Miliband renews attack on New Labour ahead of "peace meeting" with Blair

The Labour leader tells his MPs that it is right to move on from New Labour, which was "formed 19 years ago", but new polling revives doubts over the party's performance.

Ed Miliband addressed the Parliamentary Labour Party last night for the first time since Tony Blair's intervention in the New Statesman and took the opportunity to again rebut his criticisms. He told MPs:

New Labour was formed 19 years ago. Tony Blair taught us the world changes, and the world does change, and we will learn our lessons.

After Blair warned him not to "tack right on immigration and Europe, and tack left on tax and spending", Miliband pointedly added:

I am incredibly proud of our record, but we need to learn this truth: opposition leaders who say their government got it right and the electorate got it wrong remain leaders of the opposition.

The party, he suggested, had become a victim of its own success (or at least the coalition's failure).  "Eighteen months ago, people were saying we were not up to it. Now they are claiming we are too effective an opposition". 

Miliband was aided by a spirited John Prescott, who declared that it was "crazy" for Labour start "dividing" less than three weeks before the local elections. "Let’s stop complaining and start campaigning," he said. As Tessa Jowell revealed on the Daily Politics yesterday, Blair and Miliband will meet later this week (possibly tomorrow, when they will both attend Margaret Thatcher's funeral) in an attempt to heal the rift.

At last night's meeting, Miliband compared Labour to "a football team that is winning at half-time" but given that no modern opposition has ever won without being at least 20 points ahead (the Tories' peak lead from 2005-10 was 26 points; Labour's highest to date is 16) many MPs remain alarmed at the slightness of the party's advantage.

The latest Guardian/ICM poll puts Labour just six points ahead of the Tories, while the YouGov daily tracker has them eight points ahead. Worse for Miliband, the ICM survey suggests that Labour's lead could be in spite of, rather than because of his performance as leader. The poll gives him a net approval rating of -23, well below Cameron's -11 and Osborne's -14 and worse than the -17 he recorded at the nadir of his leadership in December 2011. 

But this is a parliamentary system, you say, why should we care? The answer is that personal ratings are frequently a better long-term indicator of the election result than voting intentions. Labour often led the Tories under Neil Kinnock, for instance (sometimes by as much as 24 points), but Kinnock was never rated above John Major as a potential prime minister. A more recent example is the 2011 Scottish parliament election, which saw Alex Salmond ranked above Iain Gray even as Labour led in the polls. The final result, of course, was an SNP majority. Conversely, Margaret Thatcher won in 1979 despite trailing Jim Callaghan by 19 points as the "best prime minister".

But Labour MPs are also troubled by the Tories' continuing advantage on the economy, another historically reliable indicator of the general election result. The latest YouGov poll shows their lead stretching from one point to four. 

Blair's intervention aside, the last month has been a successful one for Miliband. David Miliband's departure for New York has finally drawn a line under the fraternal soap opera and his Commons statement on Thatcher was rightly praised by Conservative MPs for its statesmanlike qualities. But once politics as normal resumes after Wednesday, Blair is unlikely to be the only one posing tough questions for Miliband. 

Ed Miliband speaks at the CBI's annual conference on November 19, 2012 in London. Photograph: Getty Images.

George Eaton is political editor of the New Statesman.

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Want to know how you really behave as a doctor? Watch yourself on video

There is nothing quite like watching oneself at work to spur development – and videos can help us understand patients, too.

One of the most useful tools I have as a GP trainer is my video camera. Periodically, and always with patients’ permission, I place it in the corner of my registrar’s room. We then look through their consultations together during a tutorial.

There is nothing quite like watching oneself at work to spur development. One of my trainees – a lovely guy called Nick – was appalled to find that he wheeled his chair closer and closer to the patient as he narrowed down the diagnosis with a series of questions. It was entirely unconscious, but somewhat intimidating, and he never repeated it once he’d seen the recording. Whether it’s spending half the consultation staring at the computer screen, or slipping into baffling technospeak, or parroting “OK” after every comment a patient makes, we all have unhelpful mannerisms of which we are blithely unaware.

Videos are a great way of understanding how patients communicate, too. Another registrar, Anthony, had spent several years as a rheumatologist before switching to general practice, so when consulted by Yvette he felt on familiar ground. She began by saying she thought she had carpal tunnel syndrome. Anthony confirmed the diagnosis with some clinical tests, then went on to establish the impact it was having on Yvette’s life. Her sleep was disturbed every night, and she was no longer able to pick up and carry her young children. Her desperation for a swift cure came across loud and clear.

The consultation then ran into difficulty. There are three things that can help CTS: wrist splints, steroid injections and surgery to release the nerve. Splints are usually the preferred first option because they carry no risk of complications, and are inexpensive to the NHS. We watched as Anthony tried to explain this. Yvette kept raising objections, and even though Anthony did his best to address her concerns, it was clear she remained unconvinced.

The problem for Anthony, as for many doctors, is that much medical training still reflects an era when patients relied heavily on professionals for health information. Today, most will have consulted with Dr Google before presenting to their GP. Sometimes this will have stoked unfounded fears – pretty much any symptom just might be an indication of cancer – and our task then is to put things in proper context. But frequently, as with Yvette, patients have not only worked out what is wrong, they also have firm ideas what to do about it.

We played the video through again, and I highlighted the numerous subtle cues that Yvette had offered. Like many patients, she was reticent about stating outright what she wanted, but the information was there in what she did and didn’t say, and in how she responded to Anthony’s suggestions. By the time we’d finished analysing their exchanges, Anthony could see that Yvette had already decided against splints as being too cumbersome and taking too long to work. For her, a steroid injection was the quickest and surest way to obtain relief.

Competing considerations must be weighed in any “shared” decision between a doctor and patient. Autonomy – the ability for a patient to determine their own care – is of prime importance, but it isn’t unrestricted. The balance between doing good and doing harm, of which doctors sometimes have a far clearer appreciation, has to be factored in. Then there are questions of equity and fairness: within a finite NHS budget, doctors have a duty to prioritise the most cost-effective treatments. For the NHS and for Yvette, going straight for surgery wouldn’t have been right – nor did she want it – but a steroid injection is both low-cost and low-risk, and Anthony could see he’d missed the chance to maximise her autonomy.

The lessons he learned from the video had a powerful impact on him, and from that day on he became much more adept at achieving truly shared decisions with his patients.

This article first appeared in the 01 October 2015 issue of the New Statesman, The Tory tide