Labour should learn from the National Health Action Party, not strangle it

The anti-privatisation party is pioneering a new sort of politics.

Yesterday, at just about the time the Chancellor was getting to his feet to give his Autumn Statement, I met with the leadership of Britain’s newest political party the National Health Action Party (NHAP). Launched in November, the party consists of medics and health academics to fight the commercialisation and break-up of the NHS. The question is why do they feel they are necessary and what does this tell us about the state of party politics?

Lets start with reaction of at least one person in the Labour Party to the NHAP.  Paul Richards, a former special adviser and now regular commentator, said on their launch that the NHAP "must be strangled at birth" as it might deprive Labour of valuable seats. There are at least two responses we could make to Paul’s rather emotive desire.  The first is how does he know where the NHAP are going to stand candidates? And second – how come, even for a moment, he didn’t consider why they felt it was necessary to form a party to save the NHS – or more bluntly why they no longer trusted Labour with that task?

What Paul’s reaction revealed was the darkest side of ‘Laboursim’, a culture which is just about dominant within the party. It believes that if you knock on enough doors, deliver enough leaflets, elect enough Labour MPs – then they will occupy the state on a majority basis and deliver socialism to the people. Anything that gets in the way of that obvious and clear cut process must be destroyed or "strangled at birth". Indeed, the rather obvious failure to deliver socialism can only be the fault of people who get in Labour’s way – ‘it can't be our fault so it must be them’.  Hence the rather Freudian anger at the doctors but also the Liberal Democrats, Caroline Lucas, Plaid Cymru, Respect, and any independents. Someone get the couch – we need a psychologist, not a surgeon.

So ingrained is the belief in this top-down of theory of change that if "socialism is what a Labour government does" (as Herbert Morrison phrased it) then what ever it does must be socialism.  So setting the bankers free to wreck the economy is wrapped up in the glorious and crucial sound bite of New Labour that "social justice and economic efficiency go hand in hand". It means ‘let capitalism rip and we will top skim the cream and give a bit it to the poor, not least the NHS.'

But the economic efficiency side of the equation cast its shadow over everything. First you had to hide any redistribution as it was anti-free market and eventually obediently lower taxes to a level that would help wreck the country's finances. In addition, investment in the NHS had to be through capital friendly PFI schemes. Doctors and nurses could not be trusted to manage delivery themselves, there could be no public service ethos, instead they had to be forced to compete through the creation of quasi-markets and contestability – or they had to beaten over the head with ridged performance targets that always ended in with one box being ticked at the cost of failure elsewhere. Private sector clinics were brought and the likes of Virgin Health and Circle encouraged along their merry profitable way.  The Tories have of course picked up on all this and will push it to its logical conclusion.  They want to see hospitals fail and go bankrupt, they want to see chaos – out of chaos, just like the banking crash, they will say this is the fault of the big state – what we need is full privatisation. The NHS offends their free market principles and they will not rest until every element of it has a price tag.

So maybe we can see why the medics, health academics and campaigners are a tad nervous about sitting back and trusting Labour. Some of the very people who are saying warmer and kinder things now were there when all this happened. The NHAP know the currency that matters most is votes. And they intend to grab them. Not to hurt Labour, they aren’t stupid, though a thoroughly New Labour scalp would feel be nice for them I’m sure. No, the people in their sights will be the Orange Bookers and the Tories. If Labour is sensible and not just tribal, it might recognise the electoral dividend of such a move – or it could try to strangle them at birth. 

The people leading the NHAP are brave and daring. They feel like pioneers of a new sort of politics, just as Labour’s original pioneers were after becoming disillusioned with the Liberals. They are more than a single-issue party but are using a single issue to raise issues of equality, power and democracy. They refuse to fit within the narrow confines of the Labourist model that denies you any voice and any say. In a world defined by Facebook, and everything that is good and bad about it, people want to form different identities and relationships at different times. The straitjacket of obedience and conformity cannot be placed over the complexity and diversity of the future.

