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Boris Johnson’s big Brexit speech was high on rhetoric and short on answers

Remainers aren’t worried about John Stuart Mill - they’re worried about policy.

Boris Johnson and I don’t have much in common but we do share a university, albeit one we attended several decades apart. Listening to his big Brexit address at Policy Exchange, I found myself gripped by unwanted flashbacks to my time there and the speeches one would occasionally have to endure in tutorial when someone – usually but not exclusively someone from a famous private school like Johnson’s – hadn’t done the reading but did have a big argument they knew could get them through the hour.

Similarly, Johnson’s speech hung together as far as the essay question he had set himself – “Is Brexit a great liberal cause?”- went, but unfortunately it fell apart as far as the actual thing the government needs to solve; which is “What did Remainers fear to lose in the referendum, and how can they be reassured?”

The problem is that most Remainers didn’t vote to stay in the European Union because of a high-minded commitment to the institutions of the EU or an ideological sense that it was better for liberalism, or conservativism, or social democracy or socialism or whatever creed you care to name. Those that did are beyond the reach of Johnson or the government anyway. Most Remainers voted to stay in the EU because of concern about what leaving would look like, and the disruption it might cause, and it was on that subject that the speech was thinnest.

Where it did succeed in offering reassurance was the passages in which Johnson effectively pledged that in some sectors nothing would change, i.e. security and foreign affairs – for both of which the British government hopes it will effectively remain in the EU. (The same is true of science and research.)

It was when the speech entered the murkier areas – the ones where the government as a whole, and perhaps Johnson as an individual, is less clear on what they want – that it fell apart. Frankly, you can give as many fine monologues about the importance of setting our own tariffs, but the fear that occupies the minds of many Remainers, particularly those in Northern Ireland, is that Brexit means a hard border between Northern Ireland and Ireland. The only way you can prevent that is a significant measure of customs and regulatory alignment, which Johnson appeared to rule out in the speech.

Ditto, while the passages about British citizens still enjoying visa-free holidays might have been amusing, the actual point of voter concern is that they or their spouses will no longer be able to live, work and move in together freely in the EU area as they do now.

If Boris Johnson wants to make a success of Brexit, let alone to win back the Remainers it lost at the 2017 election, it needs to engage seriously with what the actual fears of the actual people who voted Remain are, and indeed engage seriously with the issues around delivering Brexit more broadly, not deliver 45 minutes of flannel about John Stuart Mill.

Stephen Bush is special correspondent at the New Statesman and the PSA's Journalist of the Year. His daily briefing, Morning Call, provides a quick and essential guide to domestic and global politics.

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Like many others, Dr Hadiza Bawa-Garba was left in charge of a failing aircraft

Ony when enough hospitals shut down, and do so often, will those with true responsibility properly resource the NHS. 

The day Leicester trainee paediatrician Dr Hadiza Bawa-Garba was struck off by the High Court for her involvement in the death of six-year-old Jack Adcock, Health Secretary Jeremy Hunt posted a tweet expressing his deep concern about possible unintended consequences of the ruling. He was referring specifically to the impact on patient safety.

At a stroke, efforts to build a culture of open learning – a cause Hunt champions – had been set back decades. You don’t get people to talk honestly about critical mistakes by threatening them with prison and professional ruin.

There may be other consequences that Hunt didn’t anticipate. Comparisons with another safety-critical industry – aviation – are instructive. On the day Jack died, from undiagnosed sepsis, Bawa-Garba was functioning as would a first officer on an aircraft. The plane’s captain was elsewhere, training other pilots on a simulator in a different city. The chief steward had failed to report for duty, so Bawa-Garba was expected to oversee cabin service as well as fly the plane single-handed.

The aircraft’s IT systems had gone down, meaning one of the stewardesses was permanently occupied looking out of the window to ensure they didn’t collide with anything. Another stewardess was off sick, and her replacement was unfamiliar with the type of plane and its safety systems. And Bawa-Garba herself had just returned from a year’s maternity leave. She’d done quite a lot of flying in the past, though, and the airline clearly believed she could slot straight back into action – they arranged no return-to-work programme, dropping her in at the deep end.

Not one of us would agree to be a passenger on that flight, yet that kind of scenario is commonplace in hospitals throughout the country. Critically ill patients have no awareness of how precarious their care is, and would have no choice about it if they knew. Since the Bawa-Garba ruling, doctors have been bombarding the General Medical Council (GMC) for advice as to what they should do when confronted with similarly parlous working conditions.

The GMC’s response has been to issue a flowchart detailing whom medics should tell about concerns. But it has failed to confirm that doing so would protect doctors should a disaster occur. Nor does it support worried doctors simply refusing to work under unsafe conditions. This is akin to telling the first officer they must inform the airline that things are bad, very bad, but that they still have to fly the plane regardless.

Jeremy Hunt has responded to the crisis by announcing an urgent review into gross negligence manslaughter, the offence of which Bawa-Garba was convicted. This is welcome, and long overdue, but it still serves to retain the focus on individuals and their performance, and keeps attention away from the failing systems that let down doctors and patients daily.

An action by the British Association of Physicians of Indian Origin is, arguably, more important than Hunt’s review. The organisation has written to Leicestershire police requesting that they investigate Bawa-Garba’s hospital trust for alleged corporate manslaughter. I sincerely hope a prosecution follows. I’m no fan of litigation, but change is only going to come when those who manage the NHS know that they are going to carry the can when things go wrong.

We need clear statements of what constitute minimum acceptable staffing levels, both in terms of numbers, and training and experience. When departments, or even whole hospitals, fall below these – or when unexpected problems such as IT failures occur – managers, faced with the real prospect of corporate lawsuits, will close the unit, rather than keep operating in unsafe conditions, as routinely occurs.

Only when enough hospitals shut down, and do so often, will those with true responsibility – Jeremy Hunt and the rest of the Conservative government – finally act to resource the health service properly. 

This would be an unintended consequence from the Dr Bawa-Garba case that would be welcome indeed. 

This article first appeared in the 15 February 2018 issue of the New Statesman, The polite extremist