George Osborne and David Cameron speak to business leaders at the AQL centre on February 5, 2015 in Leeds. Photograph: Getty Images.
Show Hide image

Osborne's dramatic Manchester NHS plan is a dangerous distraction

The Chancellor's politically-motivated project undermines the goal of the national integration of health and social care. 

The most significant political story today is George Osborne's confirmation that he intends to hand Greater Manchester control of the region's £6bn health and social care budget (a quarter of total government spending in the area). Never in the history of the NHS has there been such devolution in England. The announcement was due to be made on Friday, during a visit by Osborne to the area, but the Chancellor's plans were foiled after the Manchester Evening News got hold of a draft "memorandum of understanding" between the region's councils and the Treasury. 

This being Osborne, who remains the Conservatives' chief electoral strategist, the politics are crucial. He has framed the move, which would take effect from April 2016, as part of his drive to create a "northern powerhouse", a project with the political aim of decontaminating the Conservative brand in that region (one inspired by Osborne's special adviser Neil O'Brien, the former director of Policy Exchange). The Tories are also hailing the proposed integration of health and social care spending as evidence that they are making the running on a cause that Andy Burnham, the shadow health secretary, has long championed. 

But if the politics are clear, the policy is not. By promising Greater Manchester control of health spending, the Conservatives have set a precedent that several other areas will want to follow (Tessa Jowell, the Labour London mayoral candidate, was swift to demand equivalent powers for the capital). In so doing, they have driven a coach and horses through Labour's proposed national integration of health and social care. As Burnham noted in his response, the resultant danger is the creation of a "two-tier" NHS which destroys the principle of a universal and comprehensive service. In the middle of the greatest funding squeeze in the NHS's history, Osborne's "devo Manc" project, which would likely necessitate another reorganisation, risks being a dangerous distraction. Under Burnham's alternative vision, health and social care would be nationally integrated (producing up to £6bn in savings) with individual local authorities and GP commissioning bodies working in harness to build new services. 

Osborne's proposal of stand-alone devolution to Manchester resembles an answer in search of a problem. Worse, it threatens to create new dysfunctions. At the last count, the region's hospitals were running a deficit of £40m. Who will pick up the bill in the event of a crisis? Though the Conservatives will protest otherwise, the move risks being the first step in the ultimate unravelling of a truly national health service. 

George Eaton is political editor of the New Statesman.

Getty
Show Hide image

Why the Liberal Democrats by-election surge is not all it seems

The Lib Dems chalked up impressive results in Stoke and Copeland. But just how much of a fight back is it?

By the now conventional post-Brexit logic, Stoke and Copeland ought to have been uniquely inhospitable for the Lib Dems. 

The party lost its deposit in both seats in 2015, and has no representation on either council. So too were the referendum odds stacked against it: in Stoke, the so-called Brexit capital of Britain, 70 per cent of voters backed Leave last June, as did 62 per cent in Copeland. And, as Stephen has written before, the Lib Dems’ mini-revival has so far been most pronounced in affluent, Conservative-leaning areas which swung for remain. 

So what explains the modest – but impressive – surges in their vote share in yesterday’s contests? In Stoke, where they finished fifth in 2015, the party won 9.8 per cent of the vote, up 5.7 percentage points. They also more than doubled their vote share in Copeland, where they beat Ukip for third with 7.3 per cent share of the vote.

The Brexit explanation is a tempting and not entirely invalid one. Each seat’s not insignificant pro-EU minority was more or less ignored by most of the national media, for whom the existence of remainers in what we’re now obliged to call “left-behind Britain” is often a nuance too far. With the Prime Minister Theresa May pushing for a hard Brexit and Labour leader Jeremy Corbyn waving it through, Lib Dem leader Tim Farron has made the pro-EU narrative his own. As was the case for Charles Kennedy in the Iraq War years, this confers upon the Lib Dems a status and platform they were denied as the junior partners in coalition. 

While their stance on Europe is slowly but surely helping the Lib Dems rebuild their pre-2015 demographic core - students, graduates and middle-class professionals employed in the public sector – last night’s results, particularly in Stoke, also give them reason for mild disappointment. 

In Stoke, campaign staffers privately predicted they might manage to beat Ukip for second or third place. The party ran a full campaign for the first time in several years, and canvassing returns suggested significant numbers of Labour voters, mainly public sector workers disenchanted with Corbyn’s stance on Europe, were set to vote Lib Dem. Nor were they intimidated by the Brexit factor: recent council by-elections in Sunderland and Rotheram, which both voted decisively to leave, saw the Lib Dems win seats for the first time on massive swings. 

So it could well be argued that their candidate, local cardiologist Zulfiqar Ali, ought to have done better. Staffordshire University’s campus, which Tim Farron visited as part of a voter registration drive, falls within the seat’s boundaries. Ali, unlike his Labour competitor Gareth Snell and Ukip leader Paul Nuttall, didn’t have his campaign derailed or disrupted by negative media attention. Unlike the Tory candidate Jack Brereton, he had the benefit of being older than 25. And, like 15 per cent of the electorate, he is of Kashmiri origin.  

In public and in private, Lib Dems say the fact that Stoke was a two-horse race between Labour and Ukip ultimately worked to their disadvantage. The prospect of Nuttall as their MP may well have been enough to convince a good number of the Labour waverers mentioned earlier to back Snell. 

With his party hovering at around 10 per cent in national polls, last night’s results give Farron cause for optimism – especially after their near-wipeout in 2015. But it’s easy to forget the bigger picture in all of this. The party have chalked up a string of impressive parliamentary by-election results – second in Witney, a spectacular win in Richmond Park, third in Sleaford and Copeland, and a strong fourth in Stoke. 

However, most of these results represent a reversion to, or indeed an underperformance compared to, the party’s pre-2015 norm. With the notable exception of Richmond’s Sarah Olney, who only joined the Lib Dems after the last general election, these candidates haven’t - or the Lib Dem vote - come from nowhere. Zulfiqar Ali previously sat on the council in Stoke and had fought the seat before, and Witney’s Liz Leffman and Sleaford’s Ross Pepper are both popular local councillors. And for all the excited commentary about Richmond, it was, of course, held by the Lib Dems for 13 years before Zac Goldsmith won it for the Tories in 2010. 

The EU referendum may have given the Lib Dems a new lease of life, but, as their #LibDemFightback trope suggests, they’re best understood as a revanchist, and not insurgent, force. Much has been said about Brexit realigning our politics, but, for now at least, the party’s new normal is looking quite a lot like the old one.