Tag Archives: left

Can Starmer or Streeting really afford to lose the NHS vote?

Labour for the last few years has been too busy facing inwards. It has become obsessed in fighting deeply unpleasant ideological battles, but the people doing so claim that they had no choice. Labour is at danger of continuing to carry on with this protracted fracture rather than embracing the pragmatic issues of government. Labour does however emphasise the need to make practical pledges. The latest onslaught by Starmer and Streeting, however, could prove to be deeply damaging for their reputation as ‘guardians of the NHS’. It seems to want to turn the NHS into another ‘culture war’. If it does, I think it will fail.

I remember when I went to a seminar at the Academy of Ideas earlier this year in Church House. As ever, it was brilliant. We spoke our minds and listened respectfully to the views of others. The discussion was supposed to be on the decline on the NHS. Nobody mentioned the crisis in social care or austerity as factors, which surprised me. I pointed this out to the panel, and I remember being aghast when the director of a right-wing think tank told me that austerity had “nothing to do with it”. This is simply not backed up by the evidence. Even this week, a published report, commissioned by the Conservative Party, drew attention to it.

In recent times, the Conservatives have had a formidable reputation for economic competence. This has been enduring a previous Chancellor, Kwasi Kwarteng, causing a crash in the pound through a mini-budget. The Labour Party has always been seen as the “party of the NHS”. In December 2019, under previous management, Labour under Jeremy Corbyn had again warned about further privatisation of the NHS. Is it possible that Labour is finally going to lose its crown as ‘champion of the NHS’?

Heading into a news break this lunchtime, LBC presenter Shelagh Fogarty had to explain to a caller that a ‘zero immigration’ target was unreasonable, and that the country was not falling apart due to cross channel migrants. Brexit has overwhelmingly been found out to be a disaster, and was meant to solve the problem of ‘taking back control. There is unease about Starmer being unwilling to tackle it. Boris Johnson, meanwhile, the former MP who “got Brexit done”, is said to have pocketed more than £1 million in speaking engagements including in India and Portugal following Brexit. In the last week, Wes Streeting has given three interviews with LBC, and they do repeat the same views. Suella Braverman gave by all accounts this morning a pretty disgusting account of the deaths which had occurred on the English Channel this morning. Labour only a few years ago was pimping out its famous immigration mugs. Starmer, who has distanced himself from all policy from 2019 Labour manifesto, including – presumably – the attack on austerity, does not want to appear too ‘woke’ in case he goes ‘broke’ at the next general election in 2024.

The British Medical Association (BMA have apparently criticised Mr Streeting for what it called “disappointing” comments after he used an interview with the Sunday Telegraph to accuse the union of being hostile towards vitally needed NHS reform efforts. Wes Streeting is proud for not being on the side of the doctors but being firmly on the side of the patient, and this position certainly is more convenient also for attracting the ‘anti woke’ or Red Wall vote. Although it is time and time again said that such voters are not racist, there is a rarely a phone-in on LBC without the caller who blames an increased demand on NHS services by ‘immigrants’. Both Streeting and Starmer do not want to appear ‘close to the Unions’, which is a pathetic thing to pander to as neither the RMT or RCN are affiliated to Labour for example.

A symbol of the decline in the NHS has been the “mad scramble” for the GP appointment at 8 am. Most of us have had experience of ringing up punctually at 8 am to make an appointment only to be “number 42 in the queue” if delayed by a few minutes. GPs have been accused of offering fewer face to face appointments. The BMA have repeatedly pointed out that the promised recruitment drive in general practice never materialised, they have a retention problem with the GP workforce, and there has been a vast increase in the number of appointments overall. In July 2020, the then Secretary of State for health and social care, Matt Hancock, now more associated with ‘jungle washing’, had argued that GP apppintments “should be virtual by default“. GPs have a right to argue, therefore, that they have been delivering a system mandated to them, whilst overstretched and doctored. Streeting made no reference to the crisis in general practise in any of the interviews, presumably because he is trying to present himself as the ‘patient advocate’.

