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

Daily Mail
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Who "speaks for England" - and for that matter, what is "England"?

The Hollywood producer Sam Gold­wyn once demanded, “Let’s have some new clichés.” The Daily Mail, however, is always happiest with the old ones.

The Hollywood producer Sam Gold­wyn once demanded, “Let’s have some new clichés.” The Daily Mail, however, is always happiest with the old ones. It trotted out Leo Amery’s House of Commons call from September 1939, “Speak for England”, for the headline on a deranged leader that filled a picture-free front page on David Cameron’s “deal” to keep Britain in the EU.

Demands that somebody or other speak for England have followed thick and fast ever since Amery addressed his call to Labour’s Arthur Greenwood when Neville Chamberlain was still dithering over war with Hitler. Tory MPs shouted, “Speak for England!” when Michael Foot, the then Labour leader, rose in the Commons in 1982 after Argentina’s invasion of the Falklands. The Mail columnist Andrew Alexander called on Clare Short to “speak for England” over the Iraq War in 2003. “Can [Ed] Miliband speak for England?” Anthony Barnett asked in this very magazine in 2013. (Judging by the 2015 election result, one would say not.) “I speak for England,” claimed John Redwood last year. “Labour must speak for England,” countered Frank Field soon afterwards.

The Mail’s invocation of Amery was misconceived for two reasons. First, Amery wanted us to wage war in Europe in support of Hitler’s victims in Poland and elsewhere and in alliance with France, not to isolate ourselves from the continent. Second, “speak for England” in recent years has been used in support of “English votes for English laws”, following proposals for further devolution to Scotland. As the Mail was among the most adamant in demanding that Scots keep their noses out of English affairs, it’s a bit rich of it now to state “of course, by ‘England’. . . we mean the whole of the United Kingdom”.

 

EU immemorial

The Mail is also wrong in arguing that “we are at a crossroads in our island history”. The suggestion that the choice is between “submitting to a statist, unelected bureaucracy in Brussels” and reclaiming our ancient island liberties is pure nonsense. In the long run, withdrawing from the EU will make little difference. Levels of immigration will be determined, as they always have been, mainly by employers’ demands for labour and the difficulties of policing the borders of a country that has become a leading international transport hub. The terms on which we continue to trade with EU members will be determined largely by unelected bureaucrats in Brussels after discussions with unelected bureaucrats in London.

The British are bored by the EU and the interminable Westminster arguments. If voters support Brexit, it will probably be because they then expect to hear no more on the subject. They will be sadly mistaken. The withdrawal negotiations will take years, with the Farages and Duncan Smiths still foaming at the mouth, Cameron still claiming phoney victories and Angela Merkel, François Hollande and the dreaded Jean-Claude Juncker playing a bigger part in our lives than ever.

 

An empty cabinet

Meanwhile, one wonders what has become of Jeremy Corbyn or, indeed, the rest of the shadow cabinet. The Mail’s “speak for England” leader excoriated him for not mentioning “the Number One subject of the hour” at PM’s Questions but instead asking about a shortage of therapeutic radiographers in the NHS. In fact, the NHS’s problems – almost wholly caused by Tory “reforms” and spending cuts – would concern more people than does our future in the EU. But radiographers are hardly headline news, and Corbyn and his team seem unable to get anything into the nation’s “any other business”, never mind to the top of its agenda.

Public services deteriorate by the day, George Osborne’s fiscal plans look increasingly awry, and attempts to wring tax receipts out of big corporations appear hopelessly inadequate. Yet since Christmas I have hardly seen a shadow minister featured in the papers or spotted one on TV, except to say something about Trident, another subject that most voters don’t care about.

 

Incurable prose

According to the Guardian’s admirable but (let’s be honest) rather tedious series celeb­rating the NHS, a US health-care firm has advised investors that “privatisation of the UK marketplace . . . should create organic and de novo opportunities”. I have no idea what this means, though it sounds ominous. But I am quite certain I don’t want my local hospital or GP practice run by people who write prose like that.

 

Fashionable Foxes

My home-town football team, Leicester City, are normally so unfashionable that they’re not even fashionable in Leicester, where the smart set mostly watch the rugby union team Leicester Tigers. Even when they installed themselves near the top of the Premier League before Christmas, newspapers scarcely noticed them.

Now, with the Foxes five points clear at the top and 7-4 favourites for their first title, that mistake is corrected and the sports pages are running out of superlatives, a comparison with Barcelona being the most improbable. Even I, not a football enthusiast, have watched a few matches. If more football were played as Leicester play it – moving at speed towards their opponents’ goal rather than aimlessly weaving pretty patterns in midfield – I would watch the game more.

Nevertheless, I recall 1963, when Leicester headed the old First Division with five games to play. They picked up only one more point and finished fourth, nine points adrift of the league winners, Everton.

 

Gum unstuck

No, I don’t chew toothpaste to stop me smoking, as the last week’s column strangely suggested. I chew Nicorette gum, a reference written at some stage but somehow lost (probably by me) before it reached print.

Editor: The chief sub apologises for this mistake, which was hers

Peter Wilby was editor of the Independent on Sunday from 1995 to 1996 and of the New Statesman from 1998 to 2005. He writes the weekly First Thoughts column for the NS.

This article first appeared in the 11 February 2016 issue of the New Statesman, The legacy of Europe's worst battle