Don’t go to market

Fascinating though this election campaign has been, the debates on health have been largely predictable. No politician wins votes by promising to close hospitals or take away services, so it's not surprising that all three parties have, more or less, pledged to protect the NHS, promising to save huge amounts of money without affecting front-line services, and without giving much in the way of detail.

But away from the campaign trail, the axe is already being sharpened. Strategic health authorities have been told to achieve efficiency savings worth £20bn and staff are starting to see the consequences. More than half of GPs in a recent survey said cutbacks to local services had begun. Since we the British Medical Association (BMA) launched our election manifesto in December, we have pointed out the folly of "slash-and-burn" cuts, arguing that during a time of financial difficulty, health care is even more important.

But we have also been calling for a new approach to service provision. At a recent hustings, I asked the three candidates for health secretary to explain where they stood on the role of profit-making companies in the NHS. All three continued to advocate private provision of NHS care, albeit with slight differences in emphasis.

That this consensus exists is perhaps surprising. Surveys of the public show little appetite for private provision of NHS services, and there is scant evidence that the market experiment in England has improved standards or efficiency. It is worth noting that every eight cases diverted to an independent-sector treatment centre cost the taxpayer the equivalent of almost ten cases dealt with by the NHS.

So what's our message to the next government? Naturally we'd like you to give NHS staff a greater say in determining policy and services. But we also urge you to abandon this obsession with market "reforms" that continue to divert public money away from the front-line services you have promised to protect.


Chairman of the British Medical Association council

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Labour tensions boil over at fractious MPs' meeting

Corbyn supporters and critics clash over fiscal charter U-turn and new group Momentum. 

"A total fucking shambles". That was the verdict of the usually emollient Ben Bradshaw as he left tonight's Parliamentary Labour Party meeting. His words were echoed by MPs from all wings of the party. "I've never seen anything like it," one shadow minister told me. In commitee room 14 of the House of Commons, tensions within the party - over the U-turn on George Osborne's fiscal charter and new Corbynite group Momentum - erupted. 

After a short speech by Jeremy Corbyn, shadow chancellor John McDonnell sought to explain his decision to oppose Osborne's fiscal charter (having supported it just two weeks ago). He cited the change in global economic conditions and the refusal to allow Labour to table an amendment. McDonnell also vowed to assist colleagues in Scotland in challenging the SNP anti-austerity claims. But MPs were left unimpressed. "I don't think I've ever heard a weaker round of applause at the PLP than the one John McDonnell just got," one told me. MPs believe that McDonnell's U-turn was due to his failure to realise that the fiscal charter mandated an absolute budget surplus (leaving no room to borrow to invest), rather than merely a current budget surplus. "A huge joke" was how a furious John Mann described it. He and others were outraged by the lack of consultation over the move. "At 1:45pm he [McDonnell] said he was considering our position and would consult with the PLP and the shadow cabinet," one MP told me. "Then he announces it before 6pm PLP and tomorow's shadow cabinet." 

When former shadow cabinet minister Mary Creagh asked Corbyn about the new group Momentum, which some fear could be used as a vehicle to deselect critical MPs (receiving what was described as a weak response), Richard Burgon, one of the body's directors, offered a lengthy defence and was, one MP said, "just humiliated". He added: "It looked at one point like they weren't even going to let him finish. As the fractious exchanges were overheard by journalists outside, Emily Thornberry appealed to colleagues to stop texting hacks and keep their voices down (within earshot of all). 

After a calmer conference than most expected, tonight's meeting was evidence of how great the tensions within Labour remain. Veteran MPs described it as the worst PLP gathering for 30 years. The fear for all MPs is that they have the potential to get even worse. 

George Eaton is political editor of the New Statesman.