Ed Miliband campaigns before the Rochester and Strood by-election on October 23, 2014 in Chatham. Photograph: Getty Images.
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PMQs review: Miliband shows his confidence on the EU

The Labour leader regards his party's commitment to membership as a political strength. 

The most significant thing about today's PMQs was Ed Miliband's choice of subject matter: EU membership. If Labour once feared its stance on the issue was a weakness, it now regards it as a strength. After being rebuked by Angela Merkel for his demand to abandon the free movement of people, it is ever harder for David Cameron to argue that he can secure the reforms he believes are necessary for Britain to remain in the EU. As a result, he is being forced to flirt with the possibility of withdrawal. 

Pressed by Miliband on whether he was prepared to campaign for an "out" vote (an option he previously ruled out), the PM filibustered. "I want Britain to stay in a reformed European Union," he said. But is it possible to reform Europe? Many Conservative MPs no longer believe it is, a divide Miliband skillfully exploited today. "There's no point giving us the 'fight them on the beaches' speech because the last time he tried that was over Jean-Claude Juncker and he lost 26 votes to 2. That's his leadership in Europe," he said, and the Tory benches were notably muted. 

In contrast to Cameron, Miliband was unambiguous: "I want to stay in the EU". As well as being buoyed by polls showing support for membership at a 23-year high, Labour regards its commitment to the EU as one of its few trump cards on business (Miliband told Cameron that business leaders would have their "heads in their hands" over his stance - and many do ). But a significant number of Labour MPs continue to fear that Cameron's charge that the party is too "chicken" to "trust the people" is one that could hurt it during the election campaign. 

With the aid of an arsenal of critical Labour quotes, Cameron held his own in the chamber. He noted that Alistair Darling ("about the only person on the Labour benches who had any economic credibility") had argued that an EU referendum was inevitable ("It's a boil that has to be lanced"), that shadow deputy leader of the House Thomas Docherty had warned Labour was in a "dreadful position" and that even John Prescott was now giving Miliband lectures on the English language (although the sight of Cameron deriding the working class northerner is unlikely to have endeared him to all). 

The other notable point from today's session was the co-ordinated Labour assault on PM over VAT. With Cameron again refusing to rule out another rise, it is clear this will be a key election attack line for the opposition. 

George Eaton is political editor of the New Statesman.

Photo: Getty
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The big problem for the NHS? Local government cuts

Even a U-Turn on planned cuts to the service itself will still leave the NHS under heavy pressure. 

38Degrees has uncovered a series of grisly plans for the NHS over the coming years. Among the highlights: severe cuts to frontline services at the Midland Metropolitan Hospital, including but limited to the closure of its Accident and Emergency department. Elsewhere, one of three hospitals in Leicester, Leicestershire and Rutland are to be shuttered, while there will be cuts to acute services in Suffolk and North East Essex.

These cuts come despite an additional £8bn annual cash injection into the NHS, characterised as the bare minimum needed by Simon Stevens, the head of NHS England.

The cuts are outlined in draft sustainability and transformation plans (STP) that will be approved in October before kicking off a period of wider consultation.

The problem for the NHS is twofold: although its funding remains ringfenced, healthcare inflation means that in reality, the health service requires above-inflation increases to stand still. But the second, bigger problem aren’t cuts to the NHS but to the rest of government spending, particularly local government cuts.

That has seen more pressure on hospital beds as outpatients who require further non-emergency care have nowhere to go, increasing lifestyle problems as cash-strapped councils either close or increase prices at subsidised local authority gyms, build on green space to make the best out of Britain’s booming property market, and cut other corners to manage the growing backlog of devolved cuts.

All of which means even a bigger supply of cash for the NHS than the £8bn promised at the last election – even the bonanza pledged by Vote Leave in the referendum, in fact – will still find itself disappearing down the cracks left by cuts elsewhere. 

Stephen Bush is special correspondent at the New Statesman. He usually writes about politics.