Labour must turn and fight now – or give up its electoral hopes altogether

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Struggling to make an impact: Ed Miliband must reject the Tory Party’s narrative about the need for austerity and bring forward a vision for the future that really does make us ‘One Nation’ again, rather than hanging on David Cameron’s neoliberal coat-tails, as many former Labour voters believe.

The political debate is all about the Labour Party again today – as it has been since the Budget.

The newspapers and websites are full of advice for the party, which is now clearly seen to be struggling to gain any kind of a foothold with electors who have become disillusioned at what might best be called the Party of Very Little Opposition.

Labour “must adopt new principles” according to an alliance of thinktanks and party intellectuals who have written to The Guardian; Ed Miliband has been told “don’t play safe” with the party’s manifesto according to an article on the same paper’s site.

The BBC News site has words from left-wing MP John Mann, calling on his party leader to stop trying to be “too clever” and be “much clearer” in setting out his policies.

We can probably discount the Telegraph article by Dan Hodges, claiming that Labour is “closed for business”. It plays to right-wing readers’ prejudices just a little too much.

Will Ed pay any attention to these pleas? Evidence suggests he will not.

I should clarify from the outset that, as a Labour member, I want the Party to win in 2015 (and also to gain the lion’s share of the vote in May’s European elections).

But Miliband seems to be living in a world of his own, insulated from the rest of the Labour Party – not to mention supporters of Labour ideals who are not members – by a small group of (not-so-special) advisers who, it’s claimed, intercept any decent ideas before they get to the party leader and spin them until they turn to drivel. Whether this is true or not seems immaterial as this is the perception of the general public.

And perception is everything.

As I write this article I have just received a comment stating that “Miliband’s strategy for the next election seems to be a) to accept the Tory frame of reference for any given argument and b) to then concede the field of battle on that issue, whatever it is, without a shot being fired.” This is a common complaint, and Labour has no answer to it.

Why do Miliband, Balls, Tristram Hunt (notably), Rachel Reeves (lamentably) and all the other Labour frontbenchers blithely accept the Coalition’s terms of reference on any issue, against the wishes of their own backbenchers, their party as a whole and the public at large?

Are they really just a gang of greedy moneygrubbers, determined to screw the country for whatever they can get? That in itself would be a betrayal of Labour Party ideals and their constituency parties should deselect them if members believed that to be the case for one moment.

Are they a gang of neoliberals, their political philosophy so close to that of the Conservatives that you can’t get a credit card between them? This rings threateningly true in the cases of Oxford PPE graduats Ed Balls and Yvette Cooper, ex-Bank of England employee Rachel Reeves and Tristram Hunt. But Ed Miliband is (famously) the son of a Marxist. He, above all, should know better.

The trouble is, David Miliband is the son of the same Marxist and he was as much a part of the neoliberal New Labour Red Tory deception as Tony Blair and Gordon Brown.

Oh look – another comment has just arrived. “More people don’t bother to vote because they feel that we as a people have moved on and all we really want is people who will represent us honestly, by majority and with no hidden agendas, backhanders or lobbyists pulling the strings. I don’t see any evidence that the present government or the Labour Party are capable or willing to do just that… They should have the courage to change and become the voice of the people.”

Become the voice of the people. The meaning is clear – Labour is not currently representing anybody at all.

Is this true? Let’s look at some of the other comments on my (left-leaning, let’s not forget) blog. These are from people who are generally sympathetic to Socialism and who should, therefore, see Labour as the natural home of their vote. What do they say?

“[Is it] any wonder [that] 1. People don’t vote because they are seen as “all the bloody same”? and 2. The perceived differences have become so minuscule?”

“Until Labour wakes up and realises it is the welfare cuts that are a major concern to most of us and to anyone who has a conscience, they will lose the next election due to apathy.”

“Labour have to do something different to what they have up to now but they don’t seem to want to. Are they scared of being in government over a country in the state it is?”

“Labour have had four years to do something – anything – to fight against the welfare cuts, and to help the people they are supposed to be the party for! They’ve really done nothing when all is said and done.”

If Ed Miliband was reading this, I would be asking if he was getting the message yet (are you, Ed?) and what he proposes to do about it. You think not? Let’s have some more comments from people who should be supporting Labour – I’ve got plenty of them!