In a new policy paper from earlier this year, the Royal College of Physicians repeated the case for long-term workforce planning and sets out a range of short- to medium-term solutions the government must implement now to keep the NHS running. Wes Streeting has repeated many times his aspiration to grow the workforce of the NHS. To avoid the accusation of ‘overpromising and underdelivering’, Streeting made clear in all his recent interviews that the pledge would be paid for from the money accrued rom the ‘non dom status‘. Discussing the “back and forth”, Wes Streeting told presenter Shelagh Fogarty: “We announced the biggest expansion of NHS staff in history — so we would double the number of medical school places, increase nursing and midwifery clinical training places by 10,000, 5000 more health visitors, doubling the number of district nurses.”

But this in itself is a hopeless solution to the NHS workforce crisis in itself. It took a caller to Shelagh Fogarty’s show, “Felicity from Greenwich”, a doctor, to point out that there is a bottleneck for places at every stage of training. With doctors being unable to find jobs, therefore, it is not surprising they are leaving the profession. There is no structured return to work scheme including extended induction or reasonable adjustments (phased return) for disabled doctors for people who have taken unanticipated leave for years off the register; such a scheme is necessary for re-skilling and building up the confidence of such doctors. There is a pensions crisis in the NHS which means that long-established doctors are having to leave the profession rather than to be clobbered by huge tax bills. Wes Streeting acknowledges the campaign on pensions by the BMA. Ask any trainee how they feel about the increase in medical school places, and you’ll soon have your answers.

A report from the right wing think-tank Policy Exchange earlier this year provided details a ‘rescue package’ for general practice.  The report from Policy Exchange recommended specifically:

  • The overhaul of the current core GP contract to redefine incentives, reduce bureaucracy and free-up GPs to help the patients with the most complex needs;
  • A £6 billion ‘rescue package’ to enable improvements to general practice premises, data collection and to enable an orderly transition to new contractual models;
  • The ‘levelling-up’ of general practice with a massive boost in high-quality video consultations in areas where there are not enough doctors;
  • The introduction of ‘NHS Gateway’, a more coherent entry point to primary care and to reduce dependency upon the 8am call to the GP surgery for appointments;

The Daily Mail were so enthused it even ran an article promoting this report to its readers, including a section on how the BMA were unable to support the proposal.

Family doctors wanted extra funding to cover the rising national insurance costs and inflation.  But the final contract, given to the BMA just hours before being made public, made no mention of the additional cash it had demanded.

I don’t deny the attraction the Daily Mail must have for Streeting or Starmer, being avid consumers of the Sun and Telegraph. Streeting at no point in his LBC interviews made any mention of why the BMA had been critical of recent proposals, rather leaving the average voter with the impression that the BMA was just a militant union opposed to change. All registered doctors have a regulatory obligation under ‘domain 2’ to commit to improvement of the quality of the service with the General Medical Council, and this inevitably has involved change initiatives.

The Conservatives chose not to implement the Policy Exchange proposal, but were too busy with their own leadership election and the coronation of Liz Truss – who blew a sum vastly larger than this on crashing the UK economy as a sign of ‘taking back control’ (a Brexit dividend) from a ‘Singapore on Thames‘ economy forewarned by her Britannia Unchained movement.

Implementation of technology here might have really helped, however.

I have for nearly a decade commented on how the increasing use of technology is a ‘Trojan horse’ for further marketisation of the NHS. For example, in an article for Open Democracy back in 2015, I commented on a recent speech by Jeremy Hunt, the then Secretary of State for Health. Whatever happened to him?

I wrote,

This month Jeremy Hunt MP gave what he told us was his “most important speech as health secretary”. The speech – delivered at the Kings Fund, and entitled “”Making healthcare more human-centred not system-centred” – fulfilled its function of generating blockbuster headlines, mostly focused on the ‘7 day NHS’ and consultant pay. But there’s been relatively little comment on his new ‘big idea’ – a patient-centric transformation in a post-bureaucratic age, which he calls “intelligent transparency”.

