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How Labour broke the NHS – and why Labour must fix it

Successive attempts by Labour and the Tories to update the service have done more bad than good. It's time to put the NHS in intensive care.

It is an awkward fact for many on the left that the partial privatisation of the English National Health Service – started by the New Labour government in 2003 and enthusiastically accelerated by the current Tory-led coalition – has been such an apparent success. When Tony Blair came to power in 1997 the service was struggling, particularly in terms of elective (non-urgent) care. Like all GPs, I often saw my patients having to wait up to 18 months for routine operations.

New Labour’s initial diagnosis was of inadequate resources: public spending on health as the party returned to power was roughly 5 per cent of GDP, substantially lower than in every other developed nation. Blair’s stated ambition was to bring this percentage up to the European average; more money, it was believed, would solve the problem. Labour set about the task with gusto. Gordon Brown’s first Budget in July 1997 heralded an immediate injection of £1.2bn into the NHS, with real-terms spending to rise year on year thereafter. At the same time, Labour began to dismantle some of the previous Conservative government’s experiments with “marketisation” – ending GP fundholding (under which some family doctors operated budgets on behalf of their patients) and re-emphasising collaboration over competition between different parts of the system. For me, as for most ardent supporters of a public-service NHS, they were optimistic days.

Yet by the time of the 2001 election, New Labour was facing accusations of failure to reform. Despite the extra investment in health, service improvements had been frustratingly slow to materialise and were incremental in scale. In addition, there was a worrying new trend. Just as they were doing with the education of their children, the increasingly prosperous middle classes were opting out of state health-care provision in ever greater numbers. Over a few short years it had become noticeably more common for patients in my reasonably affluent corner of southern England to declare they had enough spare cash, or had private insurance (often included in their employment package), and would like to use it to sidestep lengthy NHS waiting times. In an era when most of us swallowed Brown’s “no more boom and bust” myth, and there was a sense the good times might just keep rolling on, we appeared to be sleepwalking towards a US-style health-care system, where those with sufficient resources could get swift access to private treatment, leaving the rest to make do with what the public service could manage to provide.

The danger, as Blair realised, was in the medium to long term: the departure of the middle class would undermine the social contract on which the very idea of a national health service depends.

These were the considerations that led to the extraordinary spectacle of a Labour government adopting a policy direction not even the Tories had dared to explore. The NHS had to become so responsive and user-friendly that there would be no incentive for anyone to go elsewhere. In short, it must be able to compete with the private sector – and the way to do that, it seemed, was to make it “compete”.

To begin with, the Blair government’s approach was to “market-make”; and so, from 2003, successive waves of independent sector treatment centres (ISTCs) were opened throughout England. Run by private companies for profit, ISTCs were contracted (often on very favourable terms) to provide solely NHS elective procedures, creating extra capacity in the system to bring down waiting lists, and at the same time forcing existing providers to polish up their act if they wanted to hang on to any of their more “profitable” work. In parallel, the best NHS hospitals were able to apply for the new foundation trust status, which freed them from public-service constraints to operate more like private businesses.

Out of this market-making grew a new logic: that as well as deliberately inserting private provision inside the NHS, the health market should be opened to external competition. In 2009, in what transpired to be its dying days, New Labour introduced the “any qualified provider” (AQP) initiative, which allowed the private sector to undertake NHS work outside the ISTC programme. It is under AQP that the vast majority of my patients who require elective procedures now choose to spurn both our local district general and the ISTC in favour of referral to the nearby private hospital run by Circle.

The coalition government seized on the inroads made by New Labour. As well as cementing competition for work on a case-by-case
basis under AQP, Section 75 of their Health and Social Care Act 2012 makes it obligatory for commissioners to put every new NHS service (above a trivial size) out to tender. Analysis of data up to 2013 shows more than £12bn of NHS contracts were awarded to private companies during the first three years of the coalition.

