How a hospital woke up democracy

Deep in Middle England, a retired doctor, enraged by NHS policies, looks set to snatch a rare genera

Richard Taylor, a slightly stooping, slightly balding retired rheumatologist, is not the type of man who is meant to win elections. He is free to stand, no doubt about it. Britain is a great democracy and anyone can put themselves before the sovereign people. As long as they are Ealing comedy characters or successors to Screaming Lord Sutch, they will find there are parts in the show for mavericks. Their presence is a light and welcome relief, but they must on no account disturb the settled opinions of Westminster and Broadcasting House by actually winning.

Everyone who matters agrees that independent victories are from an age before MORI and swingometers; an unregulated foreign country to which we can never return. Admittedly, Martin Bell took Tatton last time. But only by running with the support of new Labour and the Liberal Democrats on the banal platform that he was a regular guy while Neil Hamilton, quite obviously, was not. Richard Taylor is fighting the settled view of all the major parties that private is better than public. His target is the most arcane area of Treasury policy. There is a fair chance that he will be the next MP for Wyre Forest.

For six years he has been warning of the effects of the Private Finance Initiative (PFI) on the health services of north Worcestershire and south Shropshire. To date, his Save Kidderminster Hospital Campaign has organised mass demonstrations, taken 45 per cent of the vote in local elections and unnerved established politicians, who make little effort to conceal their horror at the unconscionable success of outsiders.

To make matters worse, the revolt against privatisation is in the heart of a Middle England which, the Peter Kellners and Philip Goulds have ruled, is filled with Worcester Women and Mondeo Men whose ambitions go no further than gawping at Jeremy Clarkson in the modest sitting rooms of their pebble-dashed houses. We were assured that these were slightly greedy and slightly oafish people, not intelligent rebels from the left.

If the Third Way meant anything, it meant appealing to them. And in 1997 David Lock, a bloodless technocrat, won Wyre Forest for new Labour with a majority of less than 7,000. Tony Blair helped him by going to Worcester and telling the women (and men) that he would bring them a new hospital. They applauded with relief. Worcester Royal Infirmary was a shambolic wreck scattered over three sites. On one was an 18th-century building. On a second was a prefab left from the war. On the third, a half-completed modern block. For 30 years, the county's citizens had been complaining to an indifferent health authority.

Building a new hospital should be a simple matter for a modern state. But this blithe assumption ignores the baroque complexities of the Private Finance Initiative and its ugly child private-public partnerships. Their achievement - which may be unique outside the kleptocracies of Africa - is to give us higher taxes and worse public services. Instead of the state putting up the money for capital projects, first the Tories and then new Labour insisted that public works should be financed by paying a mortgage to private contractors. Thus the new Edinburgh Royal Infirmary will require the taxpayer to hand over £30m a year at today's prices for 30 years (£900m in total) to a business consortium. If the government had paid for it directly, the cost would have been £180m.

The Treasury maintains that its reputation for prudence is not undeserved because the risk of costs overrunning has been passed to commercial operators who must also bear the costs of administering and running the project. If this defence was valid, then services to the public should not have to be slashed to meet the PFI's bills. At the very least, the number of hospital beds, for instance, would remain the same. Contractors' apparently extortionate demands on the public purse would be balanced by the private sector bearing unforeseen expenses. Things would sort themselves out in the wash and patients wouldn't have to bother their heads about Whitehall's accountancy.

As the occasionally fatal experience of Worcestershire patients has shown, there is every reason to be bothered. It is always cheaper to buy up-front than purchase on the never-never, and the imprudence of the PFI has radicalised Worcestershire. The costs of paying contractors to build and manage the new Worcester Royal Infirmary rose between 1996 and 2000 by 118 per cent - as a study by Professor Allyson Pollock and her colleagues at University College London showed. For all the entrepreneurial spirit of the risk-loving buccaneers, the burden has been carried by the taxpayer and the sick and infirm of Worcester and Kidderminster, who are seeing the number of available beds collapse by one-third as the health authority struggles to meet the bill.

Kidderminster has suffered the most. The town's hospital has been downsized to a glorified GP's surgery. Taylor took me for a walk round its perimeter. He is 66, and had expected to spend his retirement pursuing his interests in ornithology, the paintings of Henry Maplestone (his great-grandfather) and classic cars. Instead, he was provoked into becoming a political activist.

