Ed Miliband speaks with radiotherapists, during his visit to University College hospital, on April 4, 2011 in London. Photograph: Getty Images.
Show Hide image

Labour leads on health, but it has to be clear that money for the NHS will lead to cuts elsewhere

To achieve economic credibility, Miliband needs to speak the language of priorities. 

Scandal follows scandal in Westminster, but David Cameron continues to float above it all. For a period his government appeared dangerously inert in response to allegations of a child abuse cover-up. But the establishment of two inquiries and his vow to leave “no stone unturned” moved him into safer territory.

“Concrete Cameron” is the name some MPs have given the Prime Minister, in tribute to his strange resilience. In short succession, his party finished third in a national election for the first time in its history, his public campaign to block Jean-Claude Juncker’s nomination as European Commission president was comprehensively defeated by EU leaders and his former director of communications Andy Coulson was imprisoned for phone-hacking. But none of these moments was accompanied by the kind of ritual humiliation that Cameron’s opponents hoped for.

It is the enduring strength of the Prime Minister’s brand (he outpolls his party by 7 points; Ed Miliband trails Labour by 13) that gives the Tories hope that they will win next May by framing the general election as a presidential contest. The recent improvement in Cameron’s ratings has surprised those who predicted his reputation would be tarnished irrevocably by now. When he pressed ahead with Andrew Lansley’s National Health Service reforms in 2012, commentators on left and right said that it would prove to be his “poll tax moment”. But the measures have inspired nothing close to that insurrection. Labour focus groups show that voters believe the NHS is struggling but also that they do not connect this with any particular government policy.

The opposition’s aim for the summer is to establish the Prime Minister as the guilty man. After last year’s “cost of living” offensive, it will devote the parliamentary recess to charting the “Cameron effect” on the health service. Leaflets in target seats will focus on the year-long failure to meet the four-hour A&E waiting time target, the lack of GP availability (four in ten people wait more than a week for an appointment) and the missed cancer treatment target. Andy Burnham, the shadow health secretary, and other MPs will join a re-creation of the Jarrow march organised by a group of mothers to protest against the creeping privatisation of the service.

Labour regards raising the salience of the NHS, the issue on which it enjoys its largest poll lead, as essential to its chances of victory next year. “After living standards, we need it [the NHS] to be voters’ priority,” a strategist says. At present, that place is taken by immigration, on which Labour trails the Conservatives by 9 points. To improve its odds, the party needs to force the Tories on to its preferred battleground.

Conservative ministers, who have been ordered by Lynton Crosby, the party’s campaign manager, to avoid mentioning the NHS, believe they can repel the opposition’s assault by deriding the state of the service in Labour-run Wales. But Miliband has adopted a new riposte to this attack: Cameron wants to talk about Wales because he cannot defend his record in England. The disparity in performance between the two countries has narrowed as the health service has deteriorated under the coalition.

But Labour will be able to dwell on this issue for only so long before it is forced to confront a funding gap of £30bn by the end of the next parliament. Stephen Dorrell, the former health secretary, Sarah Wollaston, the new chair of the health select committee, and Frank Field, the former social security minister, all warn that the NHS will not survive in its present form without a real-terms increase in spending. Demographic pressures, the rising cost of technology and the growth in chronic conditions are such that merely ring-fencing the service from cuts will not suffice.

To save the NHS from collapse, Field has proposed a 1 per cent rise in National Insurance, accompanied by the lifting of the floor on contributions and the removal of the ceiling. He told me: “It both deals with the health service and deals with the double Ed problem, which is: does anyone believe them on the fiscal side?”

The plan is partly modelled on Gordon Brown’s 1 per cent increase in NI in his 2002 Budget, a move that proved more popular than almost anyone expected. Miliband, who as a Treasury adviser helped to design the policy, later described this act of social-democratic statecraft as his proudest moment. Yet there is little prospect of a sequel. Shadow cabinet ministers, including Ed Balls, believe that is untenable for the party to speak of a “cost-of-living crisis” and then to argue for a rise in taxation on low- and middle-income earners. “It would be kamikaze politics,” one tells me.

Burnham has long signalled that he does not believe an increase in NHS funding can be justified until health and social care have been integrated and all potential savings have been achieved. He is focused on securing the money needed to support his scheme, potentially through a 10 per cent levy on all estates. But while the long-term savings from integration are estimated to be as high as £6bn, health professionals believe a short-term injection of funds is essential.

“The language of priorities is the religion of socialism,” declared Nye Bevan, the father of the NHS. The only way for Labour to square the fiscal circle may be finally to reveal the austerity it would impose elsewhere in order to release resources for the health service.

Few in Westminster fully comprehend the budgetary horrors that await the next government as ministers, having trimmed Whitehall of fat, are forced to cut into bone. If Miliband is to offer himself as the saviour of the NHS, it is the language of priorities that he will need to speak.

George Eaton is political editor of the New Statesman.

This article first appeared in the 08 July 2014 issue of the New Statesman, The end of the red-top era?

