Ambulances are seen at the Accident and Emergency department of St. Thomas' Hospital in London. Photograph: Getty Images.
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We need to talk about the NHS - Cameron must break the Crosby-imposed silence

If the Tories won't face up to the problems in the health service, it's time to make way for a government that will.

David Cameron used to say that his priority could be summed up in three letters: NHS. Now, it seems, he prefers not to talk about it. The word in Westminster is that, on the advice of Lynton Crosby, the Prime Minister has asked his ministers for a period of pre-election silence on the NHS. So the Queen's Speech came and went without even a mention of Mr Cameron's erstwhile priority.

The list of reasons why Mr Cameron no longer wants to talk about the NHS is growing longer by the day. The last week has brought a stream of statistics confirming what many people suspect: the NHS is heading downhill under his government.

First, we learnt that the NHS missed its cancer treatment standard for the first time, leaving a growing number of people waiting longer for the start of treatment and families facing prolonged anguish.

Then, on Wednesday, came news that the deterioration in cancer care was worse than we thought and extended to people with suspected cancers waiting for tests. Waiting times for diagnostic tests are at a six-year high, with 17,000 waiting longer than they should.

Thursday brought the news that the number of people on NHS waiting lists had gone past the three million mark for the first time in six years - highly embarrassing for a Prime Minister who once said that the test of his NHS re-organisation would be its effect on waiting times.

Finally, it was revealed on Friday that A&E departments across the country are in the grip of a summer crisis, with record numbers attending and tens of thousands waiting too long to be seen. The NHS overall has now missed its A&E target for five weeks running; more worryingly, hospital A&Es have not hit it 47 weeks.

A&E is the barometer of the whole health and care system. This barometer is now clearly warning us that there are severe storms ahead for the NHS unless urgent steps are taken to put it back on track. Perhaps this explains why, after a run of negative statistics, there were reports that the government had resorted to panic measures to shore up England's hospitals.

Without any great announcement, or even so much as a press release, it emerged that large amounts of money are to be thrown at the NHS in a bid to keep further bad headlines at bay. It is not clear what the government has decided because of the lack of a clear statement. Some newspaper reports this weekend said £650m in "new money" had been found, while others believe it to be £250m. Whatever the amount, what is clear is that is that is unprecedented for a Prime Minister to have to throw millions at a summer A&E crisis. What is also clear is that, right now, the NHS is in a very dangerous position. All the signs show that it is slipping into a serious condition but it has a government in charge that is not prepared to talk about it. This is not good enough.

Minsters cannot be allowed to take such significant decisions without any explanation of why they are doing it or where the money is coming from. Cameron must order his ministers to come to the Commons early this week to answer these points.

Beyond that, there must now be a proper debate about what is happening in the NHS, why it is going wrong and what must be done to put it right. The reason why David Cameron is so desperate to avoid this debate at all costs is because it brings him back to his biggest misjudgement as Prime Minister: allowing Andrew Lansley to proceed with his ill-considered reorganisation. He was explicitly warned it would damage standards of patient care - and it has. Throwing money at the problems of his own making is no long-term solution for the NHS he has so disastrously destabilised.

David Cameron's great problem is that, though he thinks he can keep things quiet with a few bungs here and there, the public can see for themselves what is happening. They know it has for much harder to get a GP appointments. They are hearing the stories of friends and family being told that they can't have the treatment they need and facing the agonising choice of waiting in discomfort or paying to go private.

The voters are on to Mr Cameron and his damage to the NHS. Worryingly for him, a poll this week found that, for the first time in a long time, the NHS has risen to the top of voters' concerns. Storm clouds are gathering over the NHS, but it is trapped in a situation where the government of the day is not prepared to discuss them. This won't do. If they won't face up to the problems in the NHS, it's time to make way for a government that will.

Andy Burnham is the shadow health secretary

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David Osland: “Corbyn is actually Labour’s only chance”

The veteran Labour activist on the release of his new pamphlet, How to Select or Reselect Your MP, which lays out the current Labour party rules for reselecting an MP.

Veteran left-wing Labour activist David Osland, a member of the national committee of the Labour Representation Committee and a former news editor of left magazine Tribune, has written a pamphlet intended for Labour members, explaining how the process of selecting Labour MPs works.

Published by Spokesman Books next week (advance copies are available at Nottingham’s Five Leaves bookshop), the short guide, entitled “How to Select or Reselect Your MP”, is entertaining and well-written, and its introduction, which goes into reasoning for selecting a new MP and some strategy, as well as its historical appendix, make it interesting reading even for those who are not members of the Labour party. Although I am a constituency Labour party secretary (writing here in an expressly personal capacity), I am still learning the Party’s complex rulebook; I passed this new guide to a local rules-boffin member, who is an avowed Owen Smith supporter, to evaluate whether its description of procedures is accurate. “It’s actually quite a useful pamphlet,” he said, although he had a few minor quibbles.

