How Boris is spoiling Cameron's EU speech in advance

The Mayor's demand for an EU referendum before 2015 means it will be harder for Cameron to impress.

There is no prospect of David Cameron staging an EU referendum before 2015, so it was typically mischievous of Boris Johnson to declare this morning that it would be "fantastic" if one were to be held before the next election. Such interventions by Boris mean that Cameron's plan to offer a referendum after 2015 on "a new settlement" for Britain (to be announced in his long-delayed speech on Europe) will inevitably disappoint. The PM declared this week: "Thanks for reminding me that my Europe speech remains as yet unmade. This is a tantric approach to policy-making: it'll be even better when it does eventually come." But conscious of the growing threat from UKIP, many Tory MPs will complain that a vote can't be held sooner. The presence of the Lib Dems in goverment, however, leaves Cameron with little choice.

Boris also added to the Prime Minister's woes by arguing that the UK should be prepared to leave the EU if it proves unable to secure radically changed terms of membership. "That is correct, absolutely correct [that Britain should be prepared to exit the EU]," he said. "I don’t think that [leaving the EU] is necessarily the end of the world.

"Don’t forget that 15 years ago the entire CBI, British Industry, the City, everybody was prophesying that there’d be gigantic mutant rats with two or three eyes swarming out of the gutters, the sewers, to gnaw the faces of the remaining British bankers because we didn’t go into the euro. My preferred option is for us to stay in there. I will stress [leaving] is not my preferred option."

Cameron's referendum is expected to offer voters a choice between renegotiated membership and withdrawal, but the PM will struggle to prevent many Tories arguing for the latter, regardless of the concessions he extracts from Brussels. The promise of a vote on Europe will only prove the start of his problems, not the end.

Mayor of London Boris Johnson said leaving the EU would not be "the end of the world". Photograph: Getty Images.

George Eaton is political editor of the New Statesman.

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Is anyone prepared to solve the NHS funding crisis?

As long as the political taboo on raising taxes endures, the service will be in financial peril. 

It has long been clear that the NHS is in financial ill-health. But today's figures, conveniently delayed until after the Conservative conference, are still stunningly bad. The service ran a deficit of £930m between April and June (greater than the £820m recorded for the whole of the 2014/15 financial year) and is on course for a shortfall of at least £2bn this year - its worst position for a generation. 

Though often described as having been shielded from austerity, owing to its ring-fenced budget, the NHS is enduring the toughest spending settlement in its history. Since 1950, health spending has grown at an average annual rate of 4 per cent, but over the last parliament it rose by just 0.5 per cent. An ageing population, rising treatment costs and the social care crisis all mean that the NHS has to run merely to stand still. The Tories have pledged to provide £10bn more for the service but this still leaves £20bn of efficiency savings required. 

Speculation is now turning to whether George Osborne will provide an emergency injection of funds in the Autumn Statement on 25 November. But the long-term question is whether anyone is prepared to offer a sustainable solution to the crisis. Health experts argue that only a rise in general taxation (income tax, VAT, national insurance), patient charges or a hypothecated "health tax" will secure the future of a universal, high-quality service. But the political taboo against increasing taxes on all but the richest means no politician has ventured into this territory. Shadow health secretary Heidi Alexander has today called for the government to "find money urgently to get through the coming winter months". But the bigger question is whether, under Jeremy Corbyn, Labour is prepared to go beyond sticking-plaster solutions. 

George Eaton is political editor of the New Statesman.