Embracing technology within a nationalised service is sensible. Using technology to privatise a service and to demolish the workforce is a different motive, and one which is bound to cause a problem with core Labour voters. It has been a consistent tactic of the right wing opposition and Wes Streeting to frame anyone who won’t embrace technology as being opponents of change. To give just one example, in August 2022, the RMT reported that a funding deal struck by Transport for London and ministers would attack tube workers’ pay and pensions and would lead to further strike action, RMT have warned. The proposals seemed conditional on attacks on workers’ pensions, potential job losses and a push for pay restraint in the future despite the astronomical rise in inflation and an escalating cost of living crisis. Driverless trains are also part of the reforms insisted on by a previous Secretary of State for transport, despite the huge costs involved and safety concerns. Driverless trains are a massive safety concern for disabled passengers, and are not a trivial matter. To frame protection of the workforce as ‘looking after vested interest’ is a political choice which Starmer and Streeting have decided to take. Technology can be used alongside the workforce to improve their working conditions, and not just as a replacement for the workforce to maximise profit margins. Technology besides is not a universal panacea. The report of the AI chat bot which ‘turned racist’ is notorious. Tay was an chatbot that was originally released in March 2016 which caused subsequent controversy when the bot began to post inflammatory and offensive tweets through its Twitter account, causing Microsoft to shut down the service only 16 hours after its launch.

All people, including clinicians, are the lifeblood of the NHS, and Labour talking over them is poor mood music.

Here, for example, is Labour taking credit for ‘training doctors’. It is the existing workforce who is expected to train others.

At this very second, the likelihood is that Labour might become the largest party in the 2024 general election, but unlikely to win an overall majority. Streeting says that he and Starmer have been working on a plan for the NHS and social care. Many of us remember how traumatic the last NHS reform was in 2012, a ‘top down reorganisation’ which David Cameron had said would never happen (see for example an open letter some of us sent in 2016). The mood music from Streeting was bad, and has opened up much mistrust amongst hardworking professionals within the NHS. Lifelong Labour voters are telling me now that they might never vote for Labour again, given how bad the coverage was. But there are many patients in the voting public, just as there are many NHS staff who want to vote Labour ideally.


Listen to all the podcasts and sign the petitions all you want, but still prepare yourself for eternal opposition

Podcast audiences don’t win elections. Petitions don’t win elections. Political parties win elections in first part the post in the UK elections.

For the first time in my lifetime, I think the era of mass civil disobedience is coming faster than a Labour government. I wonder if you remember the saying that ‘millions of people are relying on the election of a Labour government’. This was also true for the 2019 general election, dubbed the “Brexit election”. It was pretty easy to identify that Boris Johnson was a repellent liar at the time, even pre pandemic. It was obvious that the arrangements in Northern Ireland were a fudge, and that the trade barriers would be pretty ruinous to the macroeconomy of the UK. Labour had the ‘worst performance for many years’, but it is impossible to untangle from that how monstered Jeremy Corbyn was by the media, from James O’Brien to the Guardian, from Alasdair Campbell to other prominent has beens. On offer were ‘far left’ policies, such as a national care service, national education service, ‘free’ broadband – and what you got was Dido Harding, Matt “Jungle Fever” Hancock and Michelle Mone.

I don’t want even to contemplate what degrees of shit will be voted in next time around. One looming disaster is withdrawal from the European Convention of Human Rights – the perfect ‘get out’ clause to allow flights full of legal asylum seekers to fly to Rwanda, or to do other odious activities with cross-channel dinghies as there are no legal routes to enter the United Kingdom. While the Labour Party appears to have big corporate sponsors now, its Union support is dwindling. Labour cannot offer unequivocal support to the workers, some of whom are affiliated through the trades unions. Labour won’t offer to repeal the mercenary anti-Union legislation heavily signposted for the new year, and seems to wish to do its own form of austerity. Yvette Cooper and Rachel Reeves of course are past masters in their activities with welfare benefits, as most of us from that vintage will remember.

