Ed Miliband walks with Doctor Tom Coffey at The Brocklehurst Medical Centre in Wandsworth on May 16, 2011 in London. Photograph: Getty Images.
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Miliband puts NHS centre stage with new GP guarantee

Labour leader pledges that all patients will win the right to an appointment within 48 hours. 

Labour laid the ground for Ed Miliband's NHS speech over the weekend by highlighting new figures showing that patients waited more than a week to see their GP on almost 50 million occasions last year. In his address in Manchester this evening, Miliband will offer his antidote.  

He will unveil a "GP guarantee", promising that Labour will give all patients the right to an appointment within 48 hours if they want one - and on the same day if they need one. Under the coalition, the proportion seeing a GP within 48 hours has fallen from 80 per cent to just 40 per cent.

Labour plans to invest an extra £100m a year in family doctor practices, enough to pay for an additional three million GP appointments. One of the central aims of the policy is to reduce the burden on A&E and the number of avoidable hospital admissions. Labour cites studies showing that a 5 per cent increase in patients seeing their preferred GP could reduce emergency admissions by as much as 159,000 a year – saving the NHS £375m. The ambition, as a Labour spokesman told me, is to both "improve the health service and save money". 

Labour plans to pay for the new investment by scrapping government rules which have led to unnecessary administration and legal fees (costing at least £78m) because NHS services are now under threat from EU competition law; and by cutting spending by the three main health quangos: Monitor, the Trust Development Authority and Commissioning Support Units. 

The speech will be followed by an election broadcast tomorow night featuring Miliband volunteering at a hospital.

Miliband will say this evening: 

In the year leading up to the next General Election and beginning in this local and European campaign the National Health Service needs to be on the centre stage of British politics. People remember the promises David Cameron made at the last election: the airbrushed posters and the three letters he said he cared about most: NHS. But we all know the reality now: the broken promises.

David Cameron said there would be moratorium on hospital closures.But he has taken on sweeping new powers to close services over the heads of local people. He said there would be no return to people waiting for hours in A&E. But last year more people waited for over four hours in A&E than for any time for a decade. He promised to protect frontline services. But a quarter of walk-in centres have been closed since 2010.

He promised that people should be able to see their GP '24/7' But a quarter of the public now say they can’t get an appointment in the same week. It’s a scandal that people are waiting that long, it is not how our NHS, the pride of Britain, should work.

And he promised there would be no more top down reorganisations.But he spent billions of pounds on a top-down reorganization that nobody wanted and nobody voted for which has put the principles of markets and competition at the heart of the NHS like never before: Aboost for the private companies and competition lawyers; a burden for everyone else.

Competition, fragmentation, and privatisation - that’s how the Tories see the future of our NHS and that’s why it is going backwards. David Cameron has broken his bond of trust with the British people on the NHS. He has proved the oldest truth in British politics: you can’t trust the Tories with the NHS.

"You can't trust the Tories with the NHS" may be a familiar Labour refrain, but it is no less effective for being so. Even after a concerted Conservative attempt to pin the blame for the Mid-Staffs scandal on the last government, the opposition continues to enjoy a 12-point lead on health. There is every reason for Labour to "bang on" about the NHS. 

But while Miliband can reasonably point to savings that would be achieved by cutting bureaucracy, integrating health and social care, and devolving services, this will not be enough to plug te long-term funding gap. 

At present, despite the common view that it has been shielded from austerity, the NHS is experiencing the toughest spending settlement in its history. Since 1950, health spending has grown at an average annual rate of 4%, but over the current Spending Review it will rise by an average of just 0.5%. As a result, in the words of a recent Social Market Foundation paper, there has been "an effective cut of £16bn from the health budget in terms of what patients expect the NHS to deliver". Should the NHS receive flat real settlements for the three years from 2015-16 (as seems probable), this cut will increase to £34bn or 23%.

If they wish to avoid a significant fall in the quality of the health service, this government and future ones are left with three choices: to raise taxes (my preference), to cut spending elsewhere, or to impose patient charges. With this in mind, Labour figures have begun the tough work of considering which taxes, most obviously National Insurance, they could raise in order to sustain a free, universal NHS. But that remains a battle for another day. 

George Eaton is political editor of the New Statesman.

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Can Nicola Sturgeon keep Scotland in the EU?

For Sturgeon, Scotland's rightful place is in the EU. If that means independence, so be it.

