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

Photo: Getty Images
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What's to be done about racial inequality?

David Cameron's words on equal opportunities are to be welcomed - now for some action, says Sunder Katwala.

David Cameron made the strongest, clearest and most high profile statement about ethnic inequalities and the need to tackle discrimination ever yet offered by a British Prime Minister in his leader’s speech to the Conservative Party conference in Manchester.
“Picture this. You’ve graduated with a good degree. You send out your CV far and wide. But you get rejection after rejection. What’s wrong? It’s not the qualifications or the previous experience. It’s just two words at the top: first name, surname. Do you know that in our country today: even if they have exactly the same qualifications, people with white-sounding names are nearly twice as likely to get call backs for jobs than people with ethnic-sounding names? … That, in 21st century Britain, is disgraceful. We can talk all we want about opportunity, but it’s meaningless unless people are really judged equally”, said Cameron.
While the proof of the pudding will be in the eating, this was a powerfully argued Prime Ministerial intervention – and a particularly well-timed one, for three reasons.

Firstly, the Prime Minister was able to root his case in an all-but-universally accepted appeal for equal opportunities. It will always prove more difficult in practice to put political energy and resources behind efforts to remedy discrimination against a minority of the population unless a convincing fairness case is made that values cherished across our whole society are at stake. Cameron’s argument, that any party which tells itself that it is the party of the ‘fair chance’ and ‘the equal shot’ must have a response when there is such clear evidence of discrimination, should prove persuasive to a Conservative Party that has not seen race inequalities as its natural territory. Cameron argued that the same principles should animate responses to discrimination when it comes to race, gender and social class. Put like that, wanting job interviews to be fair – by eradicating conscious and unconscious patterns of bias wherever possible – would strike most Britons as offering as clear a case of the values of fair play as wanting the best baker to win the Great British Bake-Off on television.
Secondly, Cameron’s intervention comes at a potential "tipping point" moment for fair opportunities across ethnic groups. Traditionally, ethnic discrimination has been discussed primarily through the lens of its impact on the most marginalised. Certainly, persistent gaps in the criminal justice system, mental health provision and unemployment rates remain stark for some minority groups. What has been less noticed is the emergence of a much more complex pattern of opportunity and disadvantage – not least as a consequence of significant ethnic minority progress.

Most strikingly of all, in educational outcomes, historic attainment gaps between ethnic minorities and their white British peers have disappeared over the last decade. In the aggregate, ethnic minorities get better GCSE results on average. Ethnic minority Britons are more likely, not less likely, to be university graduates than their fellow citizens. 

As a result of that progress, Cameron’s intervention comes at a moment of significant potential – but significant risk too. Britain’s ethnic minorities are the youngest and fastest-growing sections of British society. If that educational progress translates into economic success, it will make a significant contribution to the "Great British Take-Off" that the Prime Minister envisions. But if that does not happen, with educational convergence combined with current ‘ethnic penalties’ in employment and income persisting, then that potential could well curdle into frustration that the British promise of equal opportunities is not being kept.  Cameron also mirrored his own language in committing himself to both a ‘fight against extremism’ and a ‘fight against discrimination’: while those are distinct challenges and causes, actively pursuing both tracks simultaneously has the potential, at least, depolarise some debates about responses to extremism  - and so to help deepen the broad social coalitions we need for a more cohesive society too.

Thirdly, Cameron’s challenge could mark an important deepening in the political competition between the major parties on race issues. Many have been struck by the increase in political attention on the centre-right to race issues over the last five to ten years. The focus has been on the politics of representation. By increasing the number of non-white Conservative MPs from two to seventeen since 2005, Cameron has sent a powerful signal that Labour’s traditional claim to be ‘the party of ethnic minorities’ would now be contested. Cameron was again able to celebrate in Manchester several ways in which his Cabinet and Parliamentary benches demonstrate many successful journeys of migrant and minority integration in British society. That might perhaps help to ease the fears, about integration being impossible in an era of higher immigration, which the Home Secretary had articulated the previous day.

So symbolism can matter. But facial diversity is not enough. The politics of ethnic minority opportunity needs to be about more than visits to gurdwaras, diversity nights at the party conference fringes and unveiling statues of Mahatma Gandhi in Parliament Square. Jeremy Corbyn’s first speech as Labour leader did include one brief celebratory reference to Britain’s ethnic diversity – “as I travelled the country during the leadership campaign it was wonderful to see the diversity of all the people in our country” – and to Labour bringing in more black, Asian and ethnic minority members - but it did not include any substantial content on discrimination. Tim Farron acknowledged during his leadership campaign that the Liberal Democrats have struggled to get to the starting-line on race and diversity at all. The opposition parties too will no doubt now be challenged to match not just the Prime Minister’s rhetorical commitment to challenging inequalities but also to propose how it could be done in practice.

Non-white Britons expect substance, not just symbolism from all of the parties on race inequalites.  Survation’s large survey of ethnic minority voters for British Future showed the Conservatives winning more ethnic minority support than ever before – but just 29 per cent of non-white respondents were confident that the Conservatives are committed to treating people of every ethnic background equally, while 54 per cent said this of Labour. Respondents were twice as likely to say that the Conservatives needto do more to reach out – and the Prime Minister would seem to be committed to showing that he has got that message.  Moreover, there is evidence that ethnic inclusion could be important in broadening a party’s appeal to other younger, urban and more liberal white voters too – which is why it made sense for this issue to form part of a broader attempt by David Cameron to colonise the broad centre of British politics in his Manchester speech.

But the case for caution is that there has been limited policy attention to ethnic inequalities under the last two governments. Restaurateur Iqbal Wahhab decided to give up his role chairing an ethnic minority taskforce for successive governments, unconvinced there was a political commitment to do much more than convene a talking shop. Lib Dem equalities minister Lynne Featherstone did push the CV discrimination issue – but many Conservatives were sceptical. Cameron’s new commitment may face similar challenges from those whose instinct is to worry that more attention to discrimination or bias in the jobs market will mean more red tape for business.

Labour had a separate race inequalities manifesto in 2015, outside of its main election manifesto, while the Conservative manifesto did not contain significant commitments to racial inequality. The mid-campaign launch in Croydon of a series of race equality pledges showed an increasing awareness of the growing importance of ethnic minority votes - though the fact that they all involved aiming for increases of 20 per cent by 2020 gave them a slightly back-of-the-envelope feel. 

Prime Ministerial commitments have an important agenda-setting function. A generation ago the Stephen Lawrence case opened the eyes of middle England to racist violence and police failures, particularly through the Daily Mail’s persistent challenging of those injustices. A Conservative Prime Minister’s words could similarly make a big difference in the mainstreaming of the issue of inequalities of opportunity. What action should follow words? Between now and next year’s party conference season, that must will now be the test for this Conservative government – and for their political opponents too. 

Sunder Katwala is director of British Future and former general secretary of the Fabian Society.