Protesters demonstrate against the Health and Social Care Bill. (Photo: Getty)
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A new Bill plots the way back for the NHS - but it's not Labour who are behind it

Caroline Lucas and Andrew George, a Liberal Democrat rebel, are working together on a bill that could be a roadmap for the NHS.

Later today, in the dusk of this parliament, a new Bill will get its first and perhaps only reading in the Commons. It’s unlikely to set pulses racing in any of the main party machines, but in certain circles the NHS Bill represents the last ditch to save a dying public service.

It is the result of three years of patient work led by two leading public health experts, Professor Allyson Pollock and Peter Roderick of the Centre for Primary Care and Public Health at Queen Mary, University of London.

In the bill, they say, lies a trail of breadcrumbs to take us back to a different era. A time before the Health and Social Care Act; before the NHS was such fertile ground for profiteers. A time when money allocated for patient care wasn’t routinely squandered on futile bidding wars, failed private experiments, a contrived internal market and debilitating PFI repayments.

“We’ve been working on this ever since the Health and Social Care Act came in,” says Allyson Pollock, speaking to me earlier this week. “We knew this time would come. What we’ve got in the Health and Social Care Act is a destructive reorganisation which has started the breakup of the NHS.

“If we don’t bring in legislation then privatisation and the breakup of the service will continue; by 2020 the NHS will be unrecognisable”.

Andy Burnham has said in no uncertain terms that a Labour government would repeal the Health and Social Care Act, and end the “Tory market experiment in the NHS”. Strong words, and a welcome departure from the New Labour days when much of the damage was done.

But this isn’t a Labour Bill. The political will has come from the Green Party’s only MP, Caroline Lucas, and a Liberal Democrat, Andrew George. It's backed by rebels from across the benches, PPCs, medical professionals and campaign groups throughout England.

Why do this now, with such a solemn pledge from Labour firmly and repeatedly on record? “They have said they would repeal the act”, says Pollock, “but they haven’t said what they would replace it with and how they would go about reinstating the principles of the NHS”.

If Labour wins enough power to repeal the Health and Social Care Act, and stays true to its word, it will be a tremendous victory. But with contracts in place and business plans cooked up, there will be plenty of clearing up to do even from the two years since the Act came into effect. Arguably, too much than simply canning it can possibly manage.

“We’ve already come too far down this road,” says Caroline Lucas, speaking to me yesterday. “We want to roll back 25 years, look at the whole programme of marketisation that New Labour brought in right up until what’s happening now”.

In its own words, the Bill proposes to “fully restore the NHS as an accountable public service by reversing 25 years of marketisation in the NHS, by abolishing the purchaser-provider split, ending contracting and re-establishing public bodies and public services accountable to local communities”.

How will this be done? With what now seem like very radical ideas behind them, some of the key objectives are:

  • To “reinstate the government’s duty to provide the key NHS services throughout England, including hospitals, medical and nursing services, primary care, mental health and community services”;
  • “abolish the NHS Commissioning Board (NHS England) and re-establish it as a Special Health Authority with regional committees”;
  • “abolish Monitor and repeal the competition and core marketisation provisions of the 2012 Act”;
  • “prohibit ratification of the Transatlantic Trade and Investment Partnership and other international treaties without the approval of Parliament and the devolved legislatures if they would cover the NHS”;
  • centralise NHS debts under the Private Finance Initiative in the Treasury, and require the Treasury to report to Parliament on reducing them;

Given the timing, it’s less clear what can be achieved in the coming weeks - indeed it has attracted its critics for this reason. But as Lucas tells me: “This is about setting an agenda for the election, and for the next parliament. I don’t think it should be about just choosing between the Efford Bill and the status quo. We need something more robust”.

If Labour is serious about ending the Tory market experiment, the party should take note of today’s proceedings. In an emerging corporate climate, the NHS Bill is a refreshing reiteration of the founding principles of a health service being systematically altered, and a blueprint for restoring them, laid down in black-and-white, waiting for anyone with the will to pick them up.