On the face of it, the drive to compel competition has done what it was supposed to do (albeit at vastly increased administration costs, with contracts being negotiated, invoiced and monitored by armies of bean-counters on all sides). Much elective NHS care nowadays is provided within weeks, not months or even years. This is unquestionably good for patients. And fears for the future of the social contract have receded: where is the advantage in going private when you can get your operation paid for by the NHS at the same independent hospital?

The health insurance industry has adapted to the new realities, offering cheaper products that pay out only if the NHS should be unable to provide treatment within a specified time frame. With the fall in disposable income that has accompanied austerity, it is once again relatively unusual for my patients to request private referrals. One way or another, the NHS has remained the franchise to which most people look when they have an elective health-care need.

Why then is there a renewed row over NHS privatisation in the current election campaign? It has often been said (by both Labour and the Conservatives at different times) that patients don’t really care who provides their treatment, as long as it’s convenient, of good quality and funded out of general taxation. Surely Ed Miliband should be claiming credit for Labour having been bold enough to go where no political party had ever dared tread? And why is Andy Burnham, the shadow health secretary, publicly committed to repealing the Health and Social Care Act, with its compulsion to competitive procurement?

Burnham is resurrecting the language of the past, articulating a desire to see the NHS as the “preferred provider” of most services, and labelling the 100 days of this election campaign as the last chance to save this concept. Is this simply a belated restatement of an ideology that the left is now embarrassed to have renounced during its most recent years in government? An ideology, furthermore, whose time has been and gone?

The answers to those questions lie in the nature of the problems now facing the health service and how the privatisation agenda has created barriers to tackling them. This is where things begin to get complicated, which is why politicians generally shy away from trying to air them in the media, preferring to fall back on meaningless soundbites such as X billion pounds’ additional spending, or Y thousand extra doctors and nurses. Let me take you on a whistle-stop tour.

The first thing to appreciate is that commercial competition was a response to the NHS’s historically poor performance in providing timely access to mundane, high-volume procedures: cataract removals, joint replacements, gall bladder operations and so on. These elective cases are all discrete episodes: there’s a single problem and a definable clinical activity that will close the case. There are also readily quantifiable measures by which performance can be rated: most obviously, the length of the waiting list.

Markets can work well in this sort of scenario, particularly if risk can be mitigated by excluding complex, often very elderly patients in poor general health with multiple chronic diseases, who are more likely to experience unpredictable and expensive complications. The problem is, with every passing year, there are more and more of us living to become just this kind of patient – patients the private sector doesn’t want to do elective business with at NHS tariff prices, and for whom the old NHS is therefore the default source of help.

The second issue is that these elderly patients with multiple health problems are also presenting to the NHS’s other major arm – urgent-care services – in ever greater numbers. Their health is fragile and they are prone to frequent exacerbations in underlying chronic conditions such as heart failure or lung disease. Otherwise trivial illnesses can have a devastating impact – a simple urinary infection will, in a matter of hours, render a frail and elderly patient completely “off legs” and unable to look after him or herself. Social circumstances are often precarious, patients widowed or living with an equally vulnerable spouse, with far-flung and busy families unable to provide a rapid response should the home situation suddenly deteriorate.

When a patient of this kind becomes unwell, unless significant nursing and social care can be parachuted in at a moment’s notice to shore up community treatment (and at present they can’t) he or she is heading for hospital. Once the person is an inpatient, it can take an unconscionable length of time to help them rehabilitate, and for the social-care system to reinstate or augment a package of care that will allow them to be discharged. Beds get filled; beds get “blocked”.

The third factor is the changed face of NHS urgent-care services. There are all sorts of things one could say about this but here’s the fundamental point: when someone with anything more than a completely straightforward illness becomes unwell, at some stage you are going to need an experienced clinician to decide how to manage it. When I began in practice in 1990 there were only three places you could turn to if a crisis arose: your GP (day or night), the ambulance service, or A&E. The system was understood by virtually everyone and the vast majority of contacts went through their GP first. This, crucially, introduced a highly trained professional at the earliest stage of the process. GPs are thoroughly at home managing uncertainty and negotiating complexity, and we kept a vast amount of work away from hospitals.

