David Cameron making a speech about NHS reforms at University College Hospital in June 7, 2011 in London. Photograph: Getty Images.
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Why the Tories have stopped talking about the NHS

Election strategist Lynton Crosby has warned them that it helps Labour, which has a double-digit lead on the issue.

In his first speech to the Conservative conference as leader, David Cameron declared that while it took Tony Blair three words to sum up his priorities ("Education, education, education"), he could do it in three letters: "N-H-S". But there was no mention of the health service in the Queen's Speech. Indeed, the Tories have had little to say on the subject at all recently. 

I'm told that there is a precise reason for this: Lynton Crosby has ordered them not to. Recent polling by the Conservative election strategist has shown that the Tories continue to trail Labour by a double-digit margin on the issue, despite a concerted effort to pin the blame for the Mid-Staffs scandal on the opposition and shadow health secretary Andy Burnham. The Tories' fateful decision to break their promise to end the "top-down reorganisation" of the NHS means that they have lost the ground they gained in opposition, when they polled level with Labour. Such is the damage that the mere mention of the health service is now regarded as aiding Ed Miliband. 

In his speech at last year's Conservative conference, Cameron said: "Some people said the NHS wasn't safe in our hands. Well - we knew otherwise. Who protected spending on the NHS? Not Labour - us. Who started the Cancer Drugs Fund? Not Labour - us. And by the way - who presided over Mid Staffs? Patients left for so long without water, they were drinking out of dirty vases...people's grandparents lying filthy and unwashed for days. Who allowed that to happen? Yes, it was Labour...and don't you dare lecture anyone on the NHS again." 

But don't expect to see a similar passage in this year's pre-election address. One of Crosby's most consistent pieces of advice to the Tories is "not to play on Labour's side of the pitch". This means talking about issues on which the party is strong, such as the economy, immigration and welfare, and avoiding those on which it is weak, such as the NHS, child poverty and the environment. Cameron's decision to obey Crosby's edict marks the final abandonment of Conservative modernisation, under which the party sought to capture ground traditionally colonised by Labour. 

Miliband now has even more reason than before to ensure the NHS is one of the defining election issues. Recent polling by Lord Ashcroft has shown that the health service ranks level with immigration as the second most important policy area for voters after the economy. A radical offer on the NHS and social care, most likely to be unveiled at this year's Labour conference, will be crucial to the party's chances of victory. 

George Eaton is political editor of the New Statesman.

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Air pollution: 5 steps to vanquishing an invisible killer

A new report looks at the economics of air pollution. 

110, 150, 520... These chilling statistics are the number of deaths attributable to particulate air pollution for the cities of Southampton, Nottingham and Birmingham in 2010 respectively. Or how about 40,000 - that is the total number of UK deaths per year that are attributable the combined effects of particulate matter (PM2.5) and Nitrogen Oxides (NOx).

This situation sucks, to say the very least. But while there are no dramatic images to stir up action, these deaths are preventable and we know their cause. Road traffic is the worst culprit. Traffic is responsible for 80 per cent of NOx on high pollution roads, with diesel engines contributing the bulk of the problem.

Now a new report by ResPublica has compiled a list of ways that city councils around the UK can help. The report argues that: “The onus is on cities to create plans that can meet the health and economic challenge within a short time-frame, and identify what they need from national government to do so.”

This is a diplomatic way of saying that current government action on the subject does not go far enough – and that cities must help prod them into gear. That includes poking holes in the government’s proposed plans for new “Clean Air Zones”.

Here are just five of the ways the report suggests letting the light in and the pollution out:

1. Clean up the draft Clean Air Zones framework

Last October, the government set out its draft plans for new Clean Air Zones in the UK’s five most polluted cities, Birmingham, Derby, Leeds, Nottingham and Southampton (excluding London - where other plans are afoot). These zones will charge “polluting” vehicles to enter and can be implemented with varying levels of intensity, with three options that include cars and one that does not.

But the report argues that there is still too much potential for polluters to play dirty with the rules. Car-charging zones must be mandatory for all cities that breach the current EU standards, the report argues (not just the suggested five). Otherwise national operators who own fleets of vehicles could simply relocate outdated buses or taxis to places where they don’t have to pay.  

Different vehicles should fall under the same rules, the report added. Otherwise, taking your car rather than the bus could suddenly seem like the cost-saving option.

2. Vouchers to vouch-safe the project’s success

The government is exploring a scrappage scheme for diesel cars, to help get the worst and oldest polluting vehicles off the road. But as the report points out, blanket scrappage could simply put a whole load of new fossil-fuel cars on the road.

Instead, ResPublica suggests using the revenue from the Clean Air Zone charges, plus hiked vehicle registration fees, to create “Pollution Reduction Vouchers”.

Low-income households with older cars, that would be liable to charging, could then use the vouchers to help secure alternative transport, buy a new and compliant car, or retrofit their existing vehicle with new technology.

3. Extend Vehicle Excise Duty

Vehicle Excise Duty is currently only tiered by how much CO2 pollution a car creates for the first year. After that it becomes a flat rate for all cars under £40,000. The report suggests changing this so that the most polluting vehicles for CO2, NOx and PM2.5 continue to pay higher rates throughout their life span.

For ClientEarth CEO James Thornton, changes to vehicle excise duty are key to moving people onto cleaner modes of transport: “We need a network of clean air zones to keep the most polluting diesel vehicles from the most polluted parts of our towns and cities and incentives such as a targeted scrappage scheme and changes to vehicle excise duty to move people onto cleaner modes of transport.”

4. Repurposed car parks

You would think city bosses would want less cars in the centre of town. But while less cars is good news for oxygen-breathers, it is bad news for city budgets reliant on parking charges. But using car parks to tap into new revenue from property development and joint ventures could help cities reverse this thinking.

5. Prioritise public awareness

Charge zones can be understandably unpopular. In 2008, a referendum in Manchester defeated the idea of congestion charging. So a big effort is needed to raise public awareness of the health crisis our roads have caused. Metro mayors should outline pollution plans in their manifestos, the report suggests. And cities can take advantage of their existing assets. For example in London there are plans to use electronics in the Underground to update travellers on the air pollution levels.

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Change is already in the air. Southampton has used money from the Local Sustainable Travel Fund to run a successful messaging campaign. And in 2011 Nottingham City Council became the first city to implement a Workplace Parking levy – a scheme which has raised £35.3m to help extend its tram system, upgrade the station and purchase electric buses.

But many more “air necessities” are needed before we can forget about pollution’s worry and its strife.  

 

India Bourke is an environment writer and editorial assistant at the New Statesman.