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26 February 1999

Was Two-Brains one too many?

The BBC, the universities, the NHS: the Tories wrecked them all. James Le Fanu argues that David Wil

By James Le Fanu

On Wednesdays, David “Two Brains” Willetts hosts lunch at the Tory think-tank, the Centre for Policy Studies (CPS). Willetts was director of studies at the centre during the glory days of Thatcherism and is now shadow education secretary. The last time I went, the hot topic was whether, as Willetts has strongly hinted, the Conservatives should be opposing David Blunkett’s latest plans for the national curriculum. There are a lot of good Tory reasons why they should. They are, after all, meant to be antipathetic to government dirigisme. Society is far too complex for politicians to begin to understand the minutiae of how it works, hence institutions and groups (such as teachers) should by and large be trusted to get on with their jobs as they see best.

Fair enough, but, chimes in another dining-club regular, the Telegraph leader writer Janet Daley, the teachers have long deserved a good thwacking. Their fanciful educational ideas have done enormous damage and the only way to keep them on the straight and narrow is by clearly prescribing what they should and should not be teaching.

A few doubters murmur. Is determining what goes on in the classroom down to the last ten minutes the best way of going about this? And so the discussion circulates around the table with all those present only too aware there is much more at stake than merely deciding on the right policy. It was, after all, the Tories who introduced the national curriculum in the first place and, if they are now to join the teachers in opposing it, they are going to have to admit past errors and say they are sorry. Where will it end? Start apologising to the teachers and before long they will have to start apologising to all the other professional groups disenchanted by the Tories’ reforming zeal – doctors, university lecturers, BBC employees, the army, the police and so on.

In a nutshell, the Conservatives are caught between a rock and an extremely hard place. They must, if they are to survive, reaffirm the distinctive voice of civilised Conservatism. But to do so they must at least acknowledge the mistakes of their recent past. And how have they got themselves into this political quagmire? Step forward, David Willetts.

It would be unfair to blame him for all the Tories’ current misfortunes but he certainly personifies the intellectual sophistry that has been so instrumental in his party’s undoing. Several distinct ingredients went into the Magimix of Tory thinking during his period as director of studies at the CPS.

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The first was ignorance – not just a lack of understanding of the institutions into which they were so keen to inject free-market ideas, but a perverse desire not to know how they worked. Thus back in the summer of 1989, when reforming the health service was all the rage, I was invited to a lunchtime seminar hosted by another think-tank just around the corner to hear what lessons the NHS might learn from the American health care system. The precise arguments I can no longer recall, though the general drift was obvious enough. Private health insurance and competition were much superior to our state-financed NHS because American citizens could have a brain scan at the drop of a hat and never had to wait more than a couple of weeks to have their arthritic hips replaced.

When the discussion was thrown open, I made the fairly obvious point that this was all very well, but left out the crucial question of costs. Americans pay out as much for private health insurance in a month as British citizens pay for the NHS in a year. Consequently there are 35 million Americans who, unable to afford the extortionate insurance premiums, have to rely on the emergency departments of the large county hospitals for what little health care they receive. My intervention was followed by an embarrassing silence, broken after a minute or so by a question on an entirely different topic.

In retrospect, that silence explains much of what subsequently went wrong for the Conservatives – a blind refusal to acknowledge uncomfortable, if quite obvious, facts such as that the British health service, contrary to every right-wing economic theory under the sun, is the most cost-effective in the western world, delivering more services per million pounds spent than any other.

The next ingredient, added in generous quantities to the Magimix, was cynicism. The high-minded values intrinsic to professional life – service to others, commitment and a sense of duty – were dismissed as a devious disguise for low-mindedness. In the modern Conservative world view, the only authentic human motive was selfishness so, if a doctor in his surgery or teacher in the classroom claimed to be working in the public’s best interest, they were dissimulating. Like everyone else they were just out to feather their own nest, frivolously frittering away billions of pounds of taxpayers’ money.

The third vital ingredient was a dogmatic belief in “competition”, and the power of the market to limit corruption and inefficiency. Professionals had to be subjected to the disciplinary rigours of the market because only by being pitted against each other could their sharp practices be curtailed and inefficiencies weeded out.

