Under pressure: the Queen Elizabeth Hospital in Birmingham has seen a surge in patients at A&E. Photo: Getty
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Jacqui Smith: “The NHS model isn’t broken but it needs urgent attention and support”

The former home secretary on trouble in A&E – plus the triumph of all-women shortlists and the joys of summer caravanning.

You may remember the Queen Elizabeth Hospital in Birmingham as the splendid venue for the launch of Labour’s 2010 election campaign. It was also the place where Tony Blair was challenged by Sharron Storer over her partner’s cancer treatment in 2001 – but don’t let either of those events colour your judgement. I’m very proud to chair the NHS trust that runs it. However, like the rest of the health service, we’re facing unprecedented pressures.

A decade ago, the old emergency department at Selly Oak was seeing 60,000 people each year. The A&E at the Queen Elizabeth Hospital was built to accommodate 81,000. Last year, we saw 95,000 and the figure is rising. Our chief executive, Dame Julie Moore, describes A&E as the “canary in the mine” for the health service. This canary will soon need to be nailed to its perch.

We have found that when it’s harder to see a GP, people visit casualty, where the lights never go off; as social care is cut and social care workers are forced to make shorter visits, more people turn up at the door of a hospital. Mental health faces the biggest cuts in the NHS and we find that those in crisis come to our A&E or go into a police cell. When many are struggling to make ends meet, it’s not surprising that there are more people with malnutrition, scurvy and rickets needing our care.

Recent Commonwealth Fund research identified the NHS as the best system among 11 major developed countries for quality of care, access and efficiency. The NHS model isn’t broken but it needs urgent attention and support.

 

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Spending a lot of time on trains, I enjoy the eccentric pastimes of my fellow travellers. One woman got on to the early-morning train to London, pulled out a hairdryer, plugged it in and dried her hair. Last week, I sat next to someone rolling a cigarette and reflected on the transformation made by the smoking ban. Feel free to roll but thank goodness you can’t smoke it next to me.

The same Commonwealth Fund research that found the NHS to be the most effective health service also reported that we are one of the least healthy societies (the UK came tenth out of the 11 countries). We should learn from the success of the smoking ban. Governments of all persuasions have expected NHS providers to take tough decisions but avoided them themselves. At the Queen Elizabeth Hospital, we transplant livers for alcoholics but the government avoids minimum pricing for alcohol. More than one in ten of our patients have diabetes but action on healthier food is left to the willingness of food manufacturers and retailers to put different colours on their labels.

 

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As the dust settles on the reshuffle, it’s clear that there should be no let-up in the work to gain more equal gender representation in parliament and government. The appointment of two new women cabinet ministers, though welcome, still takes the total in the cabinet to only less than a quarter. In the Labour Women’s Network, we continue to train women to stand for parliament, but self-congratulation from any party on female representation is premature while we languish at 58th in the international league table – with Rwanda, Kazakhstan and Tunisia among those doing better than us. One answer is clear. Why do women MPs make up a third of Labour, while the Tories have less than 16 per cent and the Lib Dems only one in eight? It’s because Labour uses all-women shortlists. In recent weeks, both Nick Clegg and Ken Clarke have supported their use for their own parties. Why not just get on with it?

 

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Don’t hold your breath for the publication of this government’s review of the impact of immigration from the EU. A version recently leaked to the BBC gives a nuanced but largely positive view about immigration’s effect on jobs, pay and community cohesion. A previous version was ready for publication last December but the Home Office stopped publication because it considered it too positive. A much more sceptical, rewritten version was called propagandist by the Lib Dems. It’s clear now that this is a political stitch-up. Wouldn’t it have been better to ask an independent group comprising local government, industry, union and community representatives to consider the evidence? That’s what we set up when I was in the Home Office – the Migration Impacts Forum. This government has got rid of it. Apparently one of the effects of Ukip is the victory of anecdote over evidence.

 

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This summer, I will holiday in my caravan in north-west Wales. With little mobile-phone signal, this was a sanctuary in my ministerial years – though I did manage to speak to two prime ministers standing on a rock at the top of the site where you can just about get a connection. I was not the only caravanning minister: Margaret Beckett loved hers, too. Appropriately, as foreign secretary, she had a touring caravan that she took round Europe, while as home secretary I had a static caravan and stayed at home.

Wherever you are holidaying this year, I hope you have a happy and relaxing time. 

