For the good of himself, his family and the party, it’s time for Ed Balls to fall on his sword

It’s time the shadow chancellor fell on his sword, argues Anthony Seldon. Ed Miliband would be stronger for it, Labour would lose the taint of tax and spend, Yvette would be pleased . . . and even Balls might benefit.

The co-author of “Brown at 10” writes an open letter to the shadow chancellor:

Dear Ed,

I was not your headmaster, but as somebody who has written about you for many years it falls to me to say this: the time has come for you to fall on your sword.

After 20 unbroken years at the heart of politics, you need a rest. It was another age when in 1993 Geoff Mulgan, anxious to leave Gordon Brown’s side as chief adviser to found the think tank Demos, recruited you as his successor. After leaving Oxford, you had only the briefest time to work as an academic and a journalist on the Financial Times. You need to see more of life beyond the microworld of politics. Falling on one’s sword is never easy. However, quitting in the next few months until, say, 2017 would undoubtedly benefit your leader, your party, your wife and even yourself. Let me explain.

Ed Miliband would be a much stronger leader without you. He may think he cannot live without you, which is why he promoted you in January 2011 to shadow chancellor and recently pledged to stick with you. Yet he doesn’t need you, any more than Tony Blair needed Gordon Brown after a while: he merely couldn’t find it in himself to squeeze the trigger.

Forgive me, but you stop Ed breathing fresh air. With you close to him, his breath will always be stale and smell of a toxic brand. Without a prolonged period out of the public eye, neither you nor the party will ever rid yourselves of the opportunistic, negative and bullying image of the Gordon era. Yes, we both believe he was a better prime minister than the conventional wisdom says but it will take years for his achievements to be recognised properly and the stain of his modus operandi will never be eradicated.

Economic credibility would be more readily restored with your departure. Your critique of the government’s austerity strategy may never win back public trust and your proposals for the economy will never convince. Your credibility problem will only become magnified as the general election approaches. On Europe, despite your recent about-turn, the party will find it easier to commit to holding a referendum with you gone. Your patrician attitude not to trust the people will always make any call for a referendum from you sound hollow. Think how strong the appeal would be if Miliband offered the referendum that neither Blair nor Brown dared.

Without you, Labour could present itself as a clean party, free of the factionalism and brutalism that so tarnished it when Brown was boss and you were his consigliere. I know that you think you were really a very nice person all along, vulnerable with your own insecurities. Yet you need to redeem yourself and the atonement will never happen unless you disappear and return to public life with a fresh persona. The party would be more inclusive without you.

You say you like David Miliband, but his followers are not doing well under Ed, are they? The party would be much stronger with David back in the frame. So, too, would it with Alistair Darling returning to the front bench. In the event of a hung parliament, Labour would stand a better chance of putting together a workable coalition with the Lib Dems without you. Remember how in 2010 the Lib Dems didn’t trust Gordon or you? Nothing has changed, Ed.

What might you do during your long sabbatical? You have extraordinary intellectual and personal gifts. You could write a book (not, please, a memoir), as your mentor Gordon Brown did in 1986, about the Scottish politician and leader of the Red Clydesiders James Maxton. What about a biography of Brown? Not Gordon, nor your friend Nick, but George: you would learn much more about how factionalism damaged Labour in the 1960s. How about returning to academic life or journalism? Your experience would richly inform students and readers. What about a stint at a school? You would turn up your nose at Wellington College because we are independent, but how about our academy, Wellington in Wiltshire, founded when you were schools secretary? You could even study for an MBA and learn, unlike many others who become ministers, how to run large organisations.

I wish you’d listened when you ran education and I suggested that your two great opportunities for a legacy were to embed well-being deeply into schools and transform the relationship between the public and private sectors. You did little on either and it’s rather hard to remember much that you achieved of enduring benefit for young people. So it would be good to learn how to run an organisation. You could even run or work for a charity, as John Profumo did after his involuntary retirement from politics 50 years ago.

