to buy some lemons. They mixed a few jugs of lemonade, the girl made a fetching A4 sign with some lemons drawn on it – 50p for a small cup, £1 for a large – and they carried a table from home to the end of their road. 

“People suddenly started coming up and buying stuff, pretty quickly, and they were very happy,” Spicer recalls. “People looked overjoyed at this cute little girl on the side of the road – community feel and all that sort of stuff.”

But the heart-warming scene was soon interrupted. After about half an hour of what Spicer describes as “brisk” trade – his daughter’s recipe secret was some mint and a little bit of cucumber, for a “bit of a British touch” – four enforcement officers came striding up to the stand.

Three were in uniform, and one was in plain clothes. One uniformed officer turned the camera on his vest on, and began reciting a legal script at the weeping five-year-old.

“You’re trading without a licence, pursuant to x, y, z act and blah dah dah dah, really going through a script,” Spicer tells me, saying they showed no compassion for his daughter. “This is my job, I’m doing it and that’s it, basically.”

The girl burst into tears the moment they arrived.

“Officials have some degree of intimidation. I’m a grown adult, so I wasn’t super intimidated, but I was a bit shocked,” says Spicer. “But my daughter was intimidated. She started crying straight away.”

As they continued to recite their legalese, her father picked her up to try to comfort her – but that didn’t stop the officers giving her stall a £150 fine and handing them a penalty notice. “TRADING WITHOUT LICENCE,” it screamed.


Picture: André Spicer

“She was crying and repeating, ‘I’ve done a bad thing’,” says Spicer. “As we walked home, I had to try and convince her that it wasn’t her, it wasn’t her fault. It wasn’t her who had done something bad.”

She cried all the way home, and it wasn’t until she watched her favourite film, Brave, that she calmed down. It was then that Spicer suggested next time they would “do it all correctly”, get a permit, and set up another stand.

“No, I don’t want to, it’s a bit scary to do it again,” she replied. Her father hopes that “she’ll be able to get over it”, and that her enterprising spirit will return.

The Council has since apologised and cancelled the fine, and called on its officials to “show common sense and to use their powers sensibly”.

But Spicer felt “there’s a bigger principle here”, and wrote a piece for the Telegraph arguing that children in modern Britain are too restricted.

He would “absolutely” encourage his daughter to set up another stall, and “I’d encourage other people to go and do it as well. It’s a great way to spend a bit of time with the kids in the holidays, and they might learn something.”

A fitting reminder of the great life lesson: when life gives you a fixed penalty notice, make lemonade.

Anoosh Chakelian is senior writer at the New Statesman.