On the NHS, Labour is pandering to fear. Photo: Flickr/Lydia
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Has Labour descended into the politics of fear over the NHS?

Ed Miliband's party is repeating the divisive mistakes in the history of Labour's internal debates over the NHS.

The Labour party finds it hard having heroes. As a movement that grew from the bottom of society, it has nearly always found a reason not to honour those who reach its top. Very few are spared the harshest of political judgment. Ramsay MacDonald was the original traitor, and since then the labour movement has been finding new pariahs at each and every election. Even those who happen to win three. But one light nearly always shines through the red mist; Aneurin Bevan.

The bright shining vision of the National Health Service is as acute today as it was in 1948 when the great reforming Attlee government began to heal a war-ravaged nation. Bevan, rightly, is seen as the most significant figure in the history of the NHS. His place in the pantheon of Labour greats is assured. That he was opposed, and indeed defeated, by a name that is but a passing reference in Labour's annals speaks volumes about those the party reveres over those it does not. But this figure, as Daniel Finkelstein recently noted, could hold the key to the very future of the NHS.

The bourgeois socialising and elite politicking associated with Gaitskell represented the very antithesis of Bevan. Where Bevan had created the NHS, Gaitskell introduced the first NHS charges to fund an American-led fight in distant Korea. Themes being replayed in the politics of today were first thrashed out by a Labour cabinet in 1951; namely whether the NHS could be sustained without the imposition of charges that Gaitskell first introduced. The debate now writ large is over the very future of the NHS.

The NHS is, according to the Kings Fund, facing "financial meltdown". And to what, from Labour, is the answer to this most fundamental question? Andy Burnham, the shadow health secretary, would clearly like to position himself as the latter-day Bevan, the keeper of the party of the NHS, of its conscience and soul - and whatever other mystical tones in which the party likes to drape itself. But on the key question facing the NHS, the party has been all but mute.

Candle-lit vigils, people's marches, nonagenarians deployed at party conference - Labour has descended into the politics of demagoguery over the NHS. Nostalgia, fear and politiking are driving policy. What is at stake for Labour is votes, not the secure future of the NHS. For the party has not articulated a policy that would quell the ills inflicted upon it by the coalition. Its flagship "Time to Care Fund" unravelled under the most basic scrutiny; not implemented until 2017, and only after the mansion tax, tobacco levy and tax avoidance measures are passed in a Budget when, with present polls, Labour cannot guarantee a majority.

But it is on the question of privatisation that the party is pandering to fear. Burnham will know better than many Labour's acceptance of the private sector into the NHS during the New Labour years. As part of reforms in the first years of the previous Labour government, bids for services were invited from the private sector. Labour very clearly made use of the private sector when it suited them, in particular in order to bring down waiting lists. As Finkelstein’s Times colleague David Aaronovitch highlighted, private sector involvement in the NHS rose from just under three per cent in 2006 to just over six per cent today. It is hardly a privatised Damascene conversion.

The Attlee government realised, even at the birth of the NHS, that it was a policy with a limited price tag. Since the NHS was founded, its spending has increased on average by four per cent a year in real terms. However, for the foreseeable future, the NHS budget is likely to remain flat in real terms or, at most, to increase in line with growth in the rest of the economy. It will require Gaitskell's discipline, not Bevan's vision.

Labour is absolutely right that the NHS must be at the centre of political debate between now and the election, for it is genuinely facing the biggest challenges than at any time in its history. But the battles being played out internally are all too similar. Gaitskell may have had the upper hand more often during the Labour party's 1950s civil war, but there was only going to be one winner in the Labour history stakes. Labour in the years ahead may conclude that it picked the wrong hero.

David Talbot is a political consultant and contributor to Labour Uncut

David Talbot is a political consultant

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Former Irish premier John Bruton on Brexit: "Britain should pay for our border checks"

The former Taoiseach says Brexit has been interpreted as "a profoundly unfriendly act"

At Kapıkule, on the Turkish border with Bulgaria, the queue of lorries awaiting clearance to enter European Union territory can extend as long as 17km. Despite Turkey’s customs union for goods with the bloc, hauliers can spend up to 30 hours clearing a series of demanding administrative hoops. This is the nightmare keeping former Irish premier John Bruton up at night. Only this time, it's the post-Brexit border between Northern Ireland and the Republic, and it's much, much worse.   

Bruton (pictured below), Taoiseach between 1994 and 1997, is an ardent pro-European and was historically so sympathetic to Britain that, while in office, he was pilloried as "John Unionist" by his rivals. But he believes, should she continue her push for a hard Brexit, that Theresa May's promise for a “seamless, frictionless border” is unattainable. 

