A protest in support of the NHS at last year's Labour conference. Source: Getty
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NHS funding is a taboo topic for all parties

The Tories blew their chance to be trusted on health and Labour doesn't want to talk about where the money will come from.

It is hard to think of a policy that Labour is less likely to adopt for its 2015 manifesto than the flat rate £10-per-month “membership fee” for the NHS proposed by Lord Warner, a Blair-era health minister now sitting in the Lords. Jamie Reed MP, shadow health minister has said “this is not something Labour would ever consider.” He might have added re-introduction of small pox as a health policy  closer to Ed Miliband’s preferred general election offer.

When Labour has a vast lead over the Tories as the party to be trusted with the health service, anything that sounds as if it undermines the founding principle of universal access free at the point of use is out of the question. The problem is that Labour has signed up to tight spending constraint if it forms a government and under those circumstances NHS funding is certain to become a volatile issue. People are living longer, suffering from chronic conditions that are expensive to treat – especially if they result in prolonged hospital stays – and costs in medicine tend to rise faster than inflation. Even without the ongoing fiscal crunch, this would be an issue of existential urgency for the system as it is currently configured.

MPs in all parties know this but it has become hard to say so aloud for fear of facing the follow-up question – what would you do about it? In theory, health spending this parliament has been “ring-fenced” but it doesn’t feel that way in the context of local authority cuts, which have severe consequences for social care, and “efficiency savings” that amount to real terms cuts when imposed in a climate of rising costs. GPs say privately that a growing part of what they do amounts to managing patient expectations downward and rationing.

This model of service erosion is no-one’s preferred policy but it is the inevitable consequence of persistent failure of political courage on all sides. The Tories had their moment to bring public opinion with them in a conversation about reform and they blew it with a vast restructuring that alienated pretty much everyone apart from private healthcare providers. The Lib Dems are desperate to scrub away as much trace of complicity with the Tories’ mangled reforms as they can before polling day, although Nick Clegg was a prominent co-mangler.

Labour, meanwhile, does have a plan to transform the provision of health services – the “whole person care” idea developed by Andy Burnham. This puts the emphasis on public health and investment in prevention to save costs down the line. It also envisages the merger of health and social care.

There are obstacles. First, even if the numbers can be made to add up over the long-term, it looks like a hefty up-front expense and yet another epic re-organisation to boot. Second, Ed Miliband’s office is deeply suspicious of Burnham, believing him to be building a support base in the party machine and manoeuvring into a position to be ready for a leadership contest in the event that Labour loses the next election. With an eye on those ambitions, neither Miliband nor Ed Balls seems in a massive hurry to give the shadow Health Secretary the kind of boost that would come from the adoption of his health plans as a flagship reform proposal going into the general election.

Finally, there is a feeling among some Labour MPs and activists that owning up to the imminent cost crunch in the health service and offering a complicated reform agenda to address it just confuses the message, when all the voters need to know between now and May 2015 is that “you can’t trust the Tories with the NHS.” This school of opposition would gladly build an entire campaign around the anti-Conservative message played on a loop alongside pictures of David Cameron and George Obsorne looking smug interspersed with reminders of their “tax cut for millionaires.”

The reality is that Labour expected problems with the NHS to be more extreme and more salient in political debate than they have proved to be so far. (That isn't meant as a denial of the severity of the problem, only as an observation that they haven't blasted other matters off the front pages.) It is an issue where the opposition has a huge potential advantage but only if voters think it is a matter of such urgency as to trump other questions when weighing up who to vote for – the economy; immigration; crime; education etc. Labour’s dilemma is that the obvious way to make more political noise around the health service is to talk about the funding crisis but doing so invites scrutiny of the opposition’s proposed solution. And that is a conversation the party is not yet ready to have.

Rafael Behr is political columnist at the Guardian and former political editor of the New Statesman

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Is there such a thing as responsible betting?

Punters are encouraged to bet responsibly. What a laugh that is. It’s like encouraging drunks to get drunk responsibly, to crash our cars responsibly, murder each other responsibly.

I try not to watch the commercials between matches, or the studio discussions, or anything really, before or after, except for the match itself. And yet there is one person I never manage to escape properly – Ray Winstone. His cracked face, his mesmerising voice, his endlessly repeated spiel follow me across the room as I escape for the lav, the kitchen, the drinks cupboard.

I’m not sure which betting company he is shouting about, there are just so many of them, offering incredible odds and supposedly free bets. In the past six years, since the laws changed, TV betting adverts have increased by 600 per cent, all offering amazingly simple ways to lose money with just one tap on a smartphone.

The one I hate is the ad for BetVictor. The man who has been fronting it, appearing at windows or on roofs, who I assume is Victor, is just so slimy and horrible.

Betting firms are the ultimate football parasites, second in wealth only to kit manufacturers. They have perfected the capitalist’s art of using OPM (Other People’s Money). They’re not directly involved in football – say, in training or managing – yet they make millions off the back of its popularity. Many of the firms are based offshore in Gibraltar.

Football betting is not new. In the Fifties, my job every week at five o’clock was to sit beside my father’s bed, where he lay paralysed with MS, and write down the football results as they were read out on Sports Report. I had not to breathe, make silly remarks or guess the score. By the inflection in the announcer’s voice you could tell if it was an away win.

Earlier in the week I had filled in his Treble Chance on the Littlewoods pools. The “treble” part was because you had three chances: three points if the game you picked was a score draw, two for a goalless draw and one point for a home or away win. You chose eight games and had to reach 24 points, or as near as possible, then you were in the money.

“Not a damn sausage,” my father would say every week, once I’d marked and handed him back his predictions. He never did win a sausage.

Football pools began in the 1920s, the main ones being Littlewoods and Vernons, both based in Liverpool. They gave employment to thousands of bright young women who checked the results and sang in company choirs in their spare time. Each firm spent millions on advertising. In 1935, Littlewoods flew an aeroplane over London with a banner saying: Littlewoods Above All!

Postwar, they blossomed again, taking in £50m a year. The nation stopped at five on a Saturday to hear the scores, whether they were interested in football or not, hoping to get rich. BBC Sports Report began in 1948 with John Webster reading the results. James Alexander Gordon took over in 1974 – a voice soon familiar throughout the land.

These past few decades, football pools have been left behind, old-fashioned, low-tech, replaced by online betting using smartphones. The betting industry has totally rebooted itself. You can bet while the match is still on, trying to predict who will get the next goal, the next corner, the next throw-in. I made the last one up, but in theory you can bet instantly, on anything, at any time.

The soft sell is interesting. With the old football pools, we knew it was a remote flutter, hoping to make some money. Today the ads imply that betting on football somehow enhances the experience, adds to the enjoyment, involves you in the game itself, hence they show lads all together, drinking and laughing and putting on bets.

At the same time, punters are encouraged to do it responsibly. What a laugh that is. It’s like encouraging drunks to get drunk responsibly, to crash our cars responsibly, murder each other responsibly. Responsibly and respect are now two of the most meaningless words in the football language. People have been gambling, in some form, since the beginning, watching two raindrops drip down inside the cave, lying around in Roman bathhouses playing games. All they’ve done is to change the technology. You have to respect that.

Hunter Davies is a journalist, broadcaster and profilic author perhaps best known for writing about the Beatles. He is an ardent Tottenham fan and writes a regular column on football for the New Statesman.

This article first appeared in the 05 February 2015 issue of the New Statesman, Putin's war