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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The dog at the end of the lead may be small, but in fact what I’m walking is a hound of love

There is a new, hairy face in the Hovel.

There is a new, hairy face in the Hovel. I seem to have become a temporary co-owner of an enthusiastic Chorkie. A Chorkie, in case you’re not quite up to speed with your canine crossbreeds, is a mixture of a chihuahua and a Yorkshire Terrier, and while my friend K— busies herself elsewhere I am looking after this hound.

This falls squarely into the category of Things I Never Thought I’d Do. I’m a cat person, taking my cue from their idleness, cruelty and beauty. Dogs, with their loyalty, their enthusiasm and their barking, are all a little too much for me, even after the first drink of the day. But the dog is here, and I am in loco parentis, and it is up to me to make sure that she is looked after and entertained, and that there is no repetition of the unfortunate accident that occurred outside my housemate’s room, and which needed several tissues and a little poo baggie to make good.

As it is, the dog thinks I am the bee’s knees. To give you an idea of how beeskneesian it finds me, it is licking my feet as I write. “All right,” I feel like saying to her, “you don’t have to go that far.”

But it’s quite nice to be worshipped like this, I have decided. She has also fallen in love with the Hovel, and literally writhes with delight at the stinky cushions on the sofa. Named after Trude Fleischmann, the lesbian erotic photographer of the Twenties, Thirties and Forties, she has decided, with admirable open-mindedness, that I am the Leader of the Pack. When I take the lead, K— gets a little vexed.

“She’s walking on a loose lead, with you,” K— says. “She never does that when I’m walking her.” I don’t even know what that means, until I have a think and work it out.

“She’s also walking to heel with you,” K— adds, and once again I have to join a couple of mental dots before the mists part. It would appear that when it comes to dogs, I have a natural competence and authority, qualities I had never, not even in my most deranged flights of self-love, considered myself to possess in any measurable quantity at all.

And golly, does having a dog change the relationship the British urban flâneur has with the rest of society. The British, especially those living south of Watford, and above all those in London, do not recognise other people’s existence unless they want to buy something off them or stop them standing on the left of the sodding escalator, you idiot. This all changes when you have a dog with you. You are now fair game for any dog-fancier to come up to you and ask the most personal questions about the dog’s history and genealogy. They don’t even have to have a dog of their own; but if you do, you are obliged by law to stop and exchange dog facts.

My knowledge of dog facts is scant, extending not much further beyond them having a leg at each corner and chasing squirrels, so I leave the talking to K—, who, being a friendly sort who could probably talk dog all day long if pressed, is quite happy to do that. I look meanwhile in a kind of blank wonder at whichever brand of dog we’ve just encountered, and marvel not only at the incredible diversity of dog that abounds in the world, but at a realisation that had hitherto escaped me: almost half of London seems to have one.

And here’s the really interesting thing. When I have the leash, the city looks at me another way. And, specifically, the young women of the city. Having reached the age when one ceases to be visible to any member of the opposite sex under 30, I find, all of a sudden, that I exist again. Women of improbable beauty look at Trude, who looks far more Yorkie than chihuahua, apart from when she does that thing with the ears, and then look at me, and smile unguardedly and unironically, signalling to me that they have decided I am a Good Thing and would, were their schedules not preventing them, like to chat and get to know me and the dog a bit better.

I wonder at first if I am imagining this. I mention it to K—.

“Oh yes,” she says, “it’s a thing. My friend P-J regularly borrows her when he wants to get laid. He reckons he’s had about 12 shags thanks to her in the last six months. The problems only arise when they come back again and notice the dog isn’t there.”

I do the maths. Twelve in six months! That’s one a fortnight. An idea begins to form in my mind. I suppose you don’t have to be a rocket scientist to work out what it is. But no. I couldn’t. Could I?

Nicholas Lezard is a literary critic for the Guardian and also writes for the Independent. He writes the Down and Out in London column for the New Statesman.

This article first appeared in the 28 April 2016 issue of the New Statesman, The new fascism