This article first appeared in the 23 July 2014 issue of the New Statesman, Summer Double 2014

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“We can’t do this again”: Labour conference reactions to Jeremy Corbyn’s second victory

Overjoyed members, determined allies and concerned MPs are divided on how to unite.

“I tell you what, I want to know who those 193,229 people are.” This was the reaction of one Labour member a few rows from the front of the stage, following the announcement of Jeremy Corbyn’s victory at the Labour party conference. She was referring to support received by his defeated contender, Owen Smith, who won 38.2 per cent of the vote (to Corbyn’s 61.8 per cent).

But it’s this focus on the leader’s critics – so vehement among many (and there are a lot of them) of his fans – that many politicians, of either side, who were watching his victory speech in the conference hall want to put an end to.

“It’s about unity and bringing us all together – I think that’s what has to come out of this,” says shadow cabinet member and MP for Edmonton Kate Osamor. “It shouldn’t be about the figures, and how many votes, and his percentage, because that will just cause more animosity.”

Osamor, who is supportive of Corbyn’s leadership, is not alone in urging her colleagues who resigned from the shadow cabinet to “remember the door is never shut”.

Shadow minister and member of Labour’s National Executive Committee (NEC) Jon Ashworth – not a Corbyn loyalist, but focusing on making the shadow cabinet work together – shares the sentiment.

Standing pensively in front of the now-empty stage, he tells me he backs shadow cabinet elections (though not for every post) – a change to party rules that has not yet been decided by the NEC. “[It] would be a good way of bringing people back,” he says. “I’ve been involved in discussions behind the scenes this week and I hope we can get some resolution on the issue.”

He adds: “Jeremy’s won, he has to recognise a number of people didn’t vote for him, so we’ve got to unite.”

The former Foreign Secretary Margaret Beckett, another MP on the NEC, is sitting in the audience, looking over some documents. She warns that “it’s impossible to tell” whether those who resigned from Corbyn’s shadow cabinet would be willing to return, and is concerned about talent being wasted.

“We have a lot of excellent people in the party; there are new people now in the shadow cabinet who have had a chance to show their mettle but you need experience as well as ability,” she says.

Beckett, who has urged Corbyn to stand down in the past, hopes “everybody’s listening” to his call for unity, but questions how that will be achieved.

“How much bad blood there is among people who were told that there was plotting [against Corbyn], it’s impossible to tell, but obviously that doesn’t make for a very good atmosphere,” she says. “But Jeremy says we’ll wipe the slate clean, so let’s hope everybody will wipe the slate clean.”

It doesn’t look that way yet. Socialist veteran Dennis Skinner is prowling around the party conference space outside the hall, barking with glee about Corbyn’s defeated foes. “He’s trebled the membership,” he cries. “A figure that Blair, Brown and Prescott could only dream about. On average there’s more than a thousand of them [new members] in every constituency. Right-wing members of the parliamentary Labour party need to get on board!”

A call that may go unheeded, with fervent Corbyn allies and critics alike already straying from the unity message. The shadow justice secretary Richard Burgon is reminding the PLP that, “Jeremy’s won by a bigger margin this time”, and telling journalists after the speech that he is “relaxed” about how the shadow cabinet is recruited (not a rallying cry for shadow cabinet elections).

“If Jeremy wants to hold out an olive branch to the PLP, work with MPs more closely, he has to look very seriously at that [shadow cabinet elections]; it’s gone to the NEC but no decision has been made,” says Louise Ellman, the Liverpool MP and transport committee chair who has been critical of Corbyn’s leadership. “That might not be the only way. I think he has to find a way of working with MPs, because we’re all elected by millions of people – the general public – and he seems to dismiss that.”

“If he sees it [his victory] as an endorsement of how he’s been operating up until now, the problems which led to the election being called will remain,” Ellman warns. “If we’re going to be a credible party of government, we’ve got to reach out to the general electorate. He didn’t say anything about that in his speech, but I hope that perhaps now he might feel more confident to be able to change direction.”

Corbyn may have called for cooperation, but his increased mandate (up from his last stonking victory with 59.5 per cent of the vote) is the starkest illustration yet of the gulf between his popularity in Parliament and among members.

The fact that one attempt at a ceasefire in the party’s civil war – by allowing MPs to vote for some shadow cabinet posts – is in contention suggests this gulf is in danger of increasing.

And then where could the party be this time next year? As Osamor warns: “We should not be looking at our differences, because when we do that, we end up thinking it’s a good thing to spend our summer having another contest. And we can’t. We can’t do this again.”

Anoosh Chakelian is deputy web editor at the New Statesman.