“There has been absolutely no fight in this opposition and I am ashamed of them.”

“People need a reason to apply their votes to Labour and Miliband-Balls are not providing them with one. They are sleepwalking into another hung Parliament and a very real risk of the Tories teaming up with UKIP. Then we’ll really see Nazism grip this country.”

“The would-be voters demand change and need bold new policies to blunt the Tory cutters. If the Labour Party cannot come up with policies which are radical then they don’t deserve to be in power at the next election, or ever.”

“Ed Balls worries me because he seems intent on copycatting Osborne. For example Osborne says he will run a surplus by the end of the next Parliament and Balls promises the same. Osborne say he will be introducing a Benefit Cap on social security spending on working age benefits (which could have devastating effects and lead to real terms cuts in benefits for years on end) and Balls says that Labour will vote with the Coalition to introduce it.”

“Surely we need some clear red water between Labour and the Tories? Surely Labour needs to differentiate itself more from the policies of the Coalition?”

“I sent an email to the Labour Party asking for its policy on TTIP (the rightly-feared Transatlantic Trade and Investment Partnership that will force employment standards down to third-world levels, or below), amongst other things. They were decidedly equivocal and I felt no reassurance at all. I think it’s about we faced facts, Labour aren’t being coy in a pre-election year to avoid frightening the horses, they really are just another pack of neoliberals.”

This is how left-wing voters (and the squeezed-middle waverers to whom Ed Miliband keeps trying to pander) see the modern Labour Party: Carbon-copy Tories with no fresh ideas who aren’t worth the effort of voting.

If any of Ed’s shadow cabinet is okay with that description, he needs to sack them and bring in someone with a clue. And he needed to do it last year.

If the Conservatives win in 2015, it seems clear that responsibility will lie as much with Labour’s failure to provide any clearly-visible alternative.

We have already seen carnage inflicted on the poor, the sick and disabled, and a Conservative-only government (or in collaboration withUKIP) would increase that bloodshed tenfold (senior citizens take note: the bribe you were given last week was a trick and if you vote Conservative, many of you will not live to rectify your error at another election).

Unless Ed Miliband sorts out his party – pronto – that blood will be on his hands as well, and the people will not forgive him.

Note that I did not say they won’t forgive Labour. I said they won’t forgive Ed Miliband.

Words cannot describe the way people feel at what has been done to them by the Coalition. If Labour reveals even the slightest element of complicity, I wouldn’t give a farthing for Miliband’s safety.

That goes for the rest of the shadow cabinet too.

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A&E fears fall on deaf ears

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Andy Burnham, Shadow Health Secretary: He’d rather listen to real doctors than spin doctors.

The title of this article should seem brutally ironic, considering that the Coalition government famously ‘paused’ the passage of the hugely controversial Health and Social Care Act through Parliament in order to perform a ‘listening exercise’ and get the views of the public.

… Then again, maybe not – as the Tories (with the Liberal Democrats trailing behind like puppies) went on to do exactly what they originally wanted, anyway.

Have a look at the motion that went before the House of Commons today:

“That this House is concerned about recent pressure in Accident and Emergency departments and the increase in the number of people attending hospital A&Es since 2009-10; notes a recent report by the Care Quality Commission which found that more than half a million people aged 65 and over were admitted as an emergency to hospital with potentially avoidable conditions in the last year; believes that better integration to improve care in the home or community can relieve pressure on A&E; notes comments made by the Chief Executive of NHS England in oral evidence to the Health Select Committee on 5 November 2013, that the NHS is getting bogged down in a morass of competition law, that this is causing significant cost and that to make integration happen there may need to be legislative change; is further concerned that the competition aspects of the Health and Social Care Act 2012 are causing increased costs in the NHS at a time when there is a shortage of A&E doctors; and calls on the Government to reverse its changes to NHS competition policy that are holding back the integration needed to help solve the A&E crisis and diverting resources which should be better spent on improving patient care.”