Getty
Show Hide image

It's easy to see where Berlin is being rebuilt – just hit the streets

My week, from walking the streets of Berlin to class snobbery and the right kind of gentrification.

Brick by brick, block by block, the people are rebuilding the city once called Faust’s Metropolis. To see it clearly, put your boots on. One of the most bracing walks starts by the Gethsemane Church, which served as a haven for dissenters in the last days of the GDR and takes you down ­towards the Hackescher Markt.

Here, in what is still the eastern half of a divided city that wears its division more lightly, is a Berlin experience both old and new. In three decades of frequent visits, it has been fascinating to note how much this part of town has changed. Even a decade ago these streets were rundown. With crumbling buildings showing bulletholes, it wasn’t hard to imagine what the place looked like in 1945. Now there are lilacs, blues, and yellows. Cafés, bars and restaurants abound, serving the young professionals attracted to the city by cheap rents and a renewed sense of community.

 

Breaking the fourth wall

Looking north along Schliemannstraße, you’ll find a delightful vista of well-tended balconies. It’s a pleasant place to live, notwithstanding the gaggle of grotesques who gather round the corner in the square. On Kastanienallee, which forms the second leg of the walk, an old city feels young. It’s a kind of gentrification but the right kind. There’s more to eat, to drink, to buy, for all.

Berlin, where Bertolt Brecht staged his unwatchable plays, was supposed to have been transformed by a proletarian revolution. Instead, it has been restored to health by a very middle-class one. Germany has always had a well-educated middle class, and the nation’s restoration would have impossible without such people. The irony is delicious – not that irony buttered many parsnips for “dirty Bertie”.

 

The new snobbery

The British Museum’s survey of German history “Memories of a Nation” is being presented at the Martin-Gropius-Bau as “The British View”. Germans, natürlich, are curious to see how we observe them. But how do they see us?

A German friend recently in England  said that the images that struck him most forcibly were the tins of food and cheap booze people piled up in supermarkets, and the number of teenage girls pushing prams. Perhaps Neil MacGregor, the former director of the British Museum who will shortly take up a similar role here at the new Humboldt Forum, may turn his attention to a “German View” of the United Kingdom.

There’s no shortage of material. In Schlawinchen, a bar that typifies Kreuzberg’s hobohemia, a college-educated English girl was trying to explain northern England to an American she had just met. Speaking in an ugly modern Mancunian voice that can only be acquired through years of practice (sugar pronounced as “sug-oar”), she refer­red to Durham and York as “middle class, you know, posh”, because those cities had magnificent cathedrals.

When it comes to inverted snobbery, no nation can match us. To be middle class in Germany is an indication of civic value. In modern England, it can mark you as a leper.

 

Culture vultures

The Humboldt Forum, taking shape by the banks of the Spree, reconsecrates the former site of the GDR’s Palace of the Republic. When it opens in 2018 it will be a “living exhibition”, dedicated to all the cultures of the world. Alexander von Humboldt, the naturalist and explorer, was the brother of Wilhelm, the diplomat and philosopher, whose name lives on in the nearby university.

In Potsdamerplatz there are plans to build a modern art museum, crammed in between the Neue Nationalgalerie and the Philharmonie, home to the Berlin Philharmonic. Meanwhile, the overhaul of the Deutsche Staatsoper, where Daniel Barenboim is music director for life, is likely to be completed, fingers crossed, next autumn.

Culture everywhere! Or perhaps that should be Kultur, which has a slightly different meaning in Germany. They take these things more seriously, and there is no hint of bogus populism. In London, plans for a new concert hall have been shelved. Sir Peter Hall’s words remain true: “England is a philistine country that loves the arts.”

 

European neighbours

When Germans speak of freedom, wrote A J P Taylor, a historian who seems to have fallen from favour, they mean the freedom to be German. No longer. When modern Germans speak of freedom, they observe it through the filter of the European Union.

But nation states are shaped by different forces. “We are educated to be obedient,” a Berlin friend who spent a year at an English school once told me. “You are educated to be independent.” To turn around Taylor’s dictum: when the English speak of freedom,
they mean the freedom to be English.

No matter what you may have heard, the Germans have always admired our independence of spirit. We shall, however, always see “Europe” in different ways. Europe, good: we can all agree on that. The European Union, not so good. It doesn’t mean we have to fall out, and the Germans are good friends to have.

 

Hook, line and sinker

There are fine walks to be had in the west, too. In Charlottenburg, the Kensington of Berlin, the mood is gentler, yet you can still feel the city humming. Here, there are some classic places to eat and drink – the Literaturhauscafé for breakfast and, for dinner, Marjellchen, a treasure trove of east Prussian forest delights. Anything that can be shot and put in a pot!

For a real Berlin experience, though, head at nightfall for Zwiebelfisch, the great tavern on Savignyplatz, and watch the trains glide by on the other side of Kantstraße. Hartmut Volmerhaus, a most amusing host, has been the guvnor here for more than 30 years and there are no signs that his race is run. The “Fisch” at twilight: there’s nowhere better to feel the pulse of this remarkable city. 

This article first appeared in the 01 December 2016 issue of the New Statesman, Age of outrage