Jeremy Hunt delivers a speech during a visit to the Evelina London Children's Hospital on July 5, 2013. Photograph: Getty Images.
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Jeremy Hunt's "hospital closure clause" could be a new NHS disaster for the Tories

At least 20 coalition MPs are expected to rebel against Clause 119 today, which would give administrators the power to close down any hospital or A&E without consultation.

After Andrew Lansley's botched NHS reforms, Jeremy Hunt became Health Secretary with a brief to take the service out of the headlines. But he's failed in that mission this week. Later today, MPs will debate what's been branded the "hospital closure clause". Introduced as a hurried amendment to the Care Bill, Clause 119 (formerly known as Clause 118) would give Trust Special Administrators, appointed by Hunt, the power to close or downgrade any hospital or A&E  in the country at just 40 days' notice (allowing no time for proper consultation) if a neighbouring NHS trust is in financial trouble. 

The measure was brought forward after ministers were ruled to have acted illegally by attempting to cut emergency and maternity services at Lewisham hospital after the South London Healthcare trust went into administration. Activists rightly argued that a well-performing and popular local hospital should not be made to pay for the price for failings elsewhere, and the High Court ruled in their favour. But Clause 119 would allow Hunt to overturn this defeat and ensure the government always triumphs in the future. 

The Health Secretary will get his way when parliament votes today, but he will do so in the face of significant resistance, not just from Labour but Lib Dems and Tories too. After revealing that there are 32 communities in England where NHS regulators have major concerns over the finances of trusts (and who could be left voiceless as a result of the measure), Andy Burnham has appealed to MPs to "put constituency before party" and block Hunt's plans. He said: "This Government used to say it wanted to put patients and doctors in charge of the local NHS. Now Jeremy Hunt wants to ride roughshod over local communities and have carte blanche to break up the NHS without anyone else having a say. He must be stopped.

"With more and more hospitals in financial difficulty, this move could hit every community in the land and leave them voiceless in the face of changes to their services.

"Labour is clear: changes to hospitals should be driven by clinical, not financial, reasons with local people involved every step of the way. That is why we believe these plans are dangerous and wrong. It is time for Parliament to stop an arrogant Secretary of State from overstepping the mark."

Burnham's cause is aided by the Coalition Agreement, which committed the government to ending "the centrally dictated closure of A&E and maternity wards, so that people have better access to local services." But the centrally dicated closure of services is precisely what Clause 119 would enable. 

Paul Burstow, the former Lib Dem health minister, who has tabled an amendment that would guarantee consultation rights for local people and give doctors who commission services a veto over any reorganisation, predicts that around 20 coalition MPs (who are increasingly preoccupied with their election chances) could rebel today. He said: "Support for my amendment has been growing. It feels to me that there's a growing disquiet on the Conservative side of the coalition about these plans, plus there are Liberal Democrat MPs who share the concern."

Burstow has won the support of his Lib Dem colleagues Andrew George, Julian Huppert and Mike Thornton, while Tory MPs Nick de Bois and Jeremy Lefroy are also likely to vote against the measure. De Bois, who led the Hands Off Our Hospital campaign against the downgrading of services at Chase Farm hospital in Enfield, said: "My constituents have seen first hand the flawed, unrepresentative consultations on the future of Chase Farm hospital … I have no intention of voting for a clause that reduces further the voice of patients and residents."

For the Tories, the row is a new political headache. Despite a concerted attempt to pin the blame for the Mid-Staffs scandal on Labour (including a lengthy section in David Cameron's conference speech), the opposition retains a double-digit lead on health (37-24 in the most recent YouGov poll). One party source told me that focus groups reacted "particularly strongly" when they were reminded of Cameron's past pledges on the NHS. By again exposing the Tories to the charge of broken promises, Hunt's hospital closure clause is in danger of becoming the new "top-down reorganisation". 

George Eaton is political editor of the New Statesman.

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Andy Burnham and Sadiq Khan are both slippery self-mythologisers – so why do we rate one more than the other?

Their obsessions with their childhoods have both become punchlines; but one of these jokes, it feels to me, is told with a lot more affection than the other.

Andy Burnham is a man whose policies and opinions seem to owe more to political expediency than they do to belief. He bangs on to the point of tedium about his own class, background and interests. As a result he’s widely seen as an unprincipled flip-flopper.