The dominant commercial ideology in politics and business fails to understand loyalty to institutions: that not everybody works solely for money. Taylor was at Kidderminster Hospital from 1972-95, and helped it grow until it could serve 135,000 people in the town and surrounding countryside. Everything he worked for was destroyed as the hospital was reduced to dealing with minor injuries. Absurdly, even by Treasury standards, perfectly good facilities lie idle. Taylor pointed out a smart block in the jumble of buildings. It was opened in 1995 at a cost of about £15m to provide intensive therapy, maternity wards and a "laminar-flow theatre", which, Taylor explained, allowed surgeons to operate without having to worry too much about the risk of infection.

The health authority has closed them all to meet the costs of PFI and then - in a twist beyond satire - authorised the spending of £11m on gutting the building. The accident and emergency and intensive care units have gone. You cannot stay overnight. There are no beds for the elderly, the mentally ill or for the victims of heart attacks and strokes.

In March 1998, when the consequences of the PFI became clear, Kidderminster exploded. Twelve thousand demonstrators marched behind a hearse to the town hall. The system can handle such outbursts of emotion. Michael Heseltine's closure of the pits and Dead Di Day brought spontaneous demonstrations which flared briefly and seemed terribly important at the time, but changed nothing.

What has been remarkable is that the protest has been sustained and organised when all possible outlets for dissent have been blocked. The discontented might have taken out their anger on Lock by voting Conservative. But what's the use of that? New Labour and the Conservatives are as one and the ideological ground between the parties has been reduced to a tiny stretch of scrubland.

Alternatively, protesters might have hoped that private financing would have become a national issue. But the London media paid no attention to Treasury policy until the Tube, which their journalists used, was threatened.

Undeterred, Taylor and his friends have collected the signatures of 66,000 people and organised meetings and demonstrations as well as their very own party - Health Concern. Eleven of its 13 candidates won places on the council in last year's local elections. Their success is a testimony to the brutal consequences of privatising the NHS. When the hospital was asset-stripped, the health authority sent a flyer to 100,000 families saying that if any of them fell into a coma they should call 999 while unconscious and ask for an ambulance. This is not a particularly effective public health strategy, and it is not shroud-waving to assert that the price of the PFI can be measured in corpses. Earlier this year, for example, John Jones had a heart attack. He lived five minutes from Kidderminster Hospital. An ambulance picked him up, passed the gates of the hospital, which could no longer treat him, and drove for 45 minutes to Worcester. By the time he arrived, it was too late to save him. Health Concern has taken up his widow's cause and is threatening to bring a case under the Human Rights Act, alleging that the PFI is denying the right to life.

However fanciful this action may sound, there is every likelihood that the party will sue. A loose band of protesters has become a serious force. David Lock has threatened Health Concern supporters with libel actions they cannot afford to defend, and blustered as if it were improper for Taylor to ask the voters to send him to Westminster. His presence would be pointless, Lock told the Kidderminster Shuttle. "By 'kicking up a fuss' he would isolate himself from responsible politicians by showing he is unwilling to work with anyone." Lock was so far away from democratic culture that he had forgotten, if he ever knew, that voters are entitled to "kick up a fuss" and that if "responsible politicians" cannot remedy their grievances they retain the right to throw them out and elect replacements.

The authoritarian spirit - which has propelled the junior minister in the Lord Chancellor's Department to support the government's attack on trial by jury - was on him, and Lock didn't have the sense to leave it there. If the unthinkable were to happen, he continued, and Taylor were to win, there would be "less chance of persuading those involved in government to carry on investing in Wyre Forest's health service, schools, police and employment".

In other words, vote for me or your safety, jobs and children's education will go the way of your hospital.

The Conservatives have complained that Health Concern will split the anti-Labour vote, and insisted that the Tories offer "the only alternative" to Lock. Again, you hear the voice of machine-line politicians, frustrated by an outbreak of democratic passions. Health Concern is not anti-Labour; it is opposed to a Labour government's Tory policies.

In most of this country's seats, there are no credible candidates who can appeal to public disgust at consensual Conservatism. Kidderminster has a choice. I am happy to say that these patronised voters of Middle England show every indication of seizing it.

Nick Cohen is an author, columnist and signatory of the Euston Manifesto. As well as writing for the New Statesman he contributes to the Observer and other publications including the New Humanist. His books include Pretty Straight Guys – a history of Britain under Tony Blair.

This article appears in the 19 March 2001 issue of the New Statesman, The New Statesman Essay - Trapped in the human zoo