PMQs review: Cameron plays dirty on the NHS

Miliband accuses the PM of a "disgraceful slur" after he says the Mid-Staffs report was a "reminder of Labour's record on the NHS".

Since the publication of the Francis Report into the scandal at Mid Staffordshire NHS Trust, David Cameron, against the advice of some Tories, has chosen not to politicise the issue. But at today's PMQs, the first for five weeks, he dramatically changed tack. After Ed Miliband challenged him over the sharp rise in A&E waiting times, Cameron declared:

If anyone wants a reminder of Labour's record on the NHS, they only have to look at the report on Stafford hospital. 

His remarks were greeted with loud boos and cries of "shame" from Labour MPs but Tory backbenchers were visibly energised by the intervention (one that bears all the hallmarks of Lynton Crosby). A stunned Miliband replied by accusing Cameron of "a disgraceful slur on the transformation of NHS".  

What happened at Stafford was terrible, and both of us talked about that on the day, but what a disgraceful slur on the transformation of the NHS that took place after 1997 and on the doctors and nurses that made it happen.

But in a sign that the Tories intend to make a sustained effort to pin the scandal on Labour, Cameron ended his exchanges with Miliband by declaring that under a Labour government "all the problems that we have at the Stafford hospital will be repeated again." The political war over the NHS just got dirty. 

Cameron had earlier responded to Miliband's claim that he was presiding over an NHS "crisis" by referring back to Labour's decision not to pledge to ring-fence health spending at the 2010 election. "His answer is to cut NHS spending when we are investing in it," he declared. This is a strong line for Cameron; the Tories' chaotic reform of the NHS has made it even more important for him to emphasise that the coalition has protected health.

But unfortunately for the PM, it's no longer true (if it ever was). As I noted yesterday, in his biggest spending commitment since his election, Miliband has pledged that a Labour government would not cut the NHS. Today's exchange was a good example of why. Polls regularly show that health is the most popular area of spending with voters and Miliband has no intention of finding himself on the wrong side of public opinion on this issue. 

Cameron, who has already seen tomorrow's GDP figures (which will reveal whether the UK has suffered its first-ever triple-dip recession), give no hint as to their content or on whether the government would temporarily withdraw from the European Convention on Human Rights in order to enable the deportation of Abu Qatada. But a notable moment came when, in response to a question on benefits, he declared: "I find it extraordinary that heads are shaking opposite. I thought it was the Labour Party, not the welfare party." The line was an echo of what Labour MPs such as Frank Field and Simon Danczuk have said recently and will unsettle those in the party who believe that Labour has allowed itself to be characterised as soft on "benefit cheats". Expect to see it deployed regularly between now and the election. 

David Cameron leaves 10 Downing Street before Prime Minister's Questions. Photograph: Getty Images.

George Eaton is political editor of the New Statesman.

Photo: Getty Images
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I'm far from convinced by Cameron's plans for Syria

The Prime Minister has a plan for when the bombs drop. But what about after?

In the House of Commons today, the Prime Minister set out a powerful case for Britain to join air strikes against Isil in Syria.  Isil, he argued, poses a direct threat to Britain and its people, and Britain should not be in the business of “outsourcing our security to our allies”. And while he conceded that further airstrikes alone would not be sufficient to beat Isil, he made the case for an “Isil first” strategy – attacking Isil now, while continuing to do what we can diplomatically to help secure a lasting settlement for Syria in which Assad (eventually) plays no part.

I agreed with much of David Cameron’s analysis. And no-one should doubt either the murderous barbarism of Isil in the region, or the barbarism they foment and inspire in others across the world.  But at the end of his lengthy Q&A session with MPs, I remained unconvinced that UK involvement in airstrikes in Syria was the right option. Because the case for action has to be a case for action that has a chance of succeeding.  And David Cameron’s case contained neither a plan for winning the war, nor a plan for winning the peace.

The Prime Minister, along with military experts and analysts across the world, concedes that air strikes alone will not defeat Isil, and that (as in Iraq) ground forces are essential if we want to rid Syria of Isil. But what is the plan to assemble these ground forces so necessary for a successful mission?  David Cameron’s answer today was more a hope than a plan. He referred to “70,000 Syrian opposition fighters - principally the Free Syrian Army (FSA) – with whom we can co-ordinate attacks on Isil”.

But it is an illusion to think that these fighters can provide the ground forces needed to complement aerial bombardment of Isil.  Many commentators have begun to doubt whether the FSA continues to exist as a coherent operational entity over the past few months. Coralling the myriad rebel groups into a disciplined force capable of fighting and occupying Isil territory is a heroic ambition, not a plan. And previous efforts to mobilize the rebels against Isil have been utter failures. Last month the Americans abandoned a $500m programme to train and turn 5,400 rebel fighters into a disciplined force to fight Isil. They succeeded in training just 60 fighters. And there have been incidents of American-trained fighters giving some of their US-provided equipment to the Nusra Front, an affiliate of Al Qaeda.

Why has it proven so hard to co-opt rebel forces in the fight against Isil? Because most of the various rebel groups are fighting a war against Assad, not against Isil.  Syria’s civil war is gruesome and complex, but it is fundamentally a Civil War between Assad’s forces and a variety of opponents of Assad’s regime. It would be a mistake for Britain to base a case for military action against Isil on the hope that thousands of disparate rebel forces can be persuaded to change their enemy – especially when the evidence so far is that they won’t.

This is a plan for military action that, at present, looks highly unlikely to succeed.  But what of the plan for peace? David Cameron today argued for the separation of the immediate task at hand - to strike against Isil in Syria – from the longer-term ambition of achieving a settlement in Syria and removing Assad.  But for Isil to be beaten, the two cannot be separated. Because it is only by making progress in developing a credible and internationally-backed plan for a post-Assad Syria that we will persuade Syrian Sunnis that fighting Isil will not end up helping Assad win the Civil War.  If we want not only to rely on rebel Sunnis to provide ground troops against Isil, but also provide stable governance in Isil-occupied areas when the bombing stops, progress on a settlement to Syria’s Civil War is more not less urgent.  Without it, the reluctance of Syrian Sunnis to think that our fight is their fight will undermine the chances of military efforts to beat Isil and bring basic order to the regions they control. 

This points us towards doubling down on the progress that has already been made in Vienna: working with the USA, France, Syria’s neighbours and the Gulf states, as well as Russia and Iran. We need not just a combined approach to ending the conflict, but the prospect of a post-war Syria that offers a place for those whose cooperation we seek to defeat Isil. No doubt this will strike some as insufficient in the face of the horrors perpetrated by Isil. But I fear that if we want not just to take action against Isil but to defeat them and prevent their return, it offers a better chance of succeeding than David Cameron’s proposal today. 

Stewart Wood is a former Shadow Cabinet minister and adviser to Ed Miliband. He tweets as @StewartWood.