Nowadays there is a plethora of other entry points into the urgent-care system – the NHS 111 helpline, walk-in centres, out-of- hours (OOH) services (now mostly provided by private companies) and minor injuries units. NHS 111 and, to a variable extent, the others employ either non-clinical staff operating a risk-averse computer algorithm, or clinicians who are junior and inexperienced. The net result is that the first time many patients encounter an experienced clinician is long after they’ve been admitted to hospital. The opportunity for community management, if it existed, has been lost.

These are the principal forces behind the flurry of declared major incidents this January, which led to hospitals up and down the country closing their full-to-bursting doors. Our own district general remained open – just – but in a continual state of black alert (which is every bit as bad as the name suggests). All elective surgery was abandoned and extraordinary measures were employed to free up every scrap of capacity.

If we want to do anything other than lurch from crisis to crisis, the whole system will have to be reconfigured. Hospitals, GP surgeries, community nursing, OOH, NHS 111, the ambulance service, walk-in centres and minor injuries units are all nominally NHS bodies and should, in theory, be able to work together to ensure only patients genuinely in need of acute hospital care are admitted. The problem is, in our present-day competitive NHS, each entity is trying to protect its budget and ensure its own performance meets the benchmarks by which it will be judged next time its contract comes up for renewal. Perverse and protectionist behaviour ricochets round the system, the easiest solution often being to admit a complex patient and let their care become the responsibility of the hospital. And that’s before you try to bring social care into the mix, which is integral to the project of supporting unwell patients in their homes but which historically has been provided by local government out of a completely separate (and even more pressured) budget.

It is in this incredibly complex and messy situation that Circle – the first private company to be awarded a contract to run an NHS district general hospital, at Hinchingbrooke in Cambridgeshire – announced recently that it will walk away. It’s not that a commercial company can’t run a modern acute hospital; there are half a dozen such private facilities in London (though nowhere else in the country is affluent enough to sustain one). It’s that the kind of money the NHS is offering is woefully inadequate to mitigate the risk to the private sector of unpredictable and ever more intense surges of demand, exacerbated by perverse behaviour elsewhere in the system. Circle is going back to running its controllable elective AQP business, licking the wounds that it has sustained from its adventure into the NHS acute sector.

We made a concerted effort in our area a couple of years ago to solve the problem with urgent care. Most of the big players – our district general hospital, all local GP surgeries, the ambulance service, OOH and the walk-in centre – joined together in an effort to run the newly recommissioned service. This would have aligned the interests of all parties better and should have led to some creative solutions. However, under Section 75 regulations the procurement had to be competitive, with each of the nine eventual bidders being judged on quasi-objective grounds that were rooted largely in process and that weighed only things that could readily be measured. Such is the fear of litigation under competition law that there is simply no latitude for commissioners to use common sense or professional judgement to prefer a bid on the grounds that it is a good idea and exactly what the local area needs. Our bid narrowly lost out to a company based several hundred miles away.

As well as this structural bar to commissioning joined-up working, competitive procurement is eroding the goodwill and loyalty that the NHS has historically enjoyed from its workforce. The firm that won the contract in our area now runs the out-of-hours service and urgent-care centre adjacent to A&E. It has struggled to appoint a local clinical director (the post is still vacant a year in). Many staff who supported out-of-hours provision for years have walked away, so alienated do they feel; each week, the company has to fly or chauffeur clinicians and drivers from elsewhere in the country just to keep what is at times a skeleton service going. Turnover is high and those local staff who continue to work under the new regime are weary of the constant appeals to step into the breach to fill rota gaps.

Staff and doctors who once willingly responded to requests for assistance leave their phones unanswered when they recognise the number of the rota administrator. A rich but unquantifiable resource, which might be called the public-service ethos in the NHS, has been squandered in front of our eyes. Even at this stage it may be too late to recapture it.