Now have a look at the amendment that was passed:

“That this House notes the strong performance of NHS accident and emergency departments this winter; further notes that the average waiting time to be seen in A&E has more than halved since 2010; commends the hard work of NHS staff who are seeing more people and carrying out more operations every year since May 2010; notes that this has been supported by the Government’s decision to protect the NHS budget and to shift resources to frontline patient care, delivering 12,000 more clinical staff and 23,000 fewer administrators; welcomes changes to the GP contract which restore the personal link between doctors and their most vulnerable patients; welcomes the announcement of the Better Care Fund which designates £3.8 billion to join up health and care provision and the Integration Pioneers to provide better care closer to home; believes that clinicians are in the best position to make judgements about the most appropriate care for their patients; notes that rules on tendering are no different to the rules that applied to primary care trusts; and, a year on from the publication of the Francis Report, notes that the NHS is placing an increased emphasis on compassionate care, integration, transparency, safe staffing and patient safety.”

Big difference, isn’t it?

From the wording that won the vote, you would think there was nothing wrong with the health service at all – and you would be totally mistaken.

But this indicates the sort of cuckooland where the Coalition government wants you to live; Jeremy Hunt knows what the problems are – he just won’t acknowledge them. And he doesn’t have to – the media are run by right-wing Tory adherents.

So here, for the benefit of those of you who had work to do and missed the debate, are a few of the salient points.

Principal among them is the fact that ward beds are being ‘blocked’ – in other words, their current occupants are unable to move out, so new patients cannot move in. This is because the current occupants are frail elderly people with no support in place for them to live outside hospital. With no space on wards, accident and emergency departments have nowhere to put their new admissions, meaning they cannot free up their own beds.

Health Secretary Jeremy Hunt had nothing to say about this.

Andy Burnham, who opened proceedings, pointed out the huge increase in admissions to hospital accident and emergency departments – from a rise of 16,000 between 2007 and 2010 to “a staggering” 633,000 in the first three years of the Conservative-Liberal Democrat Coalition government.

Why the rapid rise? “There has been a rise in people arriving at A and E who have a range of problems linked to their living circumstances, from people who have severe dental pain because they cannot afford to see the dentist, to people who are suffering a breakdown or who are in crisis, to people who cannot afford to keep warm and are suffering a range of cold-related conditions.”

He said almost a million people have waited more than four hours for treatment in the last year, compared with 350,000 in his year as Health Secretary; the statement in the government amendment that waiting times have halved only relates to the time until an initial assessment – not total waiting time. Hospital A and Es have missed the government’s targets in 44 of the last 52 weeks.

Illnesses including hypothermia are on the rise, and the old Victorian ailments of rickets and scurvy are back, due to increased malnutrition.

Hospitals are filling up with the frail elderly, who should never have ended up there or who cannot get the support needed to go home because of a £1.8 billion cut in adult social services and support. This, Mr Burnham said, was “the single most important underlying cause of the A and E crisis”; ward admissions cannot be made because the beds are full. The number of emergency admissions of pensioners has topped 500,000 for the first time.

Ambulances have been held in queues outside A and E, unable to hand over patients to staff because it is full. That has left large swathes of the country — particularly in rural areas — without adequate ambulance cover.

The government is downgrading A and E units across the country into GP-run clinics, while pretending that they are still to be used for accidents and emergencies – in the middle of the A and E crisis.

People in England are reducing the number of drugs they are taking because they cannot afford to buy them. Families are choosing between eating, heating or other essentials, like prescriptions.

Competition rules have been stifling care, Mr Burnham said: “The chief executive of a large NHS trust near here says that he tried to create a partnership with GP practices and social care, but was told by his lawyers that he could not because it was anti-competitive.”

He added: “Two CCGs in Blackpool have been referred to Monitor for failing to send enough patients to a private hospital. The CCG says that there is a good reason for that: patients can be treated better in the community, avoiding costly unnecessary hospital visits. That is not good enough for the new NHS, however, so the CCG has had to hire an administrator to collect thousands of documents, tracking every referral from GPs and spending valuable resources that could have been spent on the front line.”

And the health trust in Bournemouth wanted to merge with neighbouring Poole trust, but competition rules stopped the merger taking place.

Mr Burnham demanded to know: “Since when have we allowed competition lawyers to call the shots instead of clinicians? The Government said that they were going to put GPs in charge. Instead, they have put the market in charge of these decisions and that is completely unjustifiable. The chief executive of Poole hospital said that it cost it more than £6 million in lawyers and paperwork and that without the merger the trust will now have an £8 million deficit.

