The Labour party finds it hard having heroes. As a movement that grew from the bottom of society, it has nearly always found a reason not to honour those who reach its top. Very few are spared the harshest of political judgment. Ramsay MacDonald was the original traitor, and since then the labour movement has been finding new pariahs at each and every election. Even those who happen to win three. But one light nearly always shines through the red mist; Aneurin Bevan.
The bright shining vision of the National Health Service is as acute today as it was in 1948 when the great reforming Attlee government began to heal a war-ravaged nation. Bevan, rightly, is seen as the most significant figure in the history of the NHS. His place in the pantheon of Labour greats is assured. That he was opposed, and indeed defeated, by a name that is but a passing reference in Labour’s annals speaks volumes about those the party reveres over those it does not. But this figure, as Daniel Finkelstein recently noted, could hold the key to the very future of the NHS.
The bourgeois socialising and elite politicking associated with Gaitskell represented the very antithesis of Bevan. Where Bevan had created the NHS, Gaitskell introduced the first NHS charges to fund an American-led fight in distant Korea. Themes being replayed in the politics of today were first thrashed out by a Labour cabinet in 1951; namely whether the NHS could be sustained without the imposition of charges that Gaitskell first introduced. The debate now writ large is over the very future of the NHS.
The NHS is, according to the Kings Fund, facing “financial meltdown”. And to what, from Labour, is the answer to this most fundamental question? Andy Burnham, the shadow health secretary, would clearly like to position himself as the latter-day Bevan, the keeper of the party of the NHS, of its conscience and soul – and whatever other mystical tones in which the party likes to drape itself. But on the key question facing the NHS, the party has been all but mute.
Candle-lit vigils, people’s marches, nonagenarians deployed at party conference – Labour has descended into the politics of demagoguery over the NHS. Nostalgia, fear and politiking are driving policy. What is at stake for Labour is votes, not the secure future of the NHS. For the party has not articulated a policy that would quell the ills inflicted upon it by the coalition. Its flagship “Time to Care Fund” unravelled under the most basic scrutiny; not implemented until 2017, and only after the mansion tax, tobacco levy and tax avoidance measures are passed in a Budget when, with present polls, Labour cannot guarantee a majority.
But it is on the question of privatisation that the party is pandering to fear. Burnham will know better than many Labour’s acceptance of the private sector into the NHS during the New Labour years. As part of reforms in the first years of the previous Labour government, bids for services were invited from the private sector. Labour very clearly made use of the private sector when it suited them, in particular in order to bring down waiting lists. As Finkelstein’s Times colleague David Aaronovitch highlighted, private sector involvement in the NHS rose from just under three per cent in 2006 to just over six per cent today. It is hardly a privatised Damascene conversion.
The Attlee government realised, even at the birth of the NHS, that it was a policy with a limited price tag. Since the NHS was founded, its spending has increased on average by four per cent a year in real terms. However, for the foreseeable future, the NHS budget is likely to remain flat in real terms or, at most, to increase in line with growth in the rest of the economy. It will require Gaitskell’s discipline, not Bevan’s vision.
Labour is absolutely right that the NHS must be at the centre of political debate between now and the election, for it is genuinely facing the biggest challenges than at any time in its history. But the battles being played out internally are all too similar. Gaitskell may have had the upper hand more often during the Labour party’s 1950s civil war, but there was only going to be one winner in the Labour history stakes. Labour in the years ahead may conclude that it picked the wrong hero.
David Talbot is a political consultant and contributor to Labour Uncut