The deleterious effects of a competitive marketplace have been loudly argued by opponents of privatisation throughout the past decade. Yet according to one commissioner with over 20 years’ experience of health-
service procurement, no one in government had any vision of how the competition agenda might degrade integrated systems of care for patients with multiple diseases. The
focus was unrelentingly on improving elective care – the NHS’s low-hanging fruit – with fingers crossed in the forlorn hope that the changes being made wouldn’t destabilise the rest of the service.

Of the major parties contesting the forthcoming general election, it is Labour that seems to understand the issue, and it is this that underpins Andy Burnham’s pledge to repeal the Health and Social Care Act and to legislate to exempt the NHS from EU competition legislation. Integrated care is the only game in town and it can only be delivered within projected levels of spending by well-configured public services that have been freed from the fragmentary consequences of enforced competition. That said, Labour finds itself in an embarrassing position: the party that began privatisation has to explain why that process – which has, after all, resulted in improvements in the elective-care arm of the service – is simultaneously incompatible with meeting the present-day challenges the NHS faces.

The Conservatives, by contrast, are silent; the NHS was conspicuously absent when they announced their six key manifesto areas. Having gone into the last election promising no more top-down reorganisations of the service, and having then presided over arguably the most damaging such reorganisation in the history of the service, they may quite reasonably believe that nothing they say on the subject will be trusted. They may also have calculated that the complexity of the problem defies exploration in our soundbite-dominated culture and that saying nothing will allow them to continue business as usual, should they be re-elected. If so, that would be a cynical continuation of the approach that has created the mess we are all dealing with.

Burnham is right: this election does represent a fundamental decision point as to how our NHS will develop or degrade in the future. We need to know, well in advance of the poll, where each party stands on this important matter. And having declared its approach, whichever party goes on to lead the next government must somehow be held to keep the promises on which it has been voted into power.

Dr Phil Whitaker is an award-winning novelist. He writes the New Statesman’s Health Matters column

This article first appeared in the 27 February 2015 issue of the New Statesman, Russia vs the west

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Losing Momentum: how Jeremy Corbyn’s support group ran out of steam

Tom Watson says it is destroying Labour. Its supporters say it is a vital force for change. Our correspondent spent six months following the movement, and asks: what is the truth about Momentum?

1. The Bus

 The bus to the Momentum conference in Liverpool leaves at seven on a Sunday morning in late September from Euston Station, and the whole journey feels like a parody of a neoliberal play about the failings of socialism. We depart an hour late because activists have overslept and we cannot go without them. As we wait we discuss whether Jeremy Corbyn will be re-elected leader of the Labour Party this very day. One man says not; a young, jolly girl with blonde hair cries: “Don’t say that on Jezmas!” She is joking, at least about “Jezmas”.

A man walks up. “Trots?” he says, calmly. He is joking, too; and I wonder if he says it because the idea of Momentum is more exciting to outsiders than the reality, and he knows it; there is an awful pleasure in being misunderstood. Momentum was formed in late 2015 to build on Corbyn’s initial victory in the Labour leadership election, and it is perceived as a ragtag army of placard-waving Trots, newly engaged clicktivists and Corbyn fanatics.

We leave, and learn on the M1 that, in some terrible metaphor, the coach is broken and cannot drive at more than 20mph. So we wait for another coach at a service station slightly beyond Luton. “Sabotage,” says one man. He is joking, too. We get off; another man offers me his vegan bread and we discuss Karl Marx.

A new coach arrives and I listen to the others discuss Jeremy Corbyn’s problems. No one talks about his polling, because that is depressing and unnecessary for their purpose – which, here, is dreaming. They talk about Corbyn as addicts talk about a drug. Nothing can touch him, and nothing is ever his fault. “There are problems with the press office,” says one. “Perhaps he needs better PAs?” says another.

One man thinks there will be a non-specific revolution: “I hope it won’t be violent,” he frets. “There have been violent revolutions in the past.” “I stuck it out during Blair and it was worth it,” says another. “They’ve had their go.” “We don’t need them [the Blairites],” says a third. “If new members come in, it will sort itself out,” says a fourth.

