David Cameron delivers a speech on NHS reform at University College Hospital on June 7, 2011. Photograph: Getty Images.
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The NHS is becoming an ever-bigger headache for the Tories

Labour stands to gain if the crisis in the health service becomes one of the major election themes. 

One of Labour's priorities for the summer is raising the salience of the NHS, the issue on which it enjoys its largest poll lead. "After living standards, we need it [the NHS] to be voters’ priority," a strategist told me. If one of the defining questions of the election is "which party do I trust to run the health service?" Labour's chances of victory will be improved.  

It is encouraging for the party, then, that both the Sun and the Times splash on the growing NHS crisis today. The former carries an investigation warning of record A&E waiting times and longer waits for GPs, while the latter reports that one in nine people trying to see a doctor cannot get an appointment, with GPs turning patients away more than 40 million times this year.

The Tories have long regarded the NHS as the dog that hasn't barked, boasting that the oft-predicted "winter crisis" never came. But the dog is certainly barking now. Worse, the party's "top-down reorganisation" of the health service (for which, it should not be forgotten, it had no mandate. Indeed, it had a mandate not to introduce one) means Labour can easily lay the blame at the Conservatives' door. 

Having once aspired to establish themselves as "the party of the NHS", the Tories are now narrowly focused on neutralising the issue. As I've previously reported, Lynton Crosby has told ministers not to mention it on the grounds that it helps Labour. 

In his speech at last year's Conservative conference, David 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 deficit, immigration and welfare, and avoiding those on which it is weak.

Some Tories believe they can repel the opposition’s assault by deriding the state of the service in Labour-run Wales. But Ed 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 do. 

One of the biggest questions facing Labour before the election, then, is whether, and how, to promise an increase in health spending. 

George Eaton is political editor of the New Statesman.

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In the 1980s, I went to a rally where Labour Party speakers shared the stage with men in balaclavas

The links between the Labour left and Irish republicanism are worth investigating.

A spat between Jeremy Corbyn’s henchfolk and Conor McGinn, the MP for St Helens North, caught my ear the other evening. McGinn was a guest on BBC Radio 4’s Westminster Hour, and he obligingly revisited the brouhaha for the listeners at home. Apparently, following an interview in May, in which McGinn called for Corbyn to “reach out beyond his comfort zone”, he was first threatened obliquely with the sack, then asked for a retraction (which he refused to give) and finally learned – from someone in the whips’ office – that his party leader was considering phoning up McGinn’s father to whip the errant whipper-in into line. On the programme, McGinn said: “The modus operandi that he [Corbyn] and the people around him were trying to do [sic], involving my family, was to isolate and ostracise me from them and from the community I am very proud to come from – which is an Irish nationalist community in south Armagh.”

Needless to say, the Labour leader’s office has continued to deny any such thing, but while we may nurture some suspicions about his behaviour, McGinn was also indulging in a little airbrushing when he described south Armagh as an “Irish ­nationalist community”. In the most recent elections, Newry and Armagh returned three Sinn Fein members to the Northern Ireland Assembly (as against one Social Democratic and Labour Party member) and one Sinn Fein MP to Westminster. When I last looked, Sinn Fein was still a republican, rather than a nationalist, party – something that McGinn should only be too well aware of, as the paternal hand that was putatively to have been lain on him belongs to Pat McGinn, the former Sinn Fein mayor of Newry and Armagh.

According to the Irish News, a “close friend” of the McGinns poured this cold water on the mini-conflagration: “Anybody who knows the McGinn family knows that Pat is very proud of Conor and that they remain very close.” The friend went on to opine: “He [Pat McGinn] found the whole notion of Corbyn phoning him totally ridiculous – as if Pat is going to criticise his son to save Jeremy Corbyn’s face. They would laugh about it were it not so sinister.”

“Sinister” does seem the mot juste. McGinn, Jr grew up in Bessbrook during the Troubles. I visited the village in the early 1990s on assignment. The skies were full of the chattering of British army Chinooks, and there were fake road signs in the hedgerows bearing pictograms of rifles and captioned: “Sniper at work”. South Armagh had been known for years as “bandit country”. There were army watchtowers standing sentinel in the dinky, green fields and checkpoints everywhere, manned by some of the thousands of the troops who had been deployed to fight what was, in effect, a low-level counter-insurgency war. Nationalist community, my foot.

What lies beneath the Corbyn-McGinn spat is the queered problematics of the ­relationship between the far left wing of the Labour Party and physical-force Irish republicanism. I also recall, during the hunger strikes of the early 1980s, going to a “Smash the H-Blocks” rally in Kilburn, north London, at which Labour Party speakers shared the stage with representatives from Sinn Fein, some of whom wore balaclavas and dark glasses to evade the telephoto lenses of the Met’s anti-terrorist squad.

The shape-shifting relationship between the “political wing” of the IRA and the men with sniper rifles in the south Armagh bocage was always of the essence of the conflict, allowing both sides a convenient fiction around which to posture publicly and privately negotiate. In choosing to appear on platforms with people who might or might not be terrorists, Labour leftists also sprinkled a little of their stardust on themselves: the “stardust” being the implication that they, too, under the right circumstances, might be capable of violence in pursuit of their political ends.

On the far right of British politics, Her Majesty’s Government and its apparatus are referred to derisively as “state”. There were various attempts in the 1970s and 1980s by far-right groupuscules to link up with the Ulster Freedom Fighters and other loyalist paramilitary organisations in their battle against “state”. All foundered on the obvious incompetence of the fascists. The situation on the far left was different. The socialist credentials of Sinn Fein/IRA were too threadbare for genuine expressions of solidarity, but there was a sort of tacit confidence-and-supply arrangement between these factions. The Labour far left provided the republicans with the confidence that, should an appropriately radical government be elected to Westminster, “state” would withdraw from Northern Ireland. What the republicans did for the mainland militants was to cloak them in their penumbra of darkness: without needing to call down on themselves the armed might of “state”, they could imply that they were willing to take it on, should the opportunity arise.

I don’t for a second believe that Corbyn was summoning up these ghosts of the insurrectionary dead when he either did or did not threaten to phone McGinn, Sr. But his supporters need to ask themselves what they’re getting into. Their leader, if he was to have remained true to the positions that he has espoused over many years, should have refused to sit as privy counsellor upon assuming his party office, and refused all the other mummery associated with the monarchical “state”. That he didn’t do so was surely a strategic decision. Such a position would make him utterly unelectable.

The snipers may not be at work in south Armagh just now – but there are rifles out there that could yet be dug up. I wouldn’t be surprised if some in Sinn Fein knew where they are, but one thing’s for certain: Corbyn hasn’t got a clue, bloody or otherwise. 

Will Self is an author and journalist. His books include Umbrella, Shark, The Book of Dave and The Butt. He writes the Madness of Crowds and Real Meals columns for the New Statesman.

This article first appeared in the 25 August 2016 issue of the New Statesman, Cameron: the legacy of a loser