Yvette would not say it to you but, like many women working in the same organi­sation as their husband, she would be freer to think and act without you in her hair. You would have more time, too, for your three children. As a headmaster, I know how hard it is for children who have just one parent in the public eye. Having two is harder still and your family would only benefit with you being more present and less preoccupied.

The greatest beneficiary would be you. You may not see it this way now but I know you will in hindsight. A mentor of mine, Robert Skidelsky, suggested to your mentor Gordon that he take a sabbatical before becoming prime minister. Had he followed that advice, his premiership would have benefited. He would have had time to think through what he wanted to do with the power he had so long craved. As it was, he came to No 10 with the cupboard largely bare. If Labour loses in 2015, you will be blamed and your career will be damaged beyond repair. If it wins, you would return to the front bench in 2017 a redeemed and respected figure. You might even one day become leader, your long-held ambition. Oh, and don’t believe that guff about “skipping a generation”. The public will tire of young leaders, though it doesn’t yet realise it.

Others, including Ed Miliband, share responsibility for the Brown errors: you will earn praise for taking the hit. You are 46 this month. Your best years could lie ahead of you.

Yours ever, Anthony

 

Shadow chancellor Ed Balls delivers his keynote speech to delegates at the Labour Party Conference at Manchester Central on October 1, 2012 in Manchester. Photograph: Getty Images.

This article first appeared in the 25 February 2013 issue of the New Statesman, The cheap food delusion

Photo: Getty Images
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British mental health is in crisis

The headlines about "parity of esteem" between mental and physical health remain just that, warns Benedict Cooper. 

I don’t need to look very far to find the little black marks on this government’s mental health record. Just down the road, in fact. A short bus journey away from my flat in Nottingham is the Queens Medical Centre, once the largest hospital in Europe, now an embattled giant.

Not only has the QMC’s formerly world-renowned dermatology service been reduced to a nub since private provider Circle took over – but that’s for another day – it has lost two whole mental health wards in the past year. Add this to the closure of two more wards on the other side of town at the City Hospital, the closure of the Enright Close rehabilitation centre in Newark, plus two more centres proposed for closure in the imminent future, and you’re left with a city already with half as many inpatient mental health beds as it had a year ago and some very concerned citizens.

Not that Nottingham is alone - anything but. Over 2,100 mental health beds had been closed in England between April 2011 and last summer. Everywhere you go there are wards being shuttered; patients are being forced to travel hundreds of miles to get treatment in wards often well over-capacity, incidents of violence against mental health workers is increasing, police officers are becoming de facto frontline mental health crisis teams, and cuts to community services’ budgets are piling the pressure on sufferers and staff alike.

It’s particularly twisted when you think back to solemn promises from on high to work towards “parity of esteem” for mental health – i.e. that it should be held in equal regard as, say, cancer in terms of seriousness and resources. But that’s becoming one of those useful hollow axioms somehow totally disconnected from reality.

NHS England boss Simon Stevens hails the plan of “injecting purchasing power into mental health services to support the move to parity of esteem”; Jeremy Hunt believes “nothing less than true parity of esteem must be our goal”; and in the House of Commons nearly 18 months ago David Cameron went as far as to say “In terms of whether mental health should have parity of esteem with other forms of health care, yes it should, and we have legislated to make that the case”. 

Odd then, that the president of the British Association of Counselling & Psychotherapy (BACP), Dr Michael Shooter, unveiling a major report, “Psychological therapies and parity of esteem: from commitment to reality” nine months later, should say that the gulf between mental and physical health treatment “must be urgently addressed”.  Could there be some disparity at work, between medical reality and government healthtalk?

One of the rhetorical justifications for closures is the fact that surveys show patients preferring to be treated at home, and that with proper early intervention pressure can be reduced on hospital beds. But with overall bed occupancy rates at their highest ever level and the average occupancy in acute admissions wards at 104 per cent - the RCP’s recommended rate is 85 per cent - somehow these ideas don’t seem as important as straight funding and capacity arguments.