I have heard this before. Momentum supporters have told me that Labour does not need floating voters, who are somehow tainted because they dare to float. This seems to me a kind of madness. I do not know how the Labour Party will win a general election in a parliamentary democracy without floating voters; and I don’t think these people do, either.

But this is a coach of believers. Say you are not sure that Corbyn can win a general election and they scowl at you. That you are in total agreement with them is assumed, because this is the solidarity bus; and if you are in total agreement with them they are the sweetest people in the world.

That is why I do not tell them that I am a journalist. I am afraid to, and this fear baffles me. I have gone everywhere as a journalist but with these, my fellow-travellers on the left, I am scared to say it; and that, too, frightens me. MSM, they might call me – mainstream media. What it really means is: collaborator.

The man beside me has been ill. He talks sweetly about the potential renewal of society under Corbyn’s Labour as a metaphor for his own recovery, and this moves him; he has not been involved in politics until now. I like this man very much, until I mention the Jewish Labour MP Luciana Berger and the anti-Semitism she has suffered from Corbyn supporters and others; and he says, simply, that she has been employed by the state of Israel. He says nothing else about her, as if there were nothing else to say.

We listen to the results of the leadership election on the radio; we should be in Liverpool at the Black-E community centre to celebrate, but the solidarity bus is late. Corbyn thanks his supporters. “You’re welcome, Jeremy,” says a woman in the front row, as if he were on the coach. She nods emphatically, and repeats it to the man who isn’t there: “You’re welcome, Jeremy.”

In Liverpool, some of the passengers sleep on the floor at a community centre. The venue has been hired for that purpose: this is Momentum’s commitment to opening up politics to the non-connected, the previously non-engaged, and the outsiders who will attend their conference in a deconsecrated church, even as the official Labour conference convenes a mile away. But never mind that: this is the one that matters, and it is called The World Transformed.

 

2. The Conference

Later that day, outside the Black-E, a man comes up to me. Are you happy, he asks, which is a normal question here. These are, at least partly, the politics of feelings: we must do feelings, because the Tories, apparently, don’t. I say I’m worried about marginal seats, specifically that Jeremy – he is always Jeremy, the use of his Christian name is a symbol of his goodness, his accessibility and his singularity – cannot win them.

“The polls aren’t his fault,” the man says, “it’s [Labour] people briefing the Tories that he is unelectable.” I do not think it’s that simple but it’s easy to feel like an idiot – or a monster – here, where there is such conviction. As if there is something that only you, the unconvinced, have missed: that Jeremy, given the right light, hat or PA, could lead a socialist revolution in a country where 13 million people watched Downton Abbey.

But the man does say something interesting which I hope is true. “This is not about Jeremy, not really,” he says. “It is about what he represents.” He means Momentum can survive without him.

There is a square hall with trade union banners and a shop that sells Poems for Jeremy Corbyn, as well as a Corbyn-themed colouring book. When I am finally outed as a journalist, and made to wear a vast red badge that says PRESS, I attempt to buy one. “That’s all journalists are interested in,” the proprietor says angrily. That is one of our moral stains, apparently: a disproportionate (and sinister) interest in colouring books.

I go to the Black Lives Matter event. A woman talks about the experience of black students in universities and the impact of austerity on the black community. Another woman tells us that her five-year-old son wishes he was white; we listen while she cries. I go to the feminism meeting and change my mind about the legalisation of prostitution after a woman’s testimony about reporting an assault, and then being assaulted again by a police officer because of her legal status. Then I hear a former miner tell a room how the police nearly killed him on a picket line, and then arrested him.

This, to me, a veteran of party conferences, is extraordinary, although it shouldn’t be, and the fact that I am surprised is shameful. Momentum is full of the kinds of ­people you never see at political events: that is, the people politics is for. Women, members of minority communities (but not Zionist Jews, naturally), the disabled: all are treated with exaggerated courtesy, as if the Black-E had established a mirror world of its choosing, where everything outside is inverted.