Osland, who calls himself a “strong, but not uncritical” Corbyn supporter, carefully admonishes readers not to embark on a campaign of mass deselections, but to get involved and active in their local branches, and to think carefully about Labour’s election fortunes; safe seats might be better candidates for a reselection campaign than Labour marginals. After a weak performance by Owen Smith in last night’s Glasgow debate and a call for Jeremy Corbyn to toughen up against opponents by ex Norwich MP Ian Gibson, an old ally, this pamphlet – named after a 1981 work by ex-Tribune editor Chris Mullin, who would later go on to be a junior minister under Blai – seems incredibly timely.

I spoke to Osland on the telephone yesterday.

Why did you decide to put this pamphlet together now?

I think it’s certainly an idea that’s circulating in the Labour left, after the experience with Corbyn as leader, and the reaction of the right. It’s a debate that people have hinted at; people like Rhea Wolfson have said that we need to be having a conversation about it, and I’d like to kickstart that conversation here.

For me personally it’s been a lifelong fascination – I was politically formed in the early Eighties, when mandatory reselection was Bennite orthodoxy and I’ve never personally altered my belief in that. I accept that the situation has changed, so what the Labour left is calling for at the moment, so I see this as a sensible contribution to the debate.

I wonder why selection and reselection are such an important focus? One could ask, isn’t it better to meet with sitting MPs and see if one can persuade them?

I’m not calling for the “deselect this person, deselect that person” rhetoric that you sometimes see on Twitter; you shouldn’t deselect an MP purely because they disagree with Corbyn, in a fair-minded way, but it’s fair to ask what are guys who are found to be be beating their wives or crossing picket lines doing sitting as our MPs? Where Labour MPs publicly have threatened to leave the party, as some have been doing, perhaps they don’t value their Labour involvement.

So to you it’s very much not a broad tool, but a tool to be used a specific way, such as when an MP has engaged in misconduct?

I think you do have to take it case by case. It would be silly to deselect the lot, as some people argue.

In terms of bringing the party to the left, or reforming party democracy, what role do you think reselection plays?

It’s a basic matter of accountability, isn’t it? People are standing as Labour candidates – they should have the confidence and backing of their constituency parties.

Do you think what it means to be a Labour member has changed since Corbyn?

Of course the Labour party has changed in the past year, as anyone who was around in the Blair, Brown, Miliband era will tell you. It’s a completely transformed party.

Will there be a strong reaction to the release of this pamphlet from Corbyn’s opponents?

Because the main aim is to set out the rules as they stand, I don’t see how there can be – if you want to use the rules, this is how to go about it. I explicitly spelled out that it’s a level playing field – if your Corbyn supporting MP doesn’t meet the expectations of the constituency party, then she or he is just as subject to a challenge.

What do you think of the new spate of suspensions and exclusions of some people who have just joined the party, and of other people, including Ronnie Draper, the General Secretary of the Bakers’ Union, who have been around for many years?

It’s clear that the Labour party machinery is playing hardball in this election, right from the start, with the freeze date and in the way they set up the registered supporters scheme, with the £25 buy in – they’re doing everything they can to influence this election unfairly. Whether they will succeed is an open question – they will if they can get away with it.

I’ve been seeing comments on social media from people who seem quite disheartened on the Corbyn side, who feel that there’s a chance that Smith might win through a war of attrition.

Looks like a Corbyn win to me, but the gerrymandering is so extensive that a Smith win isn’t ruled out.

You’ve been in the party for quite a few years, do you think there are echoes of past events, like the push for Bennite candidates and the takeover from Foot by Kinnock?

I was around last time – it was dirty and nasty at times. Despite the narrative being put out by the Labour right that it was all about Militant bully boys and intimidation by the left, my experience as a young Bennite in Tower Hamlets Labour Party, a very old traditional right wing Labour party, the intimidation was going the other way. It was an ugly time – physical threats, people shaping up to each other at meetings. It was nasty. Its nasty in a different way now, in a social media way. Can you compare the two? Some foul things happened in that time – perhaps worse in terms of physical intimidation – but you didn’t have the social media.

There are people who say the Labour Party is poised for a split – here in Plymouth (where we don’t have a Labour MP), I’m seeing comments from both sides that emphasise that after this leadership election we need to unite to fight the Tories. What do you think will happen?

I really hope a split can be avoided, but we’re a long way down the road towards a split. The sheer extent of the bad blood – the fact that the right have been openly talking about it – a number of newspaper articles about them lining up backing from wealthy donors, operating separately as a parliamentary group, then they pretend that butter wouldn’t melt in their mouths, and that they’re not talking about a split. Of course they are. Can we stop the kamikazes from doing what they’re plotting to do? I don’t know, I hope so.

How would we stop them?

We can’t, can we? If they have the financial backing, if they lose this leadership contest, there’s no doubt that some will try. I’m old enough to remember the launch of the SDP, let’s not rule it out happening again.

We’ve talked mostly about the membership. But is Corbynism a strategy to win elections?

With the new electoral registration rules already introduced, the coming boundary changes, and the loss of Scotland thanks to decades of New Labour neglect, it will be uphill struggle for Labour to win in 2020 or whenever the next election is, under any leadership.

I still think Corbyn is Labour’s best chance. Any form of continuity leadership from the past would see the Midlands and north fall to Ukip in the same way Scotland fell to the SNP. Corbyn is actually Labour’s only chance.

Margaret Corvid is a writer, activist and professional dominatrix living in the south west.