I think Mick Lynch is putting it a bit mildly when he calls ‘Keir Starmer’. At least vanilla ice cream can be soothing or tasty. Starmer’s rhetoric does not give me any confidence that he is the man to get Britain to a state where it is proud of itself. Far before the pandemic crisis or the Ukraine war, it was very obvious that England was in decline. Nowadays the right wing loons are forced to pillar Meghan Markle and her curtsying to detract from the disgusting state of the country. The UK Labour Party doesn’t seem to care that being in England is positively risky to you and your health. Because of a sustained campaign of underfunding, to fork out billions for pointless projects such as Brexit, there is ‘no money left’ for any of the emergency services. If there’s a fire in your flat or house, run and escape for the hills. You’ll be lucky to get a fire engine. If you have a stroke, take a cab to your local hospital as you might be waiting some time for an ambulance. If you have a burglary, kiss goodbye to your property, and buy lots of cheap tat to replace them with off Amazon. The water and gas are nationalised, owned by private equity from abroad. We’re in the process of getting rid of all the EU safeguards, so we can relentlessly pump sewage into the sea. And so it goes on.

The facts are that Labour doesn’t have a hope in hell of getting many seats in Scotland in the 2024 general election, and that some voters still wouldn’t want to touch Starmer’s Labour due to various factors including lack of policy. Depending on tactical voting, and on various outcomes such as whether Sunak can ‘smash the strike’, we’re looking at Labour possibly being the largest party in a hung parliament. If you want Labour to offer something different on austerity, supporting strikers, net zero, HS2, and so on, forget it. Listen to all the podcasts and sign the petitions all you want, but still prepare yourself for eternal opposition. And don’t even rule out an unprecedented re-election of a spanking new Tory government.

It’s insane to believe that Sir Keir Starmer is completing ‘phase 1’ of his election-winning strategy

Just watching David Miliband’s interview on the Andrew Neil Show, on his new series on channel 4, will tell you why many traditionally Labour voters feel an enormous sense of frustration. To a perfectly sensible question on how he would tackle the cross channel ‘dinghy crisis’, a matter on most Faragists’ lips, David Miliband concedes calmly that he wouldn’t have wanted to start from here. He talks about how Brexit leads to not being a signatory any more of the UK to something called the Treaty of Dublin, and works backwards to think about how a legal infrastructure might be rebuilt.

I don’t suppose David Miliband devotes much time to thinking about how he could re-enter parliament, become leader of the Labour Party, and then become Prime Minister. He seems more concerned about putting his family first, and running his increasingly successful NGO well. I actually remember voting for Ed Miliband to become party leader in about 2010. I remember when his leadership was announced in 2010 to much excitement at party conference, which I think was in Manchester. Or it might have been Liverpool. Not sure. I remember meeting the late Michael Meacher who told me he was ecstatic. And he looked it. He died five years later.

2015 was coincidentally when Ed Miliband failed to win a general election. I remember the ‘one last heave’ approach very well – which had embittered many of us, with the famous ‘immigration mugs’.

The rest of course is history – David Cameron was voted in in an endorsement of ‘competence’ over ‘chaos’, while regretfully he brought in a referendum with no clear plan of what to do on voting Brexit. Corbyn was blamed for a lack lustre ‘remain’ campaign, when it is clear that Alan Johnson and Lord Stuart Rose hardly covered themselves in glory either.

My perspective I don’t feel is unique to Corbynistas. The irony is that I am not a Corbynista at all. I had supported all Labour leaders during my time supporting the party between 1992 and 2019. I thought it was a good idea in 2019 to strengthen the NHS as a public service, introduce a national care service, produce a proper infrastructure for internet services, and so on.

Somebody on Question Time recently in the audience started laying into Mick Lynch why the teams from Victoria and Euston were separate. It was calmly explained to ‘Tory boy’ that it was not common either for staff at ASDA to help routinely staff at Sainsbury’s. It was also calmed explained to him that this problem wouldn’t arise if the railways had been nationalised. Lynch calmly explained how he could not explain the ‘compulsory job cuts’ when the railways were returning multi-million revenues. And so it went on.