When Corbyn arrives he does not orate: he ruminates. “We are not going to cascade poverty from generation to generation,” he says. “We are here to transform society and the world.” I applaud his sentiment; I share it. I just wish I could believe he can deliver it outside, in the other world. So I veer ­between hope and fury; between the certainty that they will achieve nothing but an eternal Conservative government, and the ever-nagging truth that makes me stay: what else is there?

There is a rally on Monday night. Momentum members discuss the “purges” of socialist and communist-leaning members from Labour for comments they made on social media, and whether détente is possible. A nurse asks: “How do we know that ‘wipe the slate clean’ means the same for us as it does for them? How on Earth can we trust the likes of Hilary Benn who dresses himself up in the rhetoric of socialism to justify bombing Syria? The plotters who took the olive branch offered by Jeremy to stab him in the back with another chicken coup?” I am not sure where she is going with that gag, or if it is even a gag.

The next man to speak had been at the Labour party conference earlier in the day; he saw Len McCluskey, John McDonnell and Clive Lewis on the platform. “Don’t be pessimistic, folks,” he cries. “On the floor of conference today we owned the party. Progress [the centrist Labour pressure group] are the weirdos now. We own the party!”

A man from Hammersmith and Fulham Momentum is next. “The national committee of Momentum was not elected by conference,” he says. “It’s a committee meeting knocked up behind closed doors by leading people on the left, including our two heroes.” He means Jeremy Corbyn and John McDonnell. This is explicit heresy, and the chair interrupts him: “Stan, Stan . . .” “I’m winding up!” he says. “We need a central committee of Momentum elected by conference,” he says, and sits down.

The following day Corbyn speaks in the hall in front of golden balloons that spell out S-H-E-E-P. It may be another gag, but who can tell, from his face? This is his commitment to not doing politics the recognisable way. He is the man who walks by himself, towards balloons that say S-H-E-E-P. (They are advertising the band that will follow him. They are called, and dressed as, sheep.) The nobility of it, you could say. Or the idiocy. He mocks the mockers of Momentum: is it, he was asked by the mainstream media, full of extremists and entryists? “I’m not controlling any of it,” he says calmly, and in this calmness is all the Twitter-borne aggression that people complain of when they talk about Momentum, for he enables it with his self-satisfied smile. “It’s not my way to try and control the way people do things. I want people to come together.” He laughs, because no one can touch him, and nothing is ever his fault.

I meet many principled people in Liverpool whose testimony convinces me, and I didn’t need convincing, that austerity is a national disaster. I meet only one person who thinks that Momentum should take over the Labour Party. The maddest suggestion I hear is that all media should be state-controlled so that they won’t be rude about a future Corbyn government and any tribute colouring books.

 

3. The HQ

Momentum HQ is in the TSSA transport and travel union building by Euston Station in London. I meet Jon Lansman, Tony Benn’s former fixer and the founder of Momentum, in a basement room in October. Lansman, who read economics at Cambridge, lived on the fringes of Labour for 30 years before volunteering for Corbyn’s campaign for the leadership.

The terms are these: I can ask whatever I want, but afterwards James Schneider, the 29-year-old national organiser (who has since left to work for Corbyn’s press team), will decide what I can and cannot print. ­Momentum HQ wants control of the message; with all the talk of entryism and infighting reported in the mainstream media, the movement needs it.

There is a civil war between Jon Lansman and the Alliance for Workers’ Liberty (AWL) and other far-left factions, which, I am told, “wish to organise in an outdated manner out of step with the majority of Momentum members”. Some of the Momentum leadership believe that the AWL and its allies want to use Momentum to found a new party to the left of Labour. Jill Mountford, then a member of Momentum’s steering committee, has been expelled from Labour for being a member of the AWL. It screams across the blogs and on Facebook; more parody. We don’t talk about that – Schneider calls it “Kremlinology”. It is a problem, yes, but it is not insurmountable. We talk about the future, and the past.

So, Lansman. I look at him. The right considers him an evil Bennite wizard to be feared and mocked; the far left, a Stalinist, which seems unfair. It must be exhausting. I see a tired, middle-aged man attending perhaps his fifteenth meeting in a day. His hair is unruly. He wears a T-shirt.