The fourth and final ingredient was stupidity of the special sort common among know-all intellectuals with no practical experience of the world. This stupidity is really a lack of imagination in thinking through the implications of their wizard projects. The market needs pricing mechanisms and its transactions require binding contracts by which the “services” to be delivered are specified down to the last widget. Such arrangements do not spring from nowhere but require a vast army of accountants, contract officers, information technologists and, above all, managers. Perhaps, on reflection, the “market” is not such a good idea after all.

But such doubts never clouded David Willetts’ horizons. This was a brave new experiment and neither he nor any Tory cabinet minister at the time had any real idea how it was going to turn out. In a revealing anecdote, Paddy Ross, formerly senior surgeon at the Royal Hampshire Hospital, recalls asking Ken Clarke in 1989 how he thought the health service would look in a few years’ time. “When he replied ‘I don’t know, we shall just have to see when the dust settles’, I thought he was giving a typical politician’s evasive answer and was not prepared to reveal the hidden agenda,” Ross recalls. “Now I believe he was telling the truth. There was no secret agenda. Change was seen as an end in itself. It beggars belief that a government should deal with its health care system in such a cavalier fashion.”

Is this how it really happened? Looking back now at the policy documents that came tumbling out of the Conservative think-tanks during this time, the most striking feature is the complete absence of any sort of informed analysis of the strengths and weaknesses of the institutions soon to be subjected to the blitzkrieg of market forces. Thus, in Britain’s Biggest Enterprise: ideas for radical reform of the National Health Service, written by the then youthful John Redwood for the CPS in 1988, we learn the NHS is “a bureaucratic monster that must be tamed. It is a huge system with huge defects. Remedies will have to be on the same scale”. Modestly, Redwood acknowledges he has “no more than sketched out the beginnings of ideas” of what should be done but none the less insists that reform should be “started immediately”.

My personal experience of the CPS’s indifference to the quality and coherence of its policy documents came with a phone call from Willetts asking whether I would like to write a paper on reforming nursing. Flattered, I accepted, but having gone off and done some background reading and rung up a few contacts, I soon realised I just did not know enough to write anything useful or interesting. Willetts was not impressed by my reasons for backing out and urged me to at least write “something” on the subject.

It has all turned out so badly that the only difficulty is in deciding which institution has sustained the most damage.

Has it been the BBC, flattened by the bogus managerial ethos of John Birt and his friends? Or the universities, where academic enthusiasms must for ever play second fiddle to teaching and “research assessments”? Or the “bureaucratic” health service, whose costs have doubled and senior managerial staff increased by 1,000 per cent since the introduction of the market that was to make it so much more efficient?

Soon after becoming Conservative MP for Havant in the 1992 general election, Willetts seems to have recognised the dire consequences of the policies he had recently been so assiduously promoting. His new big idea was “civic Conservatism” in which he distanced himself from the free marketeers, claiming that “one of the most significant events of recent years” was their “collapse as an intellectual force”.

There are two possible interpretations for this change of heart. The first, espoused by patrician Tories such as Peregrine Worsthorne in the Sunday Telegraph, is that Willetts is the archetypal political opportunist. Worsthorne reminded his readers that a Tory philosopher had coined the verb “to willett”, as in “have any of your policies been willetted yet?”, and noted the Havant MP’s “remarkable capacity for making a coherent intellectual case out of anything”.

It is possible, however, to take a more charitable view. Willetts is not known as “Two Brains” for nothing, and at only 42 does not want to be a marginalised figure on the political stage for the next ten years. He realises that the party’s fortunes cannot be salvaged by photo-opportunities of William Hague appearing in funny hats.

All of which brings us back to the Wednesday lunchtime dining club and the question of whether, by apologising for the frivolous radicalism of their recent past, the Tories can convince the electorate they are once more a serious party. Labour renounced Clause Four and has been on a roll since. Can the Tories follow suit? That is the question, and despite everything, Willetts must take the credit for having the courage to raise it.

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