This is just the taste of things to come. British party politics is entering a volatile phase. Expectations have never been lower about what the two main parties can deliver. Witness exactly how much more growth would come from Labour’s five-point plan. But if Labour remains necessary to the possibility of radical change it is far from sufficient. The fight for totemic issues such as tax justice feel remote from it as do the real change makers out there like 38 Degrees, UK Uncut and Mumsnet.

Labour is going to have to change its ways if it wants to live in the real world – a world now a million miles from the rigid, disciplined and hierarchical structures of an essentially Victorian age. Ed Miliband knows this, as does the Labour for Democracy network that launched this week. It is not just a policy change Labour needs for a good society, but a culture change.

P.S.  Sorry this is personal but linked. This week makes the 20th anniversary of the Valley Party, the one-off Greenwich based political party who stood candidates to get Charlton Athletic back to its famous ground. They didn’t win a seat but harvested so many votes that the Labour council caved in and gave them what they wanted. Let's hope the same is true for the NHS.

Neal Lawson's column appears weekly on The Staggers.

Demonstrators protest against the government's Health and Social Care Bill in London. Photograph: Getty Images.

Neal Lawson is chair of the pressure group Compass and author of the book All Consuming.

Photo: Getty Images
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There are risks as well as opportunities ahead for George Osborne

The Chancellor is in a tight spot, but expect his political wiles to be on full display, says Spencer Thompson.

The most significant fiscal event of this parliament will take place in late November, when the Chancellor presents the spending review setting out his plans for funding government departments over the next four years. This week, across Whitehall and up and down the country, ministers, lobbyists, advocacy groups and town halls are busily finalising their pitches ahead of Friday’s deadline for submissions to the review

It is difficult to overstate the challenge faced by the Chancellor. Under his current spending forecast and planned protections for the NHS, schools, defence and international aid spending, other areas of government will need to be cut by 16.4 per cent in real terms between 2015/16 and 2019/20. Focusing on services spending outside of protected areas, the cumulative cut will reach 26.5 per cent. Despite this, the Chancellor nonetheless has significant room for manoeuvre.

Firstly, under plans unveiled at the budget, the government intends to expand capital investment significantly in both 2018-19 and 2019-20. Over the last parliament capital spending was cut by around a quarter, but between now and 2019-20 it will grow by almost 20 per cent. How this growth in spending should be distributed across departments and between investment projects should be at the heart of the spending review.

In a paper published on Monday, we highlighted three urgent priorities for any additional capital spending: re-balancing transport investment away from London and the greater South East towards the North of England, a £2bn per year boost in public spending on housebuilding, and £1bn of extra investment per year in energy efficiency improvements for fuel-poor households.

Secondly, despite the tough fiscal environment, the Chancellor has the scope to fund a range of areas of policy in dire need of extra resources. These include social care, where rising costs at a time of falling resources are set to generate a severe funding squeeze for local government, 16-19 education, where many 6th-form and FE colleges are at risk of great financial difficulty, and funding a guaranteed paid job for young people in long-term unemployment. Our paper suggests a range of options for how to put these and other areas of policy on a sustainable funding footing.

There is a political angle to this as well. The Conservatives are keen to be seen as a party representing all working people, as shown by the "blue-collar Conservatism" agenda. In addition, the spending review offers the Conservative party the opportunity to return to ‘Compassionate Conservatism’ as a going concern.  If they are truly serious about being seen in this light, this should be reflected in a social investment agenda pursued through the spending review that promotes employment and secures a future for public services outside the NHS and schools.

This will come at a cost, however. In our paper, we show how the Chancellor could fund our package of proposed policies without increasing the pain on other areas of government, while remaining consistent with the government’s fiscal rules that require him to reach a surplus on overall government borrowing by 2019-20. We do not agree that the Government needs to reach a surplus in that year. But given this target wont be scrapped ahead of the spending review, we suggest that he should target a slightly lower surplus in 2019/20 of £7bn, with the deficit the year before being £2bn higher. In addition, we propose several revenue-raising measures in line with recent government tax policy that together would unlock an additional £5bn of resource for government departments.

Make no mistake, this will be a tough settlement for government departments and for public services. But the Chancellor does have a range of options open as he plans the upcoming spending review. Expect his reputation as a highly political Chancellor to be on full display.

Spencer Thompson is economic analyst at IPPR