The last Labour government, he says, did one thing and said another: “Wanting a liberal immigration policy while talking tough about refugees and migrants. Having a strong welfare policy and generous tax credits while talking about ‘strivers’ and ‘scroungers’ unfortunately shifted opinion the wrong way.”

It also alienated the party membership: “Their approach was based on ensuring that everyone was on-message with high levels of control.” It was an “authoritarian structure even in the PLP [Parliamentary Labour Party]. Even in the cabinet. It killed off the enthusiasm of the membership. They never published the figures in 2009 because it dropped below 100,000. We’ve now got 600,000.” (The membership has since dropped to roughly 528,000.)

And the strategy? “If you have hundreds of thousands of people having millions of conversations with people in communities and workplaces you can change opinion,” he says. “That’s the great advantage of ­having a mass movement. And if we can change the Labour Party’s attitude to its members and see them as a resource – not a threat or inconvenience.”

That, then, is the strategy: street by street and house by house. “We can’t win on the back of only the poorest and only the most disadvantaged,” he says. “We have to win the votes of skilled workers and plenty of middle-class people, too – but they are all suffering from some aspects of Tory misrule.”

I ask about polling because, at the time, a Times/YouGov poll has Labour on 27 per cent to the Tories’ 41 per cent. He doesn’t mind. “It was,” he says, “always going to be a very hard battle to win the next election. I think everyone across the party will privately admit that.” He doesn’t think that if Yvette Cooper or Andy Burnham were leader they would be polling any better.

Upstairs the office is full of activists. They are young, rational and convincing (although, after the Copeland by-election on 23 February, I will wonder if they are only really convincing themselves). They talk about their membership of 20,000, and 150 local groups, and 600,000 Labour Party members, and the breadth of age and background of the volunteers – from teenagers to people in their eighties. One of them – Ray Madron, 84 – paints his hatred of Tony Blair like a portrait in the air. He has a ­marvellously posh voice. Most of all, they talk about the wounds of austerity. Where, they want to know, is the anger? They are searching for it.

Emma Rees, a national organiser, speaks in the calm, precise tones of the schoolteacher she once was. “A lot of people are sick and tired of the status quo, of politics as usual, and I think trying to do things differently is hard because there isn’t a road map and it’s not clear exactly what you’re supposed to do,” she says. She adds: “It is a coalition of different sorts of people and holding all those people together can sometimes be a challenge.”

Is she alluding to entryism? One activist, who asks not to be named, says: “I don’t want to insult anyone, but if you rounded up all the members of the Socialist Workers Party [SWP] and the Socialist Party and any other ultra-left sect, you could probably fit them in one room. Momentum has 20,000 members.”

The SWP were outside at The World Transformed in Liverpool, I say, like an ambivalent picket line. “Well,” James Schneider says pointedly, “they were outside.”

Momentum, Emma Rees says, “is seeking to help the Labour Party become that transformative party that will get into government but doesn’t fall back on that tried and failed way of winning elections”.

They tell me this repeatedly, and it is true: no one knows what will work. “The people who criticised us don’t have any route to electability, either,” says Joe Todd, who organises events for Momentum. He is a tall, bespectacled man with a kindly, open face.

“They lost two elections before Jeremy Corbyn. It’s obvious we need to do something differently,” he says. “Politics feels distant for most people: it doesn’t seem to offer any hope for real change.

“The left has been timid and negative. More and more people are talking about how we can transform society, and how these transformations link to people’s everyday experience. Build a movement like that,” Todd says, and his eyes swell, “and all the old rules of politics – the centre ground, swing constituencies to a certain extent – are blown out of the water.”

Momentum sends me, with a young volunteer as chaperone, to a rally in Chester in October to watch activists try to muster support for local hospitals. They set up a stall in the centre of the shopping district, with its mad dissonance of coffee shops and medieval houses. From what I can see, people – yet far too few people – listen politely to the speeches about austerity and sign up for more information; but I can hear the hum of internal dissent when an activist, who asks not to be named, tells me he will work for the local Labour MP to be deselected. (The official Momentum line on deselection is, quite rightly, that it is a matter for local parties.)

