NS interview - Patricia Hewitt

'People need to stand up against the perverted form of Islam that a minority of Muslims wants to imp

On the morning of the London bombs, Patricia Hewitt was one of the key ministers who attended the first meeting of the cabinet's emergency group, Cobra. As the session broke up, the new Secretary of State for Health was asked by her predecessor, John Reid, whether she was heading for her department's emergency control room. She confessed she didn't know it existed.

The learning curve is steep in a crisis. Hewitt says the National Health Service and the emergency services responded admirably. "They had rehearsed for this, they had planned for it," she says. "There was a table-top exercise several months ago. The scenario was multiple attacks on different modes of transport because a multiple terrorist attack was what we feared. We knew there was a danger that some attacks would succeed."

We talk about the causes. Hewitt suggests that some Muslims have still to understand or accept the problem, let alone tackle its roots. "It's not simply that terrorist violence is unacceptable. You all know that. We know that. That's not the issue. It is the very vicious propaganda that young Muslims are being exposed to, about a western crusade against Islam, ignoring, for instance, what we did in Kosovo to protect a Muslim community. People in positions of responsibility and leadership need to stand up against the propaganda and against the perverted form of extremist Islam that a dangerous minority in the Muslim community wants to impose."

Does this mean we have been too tolerant? "I was making this point many years ago, with my experiences as a feminist, that we have not been willing enough to say that human rights trumps an assertion of cultural exceptionalism." She refers to practices such as genital mutilation, "honour killings" and forced marriages. But she makes a broader point that might not have been made before 7 July: "There has been a misplaced tolerance. Instead of saying, 'That's cultural, we can't challenge it,' in fact we should challenge it. We should support the mainstream, modernising community."

In a previous interview in the New Statesman, in February 2003, Hewitt asserted that terrorism was the price we pay for poverty. This is what she said then: "We will never deal with terrorism and other threats to world peace if we don't deal with the hunger and misery and frustration across the developing world . . . there is a connection between destitution and war and conflict and terrorism." I read these sentences back to her. She says that she was not wrong before. "I think there is a likelihood of extremists recruiting where there is poverty." But she also says: "What I underestimated there was the ability of extremists to recruit people to their cause for whom poverty simply isn't an issue."

She talks of the "objective reality" changing, with four UK citizens prepared to launch suicide attacks in the heart of London. If young men like these could do it, "then who else?" she asks. "I'm sure there are people out there planning further attacks." She says that, as with confronting the IRA, "we need a political strategy and a security strategy", adding that the west should be "seen to be doing the right thing on global poverty and climate change, because if we don't have that moral legitimacy it is harder to put pressure on other governments and communities".

So foreign policy does influence the mindset of the terrorist, but bizarrely it seems not in one area. I put it to Hewitt that ministers cannot continue to assert that the invasion of Iraq has not damaged national security. "I simply don't accept the proposition that we would have been safer had we not done what we did in Iraq." Those influenced by al-Qaeda would have found a cause. "If it hadn't been Iraq it would have been Afghanistan. If it hadn't been Afghanistan it would have been Palestine. If it hadn't been Palestine it would have been the moral depravity of the west." Adopting the government's fallback position, she concludes: "One has to remember that 11 September had nothing whatsoever to do with Iraq, and that the Madrid bombers were planning a second one even after there had been a change of government."

It is hard to imagine that Hewitt, with her background in civil liberties, cannot accept the link between Iraq and terrorism, even if she stands by her support for the military action in principle, but there is no further mileage in this line of questioning. I turn to domestic issues, particularly public service reform, which has rarely figured in political discourse since the general election.

Only two months in the job, Hewitt has assumed the reformist zeal that appears to be a prerequisite for the person running the fourth-largest organisation in the world. By her reckoning the NHS lags behind only the Chinese army, the Indian railway system and Wal-Mart. It certainly is spending ambitiously - three times the level of 1997. "We've got unprecedented levels of investment. We have a historic opportunity, a once and once only opportunity, not only to put the NHS beyond political attack, but actually to put a core proposition of policy almost beyond attack," she says. "We can create an NHS that is not only publicly funded, not only available to everybody, free at the point of entry. We can also make that free, universal healthcare meet the rapidly rising demands of the public. We live in a time with a population better educated and informed and who want much more choice and control over their healthcare, as with other areas of life, and the NHS can respond to those expectations." But she concedes: "The political steps are going to be hard. If we can succeed with the NHS, then we can win again to assert the argument over the role of the state."

In other words, this is all or nothing. "If we fail, if all this investment fails to meet these expectations, then it opens up political ground that the Tories are longing to take: where they can say, 'We've had all this money, where's the money gone, the private sector could do better, we'll give you more of your money back and you can choose and get the treatment you want.' Given that the NHS is our largest public service, it is absolutely essential we win that argument. It is essential to the future of progressive politics.

"If we are going to do that we have to move from the command-and-control, very top-down, target-driven policy of the past 12 years to a situation where we embed the reforms so we create an inbuilt dynamic, and central to that is patient and user choice."

The left, she says, "has always been uncomfortable with choice. It was uncomfortable with the rise of the consumer society. It has never liked choice in public services. There is the fear that it would be exploited by the middle classes, that it would lead to a two-tier service. Choice has been seen as the enemy of public services." Does she believe the argument has been won? "It is part of my job to try to win that argument." And this is it: choice is good because people want it.

"People can be very patronising on the left when they make the assumption that working-class people don't and won't exercise choice when they have the opportunity." Choice gives people more control and helps improve service. "The more people say, 'I might go somewhere else', hospitals that aren't up to scratch will have to improve, or risk losing patients."

By way of conclusion, I ask about the mood in government. She describes it as a reverse honeymoon. Everyone was glum after the election but now the mood has picked up. "What we saw in Live 8 and the mobilisation of the Make Poverty History movement and the G8, the response to the Olympic victory, and then the response to the bombings, was a willingness by millions of people to be part of something bigger than themselves, which is a real counter-point to the individualism with which we tend to associate. That sense of public engagement is enormously important because progressive politics is about more than what the government does. It has to be rooted more in people's own lives, experiences and demands; in what society, what world, they want. We are seeing people saying loud and clear what kind of society they want.

"The leadership that both Tony Blair and Gordon Brown have been giving on these global issues, but now with Tony in particular around terrorism and the relationship between Islam and Muslim communities and the rest of the world, that leadership is superb." One thing Patricia Hewitt cannot be accused of is failing to see the bright side.