In the aftermath of the EU referendum, when Remain voters were still nursing their hangovers, a meme began to circulate on Scottish Facebook pages. It was an image of Nicola Sturgeon, the First Minister, her arms outspread, with a simple message: “F***in’ calm doon. Am oan it.”

At a time when British politicians are mired in the kind of chaos seen once in a generation, Sturgeon has emerged as a figure of calm. While her fellow Remain campaigners were speaking tearfully to news cameras, she addressed EU citizens, telling them: “You remain welcome here. Scotland is your home and your contribution is valued.”

When Boris Johnson declared, “Project Fear is over,” she retorted on Twitter, “Project Farce has now begun.” Her message has been retweeted more than 6,000 times. Faisal Islam, the political editor of Sky News, remarked on air that she seemed to be “the person with the most thought-through plan”.

Sturgeon now presents herself as Scotland’s anchor to Europe. Yet critics view her actions as those of a veteran independence campaigner seizing a chance denied to her by the Scottish referendum two years ago. In reality, she is working for both objectives.

It is hard to imagine now but the Scottish National Party was once suspicious of the idea of an independent Scotland in Europe. The idea took hold thanks to Jim Sillars, the Labour MP who led the 1976 breakaway that formed the Scottish Labour Party. He defected to the SNP in the early 1980s and became one of its strongest pro-EU advocates. The promise of an independent state within a larger framework was soon a mainstay of the party’s campaigns. The 1997 manifesto promised voters “the restoration of self-confidence and the creation of a modern democracy in the mainstream of European life”.

In the early years of the Scottish Parliament, Sturgeon’s approach to the EU was one of a negotiator, not an idealist. In 2003, she put forward a motion that the Scottish Executive should oppose the reduction of Scottish seats in the European Parliament from eight to seven. “Scotland, with no seat on the Council of Europe, no commissioners and fewer MEPs than comparably sized independent member states, has little enough influence in the EU,” she argued.

Her interest in representation emerged again in 2005 when she described an EU proposal on software patents as “a serious threat” to developers. She noted that: “There was apparently no Scottish minister at the Council to represent Scottish interests, the UK instead being represented by an unelected member of the House of Lords.”

Sturgeon’s commitment to work with the EU has not always been reciprocated. In the Scottish referendum, as deputy first minister, she promised the continuity of EU membership. Yet José Manuel Barroso, the then president of the European Commission, said it would be “extremely difficult, if not impossible”, for an independent Scotland to join. Some consider his statement to have been crucial to the success of the No campaign.

When the EU referendum arrived, Sillars, the architect of the SNP’s Europhile agenda, criticised the “love affair” that he believed his party was indulging in and joined the campaign for Brexit. Sturgeon made a different calculation. She threw herself into the Remain campaign, though she was careful not to stand alongside David Cameron. She played down the Scottish independence line – when asked, in the run-up to the vote, if she was a unionist, she described herself as “an enthusiastic European”.

She turned her reputation as a “nippie sweetie” to her advantage. Once viewed as a dour machine politician, now Sturgeon was warm to voters while cutting Boris Johnson down to size. There was no need to scaremonger over Europe, she said. A positive campaign was enough. There is no doubt that she tapped in to the popular feeling: 62 per cent of voters in Scotland opted to remain in the EU, compared to 48 per cent in the UK as a whole. Every local authority area north of the border voted Remain.

As the referendum results rolled in, she prepared to go it alone. “There are no rules,” Sturgeon told Andrew Marr. “The status quo we voted for doesn’t exist.” To her, Scotland’s rightful place is in the EU and if that requires independence, so be it.

She offered to meet Brussels diplomats. She contacted EU institutions. She put forward a motion in the Scottish Parliament demanding “the Scottish government to have discussions” in pursuit of “protecting Scotland’s relationship with the EU”.

Yet Barroso’s warnings may come back to haunt Sturgeon. She has always painted a picture of an independent Scotland in Europe as one that is nevertheless tied to the British Isles. Its currency is the pound; Scots and the English move freely between Glasgow and Carlisle. EU member states may seize on her proposal, or use it as a way of repeating the rebuff of 2014. Sturgeon the nippie sweetie negotiator has her plan for a European Scotland. Now she must wait for Europe to answer. 

This article first appeared in the 30 June 2016 issue of the New Statesman, The Brexit lies