We will not know what matters – is it effective? – until the general election, because no one knows what will work.

 

4. The Fallout

Now comes the result of the by-election in Copeland in the north-west of England, and the first time since 1982 that a ruling government has taken a seat from the opposition in a by-election. Momentum canvassed enthusiastically (they sent 85 carloads of activists to the constituency) but they failed, and pronounce themselves “devastated”. The whispers – this time of a “soft” coup against Corbyn – begin again.

Rees describes calls for Jeremy Corbyn to resign as “misguided. Labour’s decline long pre-dates Corbyn’s leadership.”

This produces a furious response from Luke Akehurst, a former London Labour ­councillor in Hackney, on labourlist.org. He insists that Labour’s decline has accelerated under Corbyn; that even though Rees says that “Labour has been haemorrhaging votes in election after election in Copeland since 1997”, the majority increased in 2005 and the number of votes rose in 2010, despite an adverse boundary change. “This,” he writes, “was a seat where the Labour vote was remarkably stable at between 16,750 and 19,699 in every general election between 2001 and 2015, then fell off a cliff to 11,601, a third of it going AWOL, last Thursday.”

And he adds that “‘85 carloads of Mom­entum activists’ going to Copeland is just increasing the party’s ability to record whose votes it has lost”.

But still they plan, and believe, even if no one knows what will work; surely there is some antidote to Mayism, if they search every street in the UK? Momentum’s national conference, which was repeatedly postponed, is now definitively scheduled for 25 March. Stan who complained about a democratic deficit within Momentum at The World Transformed got his way. So did Lansman. In January the steering committee voted to dissolve Momentum’s structures and introduce a constitution, after consulting the membership. A new national co-ordinating group has been elected, and met for the first time on 11 March – although, inevitably, a group called Momentum Grassroots held a rival meeting that very day.

I go to the Euston offices for a final briefing. There, two young women – Sophie and Georgie, and that will make those who think in parodies laugh – tell me that, in future, only members of the Labour Party will be allowed to join Momentum, and existing members must join Labour by 1 July. Those expelled from Labour “may be deemed to have resigned from Momentum after 1 July” – but they will have a right to a hearing.

More details of the plan are exposed when, a week later, a recording of Jon Lansman’s speech to a Momentum meeting in Richmond on 1 March is leaked to the Observer. Lansman told the Richmond branch that Momentum members must hold positions within the Labour Party to ensure that Corbyn’s successor – they are now talking about a successor – is to their liking. He also said that, should Len McCluskey be re-elected as general secretary of Unite, the union would formally affiliate to Momentum.

Tom Watson, the deputy leader of the party, was furious when he found out, calling it “a private agreement to fund a political faction that is apparently planning to take control of the Labour Party, as well as organise in the GMB and Unison”.

There was then, I am told, “a short but stormy discussion at the away day at Unison” on Monday 20 March, where the inner circle of John McDonnell, Diane Abbott and Emily Thornberry “laid into” Watson, but Shami Chakrabarti made the peace; I would have liked to see that. Watson then released a bland joint statement with Corbyn which mentioned “a robust and constructive discussion about the challenges and opportunities ahead”.

Jon Lansman, of course, is more interesting. “This is a non-story,” he tells me. “Momentum is encouraging members to get active in the party, to support socialist policies and rule changes that would make Labour a more grass-roots and democratic party, and to campaign for Labour victories. There is nothing scandalous and sinister about that.” On the Labour right, Progress, he notes, does exactly the same thing. “Half a million members could be the key to our success,” he says. “They can take our message to millions. But they want to shape policy, too. I wouldn’t call giving them a greater say ‘taking over the party’” – and this is surely unanswerable – “it’s theirs to start with.”

Correction: This article originally named Luke Akehurst as a Labour councillor. Akehurst stood down in 2014.

This article first appeared in the 23 March 2017 issue of the New Statesman, Trump's permanent revolution