Not to say the home-treatment, early-intervention arguments aren’t valid. Integrated community and hospital care has long been the goal, not least in mental health with its multifarious fragments. Indeed, former senior policy advisor at the Department of Health and founder of the Centre for Applied Research and Evaluation International Foundation (Careif) Dr Albert Persaud tells me as early as 2000 there were policies in place for bringing together the various crisis, home, hospital and community services, but much of that work is now unravelling.

“We were on the right path,” he says. “These are people with complex problems who need complex treatment and there were policies for what this should look like. We were creating a movement in mental health which was going to become as powerful as in cancer. We should be building on that now, not looking at what’s been cut”.

But looking at cuts is an unavoidable fact of life in 2015. After a peak of funding for Child and Adolescent Mental Health Service (CAMHS) in 2010, spending fell in real terms by £50 million in the first three years of the Coalition. And in July this year ITV News and children’s mental health charity YoungMinds revealed a total funding cut of £85 million from trusts’ and local authorities’ mental health budgets for children and teenagers since 2010 - a drop of £35 million last year alone. Is it just me, or given all this, and with 75 per cent of the trusts surveyed revealing they had frozen or cut their mental health budgets between 2013-14 and 2014-15, does Stevens’ talk of purchasing “power” sound like a bit of a sick joke?

Not least when you look at figures uncovered by Labour over the weekend, which show the trend is continuing in all areas of mental health. Responses from 130 CCGs revealed a fall in the average proportion of total budgets allocated to mental health, from 11 per cent last year to 10 per cent in 2015/16. Which might not sound a lot in austerity era Britain, but Dr Persaud says this is a major blow after five years of squeezed budgets. “A change of 1 per cent in mental health is big money,” he says. “We’re into the realms of having less staff and having whole services removed. The more you cut and the longer you cut for, the impact is that it will cost more to reinstate these services”.

Mohsin Khan, trainee psychiatrist and founding member of pressure group NHS Survival, says the disparity in funding is now of critical importance. He says: “As a psychiatrist, I've seen the pressures we face, for instance bed pressures or longer waits for children to be seen in clinic. 92 per cent of people with physical health problems receive the care they need - compared to only 36 per cent of those with mental health problems. Yet there are more people with mental health problems than with heart problems”.

The funding picture in NHS trusts is alarming enough. But it sits in yet a wider context: the drastic belt-tightening local authorities and by extension, community mental health services have endured and will continue to endure. And this certainly cannot be ignored: in its interim report this July, the Commission on acute adult psychiatric care in England cited cuts to community services and discharge delays as the number one debilitating factor in finding beds for mental health patients.

And last but not least, there’s the role of the DWP. First there’s what the Wellcome Trust describes as “humiliating and pointless” - and I’ll add, draconian - psychological conditioning on jobseekers, championed by Iain Duncan Smith, which Wellcome Trusts says far from helping people back to work in fact perpetuate “notions of psychological failure”. Not only have vulnerable people been humiliated into proving their mental health conditions in order to draw benefits, figures released earlier in the year, featured in a Radio 4 File on Four special, show that in the first quarter of 2014 out of 15,955 people sanctioned by the DWP, 9,851 had mental health problems – more than 100 a day. And the mental distress attached to the latest proposals - for a woman who has been raped to then potentially have to prove it at a Jobcentre - is almost too sinister to contemplate.

Precarious times to be mentally ill. I found a post on care feedback site Patient Opinion when I was researching this article, by the daughter of a man being moved on from a Mental Health Services for Older People (MHSOP) centre set for closure, who had no idea what was happening next. Under the ‘Initial feelings’ section she had clicked ‘angry, anxious, disappointed, isolated, let down and worried’. The usual reasons were given for the confusion. “Patients and carers tell us that they would prefer to stay at home rather than come into hospital”, the responder said at one point. After four months of this it fizzled out and the daughter, presumably, gave up. But her final post said it all.

“There is no future for my dad just a slow decline before our eyes. We are without doubt powerless – there is no closure just grief”.

Benedict Cooper is a freelance journalist who covers medical politics and the NHS. He tweets @Ben_JS_Cooper.