"Clegg's claims were a total distortion of the facts". Photo: Getty
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"A total distortion": Andy Burnham hits out at Nick Clegg's claims about Labour's NHS record

The shadow health secretary responds to the Deputy Prime Minister's attack on him during PMQs over "privatising" Hinchingbrooke Hospital.

In the coalition era, PMQs has become a pretty unedifying event. But, this week, it sank to a new low.

In the Prime Minister's absence, his Deputy picked up the Cameron textbook and followed it to the letter. In fact, he took it to a whole new level. Most of his replies did all, or a combination, of the following: evade the question; blame Labour; distort the facts; and celebrate a coalition policy unconnected to the original question.

Clegg's pantomime-style gestures to the massed Tory ranks behind him, inviting cheers for policies he and his Lib Dem MPs were never given a public mandate to support, will not quickly be forgotten.

But he did do one thing that may in the end prove beneficial. Clegg's incendiary claims about NHS privatisation have at last ignited a debate which the country desperately needs to have at the coming election. Because it certainly didn't happen last time out.

In this parliament, NHS policies have been introduced that were in neither the Tory nor Lib Dem manifestos. The pace of change is now accelerating: only this week the BBC reported that, of 3,494 contracts let between April 2013 and August 2014, 1,149 contracts (33 per cent) have gone to the private sector.

The NHS is changing fast and the country needs to decide whether it supports these changes, because there is a real danger that, by the 2020 election, they will be irreversible.

Clegg's opening gambit in this important debate attempts to divert attention from what his own party has done by making audacious claims about Labour. His claim - Hinchingbrooke Hospital - the only NHS hospital to be privatised, and by the Labour party - is, as I will show, simply untrue. But, if this debate is to be of a quality that the public deserve, then they do have a right to ask all parties and politicians to account for past policy decisions in this area and what they would do in future if elected. I accept that challenge on behalf of Labour.

I was involved in health policy from various vantage points throughout most of Labour's 13 years in office, from working for the NHS Confederation in 1997 to Health Secretary in 2009/10. I am well-placed to account for what we did.

Back in 1997, the relationship between the NHS and private sector we inherited was one where the latter traded off the failings of the former. People were routinely told that they would have to wait months or even years for operations on the NHS. But, if they were prepared to pay, they were often offered the operation the following week by the same consultant.

Labour set out to end this scandal - and we did. Our drive to bring down NHS waiting lists began to change the nature of the relationship with the private sector. As the NHS improved, so the private sector's main selling point began to disappear. This led to a big change in the relationship where the private sector threw its lot in with the NHS in a supporting role, making its capacity available to bring down NHS waiting lists even further.

By the end of the last decade, the NHS had the lowest-ever waiting lists in its history. I am proud of that achievement by the last government and my role in it. But, by then, a difference of opinion had opened up. Some were arguing for the continued development of the relationship with the private sector and further steps to increase choice of providers through the Any Qualified Provider concept.

I believed that approach, in an era of flat funding, would prove very damaging to the public NHS. So, in late 2009, I changed Labour policy on the NHS and the private sector from Any Qualified Provider to NHS Preferred Provider. I did this for a number of reasons.

First, I believed the AQP approach would take the NHS in the wrong direction: towards fragmentation of care when the future demanded the opposite - integration. The logical consequence of it is to bring an ever-increasing number of entities onto the pitch dealing with one person's care, intensifying the frustration they already feel of telling the same story to everyone who comes through the door.

Second, I was clear that AQP and open tendering would be a barrier to reform. I believed then, as I still do now, that re-engineering the way services work - moving from the hospital to the home - is the big challenge that the NHS faces. I believed those changes were likely to happen more quickly if NHS organisations and employees had the stability and security to embrace changes in the way they work. Also, the amount time and bureaucracy tied up in the contracting process can delay service change.

Third, I knew that all the evidence from around the world tells us that market-based systems cost more to run than systems like the NHS.

But there was another, more simple reason. In the end, I am not neutral about who provides NHS services. I believe in the public NHS and what it represents - a service based on people not profits. That is worth protecting.

These were the principles and values I brought to the on-going process I inherited as Secretary of State in late 2009 in respect of Hinchingbrooke Hospital. This process has been initiated some time before I arrived under the then thinking about provider neutrality. When I changed policy to NHS Preferred Provider, I specifically asked for my new rules to be applied to this tender process. In addition, outside of that process (and although there was still an NHS organisation involved in it), I asked the NHS to approach directly all surrounding NHS hospitals to see if an NHS operator could be found.

That was the position I left behind when the parliament was dissolved and it was the situation which the coalition inherited. Nothing had been signed by me and the process could have been stopped at any time.

From there, 18 months later, a private operator for the hospital was appointed by coalition ministers. That is why Clegg's claims in the Commons on Wednesday were a total distortion of the facts. The fact is that the decision to appoint Circle probably crossed his desk at some point. Clegg's government privatised the operation of Hinchingbrooke. That is a fact.

I have acknowledged that the last government let the market in too far. That is why I changed the policy. But the coalition's Health and Social Care Act, which Clegg and his MPs supported to the hilt, takes things much further than anything Labour did. It gives the competition authorities a role in the NHS for the very first time. It allows NHS hospitals to earn half their income from treating private patients. And it effectively mandates open tendering of NHS services and, in so doing, places the NHS in the full glare of EU procurement and competition law. That is why I fought it tooth and nail when it was going through parliament.

What is indefensible about this is that it has happened without the public ever having had a proper chance to express a clear view about NHS privatisation. No party has ever been as clear as they should have been about the extent of their plans. So the coming Election presents an opportunity to put that right.