But now when people are told, ‘remember the 1970s?’, people think the 1970s were not so bad. Harold Wilson or Jim Callaghan were not, to our knowledge, shagging multiple mistresses consecutively, nor holding parties in Downing Street, nor balls-ing up a major plank of policy which threatened our geopolitical or economy security. OK, they did not have to pretend to be Bennie Hill, with dandruff and shirt hanging out, or need to get their deputies to wink across the despatch box either.

When asked simply on the BBC Radio 4 programme yesterday what his programme for national government would be, Andy Burnham simply said social and constitutional reform. This is what he feels, apparently, is holding back Britain. This of course would be a sensible move for members of the Labour Left, who do not consider themselves ‘hard left’, to feel more part of a party which has chucked out somebody they supported and went door-knocking for years. It is indeed possible that proportional representation and the reform of the House of Lords are issues which need addressing much more than Brexit. It is still the case that not many individuals can point to a tangible benefit or beneficial outcome from Brexit apart from ‘sovereignty’. And even the ‘taking back control’ has gone pear-shaped with the ‘oven-ready’ deal – which turned out to be, who’d have thunk it, possibly yet another one of Johnson’s porkie pies. The NI protocol is such a mess, that the Government has had to introduce its own legislation which many to think to be unlawful under international law – leading to a Trumpian government to say ‘breaking the law is sometimes a necessity’ (which is not true at all).

Starmer cannot be blamed for being able to set out, now, in detail, his policy on a number of areas – but there could be a ‘snap election’, and everyone fails to know what he stands for ideologically (apart from U-turning on his own ‘pledges’ to become leader of the Party). He doesn’t seem to have any views on what to improve on Brexit. The comparison with Tony Blair is quite insulting to Tony Blair. Blair ahead of the 1997 general election was massively ahead in the polls, and had the skeleton of a clear programme for government. Look at today – the running of the NHS, ambulances, social care, passport offices and so on is a shambles. Inflation is at over 11% on one measure, and this cannot simply be put down to ‘international factors’ – I am no economist, but I am sure printing lots of money as has been a drug since Osborne had something to do with it. Ironically, Ed Miliband wanted to come in on a ticket to reform the energy ‘market’ – so how’s that going for you then?

Whisper it gently. Wakefield was hardly a massive endorsement for Labour, as their number of voters actually went down in a climate of the worst Tory Prime Minister (and government) in ‘living memory’. I am not alone. I also happen not to be that interested in culture wars or Brexit. If you’re looking for ‘security’, this Government is the pits – howeverso defined, economic, financial, or political, with the shambolic running of public services. But if you’re looking at ‘aspiration’, it’s pretty awful too. I can’t believe that many so-called entrepreneurs found Boris Johnson’s call to arms, ‘Fuck business!’, that inspiring.

It might be a case of ‘hold your nose and vote for Labour’, which is what I suspect might happen. Meanwhile, Scotland might get some momentum on its indy ref, and this might alter the landscape of the next Government of the UK. I think, however, it would be wrong to say that Starmer has successfully completed ‘phase 1’ of his election-winning strategy. If the aim was to rout out all the hard Left, he has also palpably annoyed many who supported the policies of the previous leader of the Labour Party. So as the ‘unity’ candidate, I have rarely seen the Labour Party so divided. With a possible ‘summer of discontent’, extending from railway workers to nurses, post office, fire brigade workers, the plight of the public sector who have sustained world-beating pay freezes will come under increased scrutiny. We know that Starmer has cancelled the 2019 manifesto, and it’s hard to say quite how popular/unpopular these policies were. Two things to say here, Starmer’s 2nd referendum didn’t help with Red Wall Brexiteers. Secondly, much of this policy has been assumed by a rather non-conservative Conservative Policy anyway.

Starmer’s problem is that he does not seem to be wooing as many from the ‘Centre’ as he has clearly lost from the Left. And he has – as yet – no clear view on inflation, Ukraine, or Brexit – even if he knows what a woman is. I am yet to be convinced he has completed ‘phase 1’ of his strategy – but assume for a moment that he has, what is his programme for government?