"A good example of the sort of thing that might arise is what’s happening on the Turkish-Bulgarian border," the former leader of Ireland's centre-right Fine Gael party told me. “The situation would be more severe in Ireland, because the UK proposes to leave the customs union as well."

The outlook for Ireland looks grim – and a world away from the dynamism of the Celtic Tiger days Bruton’s coalition government helped usher in. “There will be all sorts of problems," he said. "Separate permits for truck drivers operating across two jurisdictions, people having to pay for the right to use foreign roads, and a whole range of other issues.” 

Last week, an anti-Brexit protest on the border in Killeen, County Louth, saw mock customs checks bring traffic to a near standstill. But, so far, the discussion around what the future looks like for the 260 border crossings has focused predominantly on its potential effects on Ulster’s fragile peace. Last week Bruton’s successor as Taoiseach, Bertie Ahern, warned “any sort of physical border” would be “bad for the peace process”. 

Bruton does not disagree, and is concerned by what the UK’s withdrawal from the European Convention on Human Rights might mean for the Good Friday Agreement. But he believes the preoccupation with the legacy of violence has distracted British policymakers from the potentially devastating economic impact of Brexit. “I don’t believe that any serious thought was given to the wider impact on the economy of the two islands as a whole," he said. 

The collapse in the pound has already hit Irish exporters, for whom British sales are worth £15bn. Businesses that work across the border could yet face the crippling expense of duplicating their operations after the UK leaves the customs union and single market. This, he says, will “radically disturb” Ireland’s agriculture and food-processing industries – 55 per cent of whose products are sold to the UK. A transitional deal will "anaesthetise" people to the real impact, he says, but when it comes, it will be a more seismic change than many in London are expecting. He even believes it would be “logical” for the UK to cover the Irish government’s costs as it builds new infrastructure and employs new customs officials to deal with the new reality.

Despite his past support for Britain, the government's push for a hard Brexit has clearly tested Bruton's patience. “We’re attempting to unravel more than 40 years of joint work, joint rule-making, to create the largest multinational market in the world," he said. It is not just Bruton who is frustrated. The British decision to "tear that up", he said, "is regarded, particularly by people in Ireland, as a profoundly unfriendly act towards neighbours".

Nor does he think Leave campaigners, among them the former Northern Ireland secretary Theresa Villiers, gave due attention to the issue during the campaign. “The assurances that were given were of the nature of: ‘Well, it’ll be alright on the night!’," he said. "As if the Brexit advocates were in a position to give any assurances on that point.” 

Indeed, some of the more blimpish elements of the British right believe Ireland, wedded to its low corporate tax rates and east-west trade, would sooner follow its neighbour out of the EU than endure the disruption. Recent polling shows they are likely mistaken: some 80 per cent of Irish voters say they would vote to remain in an EU referendum.

Irexit remains a fringe cause and Bruton believes, post-Brexit, Dublin will have no choice but to align itself more closely with the EU27. “The UK is walking away,” he said. “This shift has been imposed upon us by our neighbour. Ireland will have to do the best it can: any EU without Britain is a more difficult EU for Ireland.” 

May, he says, has exacerbated those difficulties. Her appointment of her ally James Brokenshire as secretary of state for Northern Ireland was interpreted as a sign she understood the role’s strategic importance. But Bruton doubts Ireland has figured much in her biggest decisions on Brexit: “I don’t think serious thought was given to this before her conference speech, which insisted on immigration controls and on no jurisdiction for the European Court of Justice. Those two decisions essentially removed the possibility for Ireland and Britain to work together as part of the EEA or customs union – and were not even necessitated by the referendum decision.”

There are several avenues for Britain if it wants to avert the “voluntary injury” it looks set to inflict to Ireland’s economy and its own. One, which Bruton concedes is unlikely, is staying in the single market. He dismisses as “fanciful” the suggestions that Northern Ireland alone could negotiate European Economic Area membership, while a poll on Irish reunification is "only marginally" more likely. 

The other is a variation on the Remoaners’ favourite - a second referendum should Britain look set to crash out on World Trade Organisation terms without a satisfactory deal. “I don’t think a second referendum is going to be accepted by anybody at this stage. It is going to take a number of years,” he said. “I would like to see the negotiation proceed and for the European Union to keep the option of UK membership on 2015 terms on the table. It would be the best available alternative to an agreed outcome.” 

As things stand, however, Bruton is unambiguous. Brexit means the Northern Irish border will change for the worse. “That’s just inherent in the decision the UK electorate was invited to take, and took – or rather, the UK government took in interpreting the referendum.”