I am clear that, if the market is allowed to carry on advancing into the heart of the NHS, it will eventually destroy everything that is precious about it. So both I and Ed Miliband have nailed Labour's colours to the mast: we believe in the public NHS and will protect it by repealing the Coalition Act and making it our Preferred Provider. The Deputy Prime Minister, by contrast, continues to support a government policy of opening up the NHS to tendering and competition.

There is a legitimate debate to be had  over the next five months about which path represents the best future for the NHS. But let's at least have an informed debate on this emotive issue on the basis of the facts rather than spurious claims at PMQs. I have tried to do that by giving this honest account of how Labour's thinking has evolved over the years and shaped the clear position we will take into the coming election. Is it too much to expect Clegg, Cameron and Farage now to do the same?

Andy Burnham is Labour MP for Leigh and shadow health secretary

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Charlottesville: a town haunted by the far right

Locals fear a bitter far right will return.

On 12 August, a car ploughed down pedestrians in the street where I used to buy my pecan pies. I had recently returned to London from Charlottesville, Virginia – the scene of what appears to have been an act of white supremacist terrorism – having worked and taught at the university there for four years. While I unpacked boxes of books, the streets I knew so well were full of hate and fire.

The horror began on the evening of Friday 11 August, when thugs with torches marched across the “Lawn”. Running through the heart of the university, this is where, each Halloween, children don ghoulish costumes and trick-or-treat delighted and generous fourth-year undergraduates.

But there were true monsters there that night. They took their stand on the steps of the neoclassical Rotunda – the site of graduation – to face down a congregation about to spill out of St Paul’s Episcopal opposite.

Then, on Saturday morning, a teeming mass of different groups gathered in Emancipation Park (formerly Lee Park), where my toddler ran through splash pads in the summer.

We knew it was coming. Some of the groups were at previous events in Charlottesville’s “summer of hate”. Ever since a permit was granted for the “Unite the Right” march, we feared that this would be a tipping point. I am unsure whether I should have been there, or whether I was wise to stay away.

The truth is that this had nothing to do with Charlottesville – and everything to do with it. From one perspective, our small, sleepy university town near the Blue Ridge Mountains was the victim of a showdown between out-of-towners. The fighting was largely not between local neo-Nazis and African Americans, or their white neighbours, for that matter. It was between neo-Nazis from far afield – James Alex Fields, Jr, accused of being the driver of the lethal Dodge Challenger, was born in Kentucky and lives in Ohio – and outside groups such as “Antifa” (anti-fascist). It was a foreign culture that was foisted upon the city.

Charlottesville is to the American east coast what Berkeley is to the west: a bastion of liberalism and political correctness, supportive of the kind of social change that the alt-right despises. Just off camera in the national newsfeeds was a banner hung from the public  library at the entrance of Emancipation Park, reading: “Proud of diversity”.

I heard more snippets of information as events unfolded. The counter-protesters began the day by drawing on the strength of the black church. A 6am prayer meeting at our local church, First Baptist on Main (the only church in Charlottesville where all races worshipped together before the Civil War), set the tone for the non-violent opposition.

The preacher told the congregation: “We can’t hate these brothers. They have a twisted ideology and they are deeply mistaken in their claim to follow Christ, but they are still our brothers.” Then he introduced the hymns. “The resistance of black people to oppression has only been kept alive through music.”

The congregation exited on to Main Street, opposite my old butcher JM Stock Provisions, and walked down to the statue of Meriwether Lewis and William Clark – the early 19th-century Bear Grylls types who explored the west. They went past Feast! – the delicacy market where we used to spend our Saturday mornings – and on to the dreamy downtown mall where my wife and I strolled on summer evenings and ate southern-fried chicken at the Whiskey Jar.

The permit for the “protest” was noon to 5pm but violence erupted earlier. Between 10.30am and 12pm, the white supremacists, protected by a paramilitary guard, attacked their opponents. As the skirmishes intensified, police were forced to encircle the clashing groups and created, in effect, a bizarre zone of “acceptable” violence. Until the governor declared a state of emergency, grown men threw bottles of piss at each other.

At noon, the crowd was dispersed and the protesters spilled out into the side streets. This was when the riot climaxed with the horrific death of the 32-year-old Heather Heyer. Throughout Saturday afternoon and evening, the far-right groups marauded the suburbs while residents locked their doors and closed their blinds.

I sat in London late into the night as information and prayer requests trickled through. “There are roughly 1,000 Nazis/KKK/alt-right/southern nationalists still around – in a city of 50,000 residents. If you’re the praying type, keep it up.”

No one in Charlottesville is in any doubt as to how this atrocity became possible. Donald Trump has brought these sects to group consciousness. They have risen above their infighting to articulate a common ground, transcending the bickering that mercifully held them back in the past.

In the immediate aftermath, there is clarity as well as fury. My colleague Charles Mathewes, a theologian and historian, remarked: “I still cannot believe we have to fight Nazis – real, actual, swastika-flag-waving, be-uniformed, gun-toting Nazis, along with armed, explicit racists, white supremacists and KKK members. I mean, was the 20th century simply forgotten?”

There is also a sense of foreboding, because the overwhelming feeling with which the enemy left was not triumph but bitterness. Their permit had been to protest from noon to 5pm. They terrorised a town with their chants of “Blood and soil!” but their free speech was apparently not heard. Their safe space, they claim, was not protected.

The next day, the organiser of the march, Jason Kessler, held a press conference to air his grievances. The fear is that the indignant white supremacists will be back in greater force to press their rights.

If that happens, there is one certainty. At one point during the dawn service at First Baptist, a black woman took the stand. “Our people have been oppressed for 400 years,” she said. “What we have learned is that the only weapon which wins the war is love.”

This article first appeared in the 17 August 2017 issue of the New Statesman, Trump goes nuclear