Will the Lib Dems halt Hunt's backdoor NHS privatisation?

Health secretary promises to address "concerns" over Section 75 of the NHS bill after pressure from Lib Dems and Labour.

When the government's Health and Social Care Bill was finally passed by Parliament last year it was on the condition that GPs would not be forced to open up NHS services to private competition.

Andrew Lansley, the-then Health Secretary, told the Commons: "There is absolutely nothing in the Bill that promotes or permits the transfer of NHS activities to the private sector". In a letter to Clinical Commissioning Groups, he wrote:

I know many of you have read that you will be forced to fragment services, or put them out to tender. This is absolutely not the case. It is a fundamental principle of the Bill that you as commissioners, not the Secretary of State and not regulators – should decide when and how competition should be used to serve your patients interests. 

Having accepted Lansley's assurances, the Lib Dems granted the bill their support. But new regulations published under Section 75 of the act flatly contradict the government's promises. The guidelines state that commissioners may only award a contract without competition if they are "satisfied that the services to which the contract relates are capable of being provided only by that provider". In practice, then, GPs will be forced to open up all NHS services to private companies, regardless of the wishes of local people, with the healthcare regulator Monitor granted the power to block any "unnecessary" restriction of competition. 

Secondary legislation like this is normally nodded through parliament without debate but Labour, smelling a rat, warned that the regulations amounted to an attempt at backdoor privatisation. Jeremy Hunt, Lansley's replacment as health secretary, initially sought to dismiss the opposition's concerns. In response to a question from Jamie Reed, the shadow health minister, he declared: "Who exactly are the section-75 bogeymen [he] hates: Whizz-Kidz, who are supplying services to disabled children in Tower Hamlets? Or Mind, which is supplying psychological therapy to people in Middlesbrough?"

But after the Lib Dems joined Labour in raising concerns, Hunt has been forced to think again. Norman Lamb, the Lib Dem health minister, told his party colleague Andrew George, one of those opposed to the regulations, "We are looking at this extremely seriously. Clear assurances were given in the other place during the passage of the legislation, and it is important that they are complied with in the regulations."

In reponse, as today's Guardian reports, Hunt has made it clear that he is prepared to rewrite the new guidelines. A source tells the paper: "We are aware that there are concerns over the wording and the way it may be interpreted. We are speaking to the Lib Dem peers to make sure they are happy. We want to make sure everyone is happy."

The shadow health secretary, Andy Burnham, said in response: "The government has been caught out trying to force through privatisation of the NHS by the back door.

"This is another humiliating U-turn to add to the government list, but we believe ministers will stop at nothing to drive through their plans to put the NHS up for sale to the highest bidder."

But will this be anything other than a comestic rewrite? Ahead of the Lib Dems' spring conference next month, this is a key test of the party's nerve. 

Health Secretary Jeremy Hunt speaks at the Conservative conference in Manchester last year. Photograph: Getty Images.

George Eaton is political editor of the New Statesman.

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Byron burgers and bacon sandwiches: can any politician get away with eating on camera?

Memo to aspirant world leaders: eating in public is a political minefield.

Miliband’s sandwich. Cameron’s hot dog. Osborne’s burger. The other Miliband’s banana. As well as excellent names for up-and-coming indie bands, these are just a few examples of now infamous food faux pas committed by British politicians.

During his entire mayoral campaign, Sadiq Khan refused to eat anything in public. When journalist Simon Hattenstone met him in his local curry house for the Guardian, the now-mayor didn’t eat a single bite despite “dish after dish” arriving at the table. Who can blame him? Though Ed Miliband had been pictured blunderingly eating a bacon sandwich an entire year earlier, the national furore around the incident had not yet died down. “He can make me look Clooneyesque or make me look like Ed eating a bacon sandwich,” Khan said of the photographer at the time.

Miliband’s bacon sandwich is now so infamous that I need offer no explanation for the event other than those words. There is an entire Wikipedia page dedicated to the photograph of Ed, lips curled and eyes rolling, as he tucks into that fateful sarnie. Yet politicians frequently bite off more than they can chew – why did Ed’s mishap inspire multiple headlines and an entire front page of The Sun?

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“The momentum got behind the bacon sandwich story because he was awkward, it showed him in a light which was true - he was an awkward candidate in that election,” says Paul Baines, a professor of political marketing at Cranfield University. “He didn’t come across right.”

The photograph of Miliband fit neatly within a pre-existing image of the politician – that he was bumbling, incompetent, and unable to take control. Similarly, when David Cameron was pictured eating a hot dog with a knife and fork months later, the story reinforced popular notions of him as a posh, out-of-touch, champagne-swilling old Etonian. Though Oxford-educated, two-kitchen Miliband is nearly as privileged as Cameron, and Brexit-inducing Dave equally as incompetent as Ed, the pictures would not gain the same popularity in reverse. There are many, many less-than-flattering pictures of Cameron eating, but they didn’t fit into a workable narrative.

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No one, for example, focused on the price of Ed’s sandwich. Purchased at New Covenant Garden Market, it was undoubtedly more expensive than Greggs’ £1.75 bacon roll – but no one cared. When George Osborne was pictured eating an £8 Byron burger whilst cutting £11.5 million from the British budget, however, the picture spoke to many. The then-chancellor was forced to explain that “McDonalds doesn't deliver”, although, as it turned out, Byron didn’t either.

“The idea was to try and display him in a good light – here's a guy eating a burger just like everyone else. The only problem was it was a posh burger and of course he didn't look like everyone else because he was spending ten quid on a burger,” explains Baines.

But Dave, Ed, and George are just the latest in a long, long line of politicians who have been mocked for their eating habits. Across the ocean, Donald Trump has been lambasted for liking his steak well done, while in 1976, Gerald Ford was mocked after biting into the inedible corn husk of a tamale. Why then, do politicians not copy Khan, and avoid being pictured around food altogether?

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“Food connects everybody, food is essentially a connection to culture and the 'every person',” explains Baines. “[Nigel] Farage's appearance in the pub has definitely had a positive impact on how he's perceived by a big chunk of the working class electorate which is an important, sizeable group.” Though Cameron, too, has been pictured with pints, his undeniably weird grasp on the glass make the pictures seem inauthentic, compared to Farage whose pints are clearly at home in his hands. In America, Joe Biden managed to capture the same authenticity with an ice-cream cone.

“I think when it comes across badly is when it comes across as inauthentic,” says Baines. “If I were advising, I certainly wouldn't advise Theresa May to be seen in the pub having a pint, that would not shine with her particular character or style. But could Tim Farron come across better in that way? Possibly but it does have to be authentic.”

Food, then, can instantly make a politician seem in or out of touch. This is especially true when food connects to national identity. Tony Blair, for example, publicly claimed his favourite dish was fish and chips despite earlier saying it was fettuccine with olive oil, sundried tomatoes and capers. In the 1980s, Lord Mandelson allegedly mistook mushy peas for guacamole, insulting us all. In the States, you’d be hard pressed to find a politician who hasn’t been pictured with a hot dog, and there are entire articles dedicated to US politicians who eat pizza with a knife and fork. Again, the food fits a narrative – politicians out of touch with the common person.  

Then again, sometimes, just sometimes, no narrative is needed. We’d advise any candidate who seriously wants a shot in the 2017 General Election to not, under any circumstances, be pictured casually feeding a Solero to an unidentified young woman. 

Amelia Tait is a technology and digital culture writer at the New Statesman.

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