Sadiq Khan is a man whose policies and opinions seem to owe more to political expediency than they do to belief. He bangs on to the point of tedium about his own class, background and interests. As a result he’s the hugely popular mayor of London, the voice of those who’d be proud to think of themselves as the metropolitan liberal elite, and is even talked of as a possible future leader of the Labour party.

Oh, and also they were both born in 1970. So that’s a thing they have in common, too.

Why it is this approach to politics should have worked so much better for the mayor of London than the would-be mayor of Manchester is something I’ve been trying to work out for a while. There are definite parallels between Burnham’s attempts to present himself as a normal northern bloke who likes normal things like football, and Sadiq’s endless reminders that he’s a sarf London geezer whose dad drove a bus. They’ve both become punchlines; but one of these jokes, it feels to me, is told with a lot more affection than the other.

And yes, Burnham apparent tendency to switch sides, on everything from NHS privatisation to the 2015 welfare vote to the leadership of Jeremy Corbyn, has given him a reputation for slipperiness. But Sadiq’s core campaign pledge was to freeze London transport fares; everyone said it was nonsense, and true to form it was, and you’d be hard pressed to find an observer who thought this an atypical lapse on the mayor’s part. (Khan, too, has switched sides on the matter of Jeremy Corbyn.)

 And yet, he seems to get away with this, in a way that Burnham doesn’t. His low-level duplicity is factored in, and it’s hard to judge him for it because, well, it’s just what he’s like, isn’t it? For a long time, the Tory leadership’s line on London’s last mayor was “Boris is Boris”, meaning, look, we don’t trust him either, but what you gonna do? Well: Sadiq is Sadiq.

Even the names we refer to them by suggest that one of these two guys is viewed very differently from the other. I’ve instinctively slipped into referring to the mayor of London by his first name: he’s always Sadiq, not Khan, just as his predecessors were Boris and Ken. But, despite Eoin Clarke’s brief attempt to promote his 2015 leadership campaign with a twitter feed called “Labour Andy”, Burnham is still Burnham: formal, not familiar. 

I’ve a few theories to explain all this, though I’ve no idea which is correct. For a while I’ve assumed it’s about sincerity. When Sadiq Khan mentions his dad’s bus for the 257th time in a day, he does it with a wink to the audience, making a crack about the fact he won’t stop going on about it. That way, the message gets through to the punters at home who are only half listening, but the bored lobby hacks who’ve heard this routine two dozen times before feel they’re in the joke.

Burnham, it seems to me, lacks this lightness of touch: when he won’t stop banging on about the fact he grew up in the north, it feels uncomfortably like he means it. And to take yourself seriously in politics is sometimes to invite others to make jokes at your expense.

Then again, perhaps the problem is that Burnham isn’t quite sincere enough. Sadiq Khan genuinely is the son of a bus-driving immigrant: he may keep going on about it, but it is at least true. Burnham’s “just a northern lad” narrative is true, too, but excludes some crucial facts: that he went to Cambridge, and was working in Parliament aged 24. Perhaps that shouldn’t change how we interpret his story; but I fear, nonetheless, it does.

Maybe that’s not it, though: maybe I’m just another London media snob. Because Burnham did grow up at the disadvantaged end of the country, a region where, for too many people, chasing opportunities means leaving. The idea London is a city where the son of a bus driver can become mayor flatters our metropolitan self-image; the idea that a northerner who wants to build a career in politics has to head south at the earliest opportunity does the opposite. 

So if we roll our eyes when Burnham talks about the north, perhaps that reflects badly on us, not him: the opposite of northern chippiness is southern snobbery.

There’s one last possibility for why we may rate Sadiq Khan more highly than Andy Burnham: Sadiq Khan won. We can titter a little at the jokes and the fibs but he is, nonetheless, mayor of London. Andy Burnham is just the bloke who lost two Labour leadership campaigns.

At least – for now. In six weeks time, he’s highly likely to the first mayor of Greater Manchester. Slipperiness is not the worst quality in a mayor; and so much of the job will be about banging the drum for the city, and the region, that Burnham’s tendency to wear his northernness on his sleeve will be a positive boon.

Sadiq Khan’s stature has grown because the fact he became London’s mayor seems to say something, about the kind of city London is and the kind we want it to be. Perhaps, after May, Andy Burnham can do the same for the north – and the north can do the same for Andy Burnham.

Jonn Elledge edits the New Statesman's sister site CityMetric, and writes for the NS about subjects including politics, history and Daniel Hannan. You can find him on Twitter or Facebook.