 

Benedict Cooper is a freelance journalist who covers medical politics and the NHS. He tweets @Ben_JS_Cooper.

Wikipedia.
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Daniel Hannan harks back to the days of empire - the Angevin Empire

Did the benign rule of some 12th century English kings make western France vote Macron over Le Pen?

I know a fair amount about British politics; I know a passable amount about American politics, too. But, as with so many of my fellow Britons, in the world beyond that, I’m lost.

So how are we, the monolingual Anglophone opinionators of the world, meant to interpret a presidential election in a country where everyone is rude enough to conduct all their politics in French?

Luckily, here’s Daniel Hannan to help us:

I suppose we always knew Dan still got a bit misty eyed at the notion of the empire. I just always thought it was the British Empire, not the Angevin one, that tugged his heartstrings so.

So what exactly are we to make of this po-faced, historically illiterate, geographically illiterate, quite fantastically stupid, most Hannan-y Hannan tweet of all time?

One possibility is that this was meant as a serious observation. Dan is genuinely saying that the parts of western France ruled by Henry II and sons in the 12th century – Brittany, Normandy, Anjou, Poitou, Aquitaine – remain more moderate than those to the east, which were never graced with the touch of English greatness. This, he is suggesting, is why they generally voted for Emmanuel Macron over Marine Le Pen.

There are a number of problems with this theory. The first is that it’s bollocks. Western France was never part of England – it remained, indeed, a part of a weakened kingdom of France. In some ways it would be more accurate to say that what really happened in 1154 was that some mid-ranking French nobles happened to inherit the English Crown.

Even if you buy the idea that England is the source of all ancient liberties (no), western France is unlikely to share its political culture, because it was never a part of the same polity: the two lands just happened to share a landlord for a while.

As it happens, they didn’t even share it for very long. By 1215, Henry’s youngest son John had done a pretty good job of losing all his territories in France, so that was the end of the Angevins. The English crown reconquered  various bits of France over the next couple of centuries, but, as you may have noticed, it hasn’t been much of a force there for some time now.

At any rate: while I know very little of French politics, I’m going to go out on a limb and guess the similarities between yesterday's electoral map and the Angevin Empire were a coincidence. I'm fairly confident that there have been other factors which have probably done more to shape the French political map than a personal empire that survived for the length of one not particularly long human life time 800 years ago. Some wars. Industrialisation. The odd revolution. You know the sort of thing.

If Daniel Hannan sucks at history, though, he also sucks at geography, since chunks of territory which owed fealty to the English crown actually voted Le Pen. These include western Normandy; they also include Calais, which remained English territory for much longer than any other part of France. This seems rather to knacker Hannan’s thesis.

So: that’s one possibility, that all this was an attempt to make serious point; but, Hannan being Hannan, it just happened to be a quite fantastically stupid one.

The other possibility is that he’s taking the piss. It’s genuinely difficult to know.

Either way, he instantly deleted the tweet. Because he realised we didn’t get the joke? Because he got two words the wrong way round? Because he realised he didn’t know where Calais was?

We’ll never know for sure. I’d ask him but, y’know, blocked.

UPDATE: Breaking news from the frontline of the internet: 

It. Was. A. Joke.

My god. He jokes. He makes light. He has a sense of fun.

This changes everything. I need to rethink my entire world view. What if... what if I've been wrong, all this time? What if Daniel Hannan is in fact one of the great, unappreciated comic voices of our time? What if I'm simply not in on the joke?

What if... what if Brexit is actually... good?

Daniel, if you're reading this – and let's be honest, you are definitely reading this – I am so sorry. I've been misunderstanding you all this time.

I owe you a pint (568.26 millilitres).

Serious offer, by the way.

 

Jonn Elledge edits the New Statesman's sister site CityMetric, and writes for the NS about subjects including politics, history and Daniel Hannan. You can find him on Twitter or Facebook.

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