“The chief executive of NHS England told the Health Committee about the market madness that we now have in the NHS: ‘I think we’ve got a problem, we may need legislative change… What is happening at the moment… we are getting bogged down in a morass of competition law… causing significant cost and frustration for people in the service in making change happen. If that is the case, to make integration happen we will need to change it’ – that is, the law. That is from the chief executive of NHS England.”

The response from current Health Secretary Jeremy Hunt needs to be examined carefully.

He said more than 96 per cent of patients were seen within four hours – but this conforms with Mr Burnham’s remark; they were seen, but not treated.

He tried to rubbish Mr Burnham’s remarks about scurvy by saying there had been only 26 admissions relating to scurvy since 2011 – but this misses the point. How many were there before 2011? This was an illness that had been eradicated in the UK – but is now returning due to Coalition policies that have forced people into malnutrition.

He dodged the issue of competition rules strangling the NHS, by saying that these rules were in place before the Health and Social Care Act was passed. In that case, asked Mr Burnham, “Why did the government legislate?” No answer.

As stated at the top of this article. he did not answer the question of the frail elderly blocking hospital beds at all.

The vote was won by the government because it has the majority of MPs and can therefore have its own way in any division, unless the vote is free (unwhipped) or a major rebellion takes place among its own members.

But anyone considering the difference between the Labour Party’s motion and the government’s amendment can see that there is a serious problem of perception going on here.

Or, as Andy Burnham put it: “This Secretary of State … seems to spend more time paying attention to spin doctors than he does to real doctors.”

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How can we believe the government’s ‘health tourism’ statistics?

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“It’s my policy and I’ll cry if I want to” – or is Jeremy *unt simply responding to criticism of his bid to climb on the anti-immigration bandwagon?

A speech by Iain Duncan Smith is immediately reminiscent of a wasp negotiating its way through a bulldog’s digestive system; there’s a lot of droning and implied pain, but through it all you know exactly what the outcome will be.

From this starting point, one may liken a speech by Jeremy Hunt to a hippo having an unhappy bowel movement as a result of an unwise dietary choice; much clumsy blundering in the wilderness and a fair amount of distress – which may be transferred to any poor creature unlucky enough to get in the way.

It seems that migrants and visitors from abroad who use the NHS are now facing the full onslaught of the Health Secretary’s metaphorical indigestion, with nary a bucket of Rennie in sight – except in this case the cure would be a set of reliable statistics covering the use of NHS services by our foreign-born friends.

Armed with new reports by independent firms Prederi and Creative Research, the Health Secretary (and well-known misprint) believes ‘health tourism’ is costing the NHS £2 billion every year – and has announced that he plans to claw back around £500 million of that money.

A BBC report states that ministers believe some of the spending is unavoidable but “it would be realistic to save a quarter. Savings would come from deterring so-called health tourism, recovering money owed by other countries and a levy on non-European temporary residents”.

But the cost of health tourism, as set out in the report, is tiny – at a maximum of £80 million it would be four per cent of the estimated total loss – and this is based on evidence which even one of the reports’ authors, Prederi, have admitted is incomplete. On its own, it could not possibly generate the saving demanded by the new policy, nor could it justify the claim that £2 billion is currently being lost.

That is not the point, though. This is about getting the NHS on the anti-immigration bandwagon.

The study has been released to coincide with the Immigration Bill, which (surprise, surprise) includes plans for a £200-per-person-per-year charge for temporary migrants to use the NHS during any stay lasting between six months and five years.

The Conservative-led Coalition government says this could recoup around £200 million per year, but this is clearly nonsense.

Put yourself in the position of a person from abroad, considering an extended stay in the UK. If an extra cost of up to £1,000 for a five-year stay was added to the trip, out of the blue, would you go ahead with it? Or would you consider other destinations?

Alternatively, if the trip could not be avoided, would this not make you more likely to use the NHS, in order to simply get your money’s worth? The trouble with this is that such a person would not know the cost of a consultation. According to Dr Chaand Nagpaul, chairman of the British Medical Association’s GPs committee, the cost of a single hospital outpatient appointment would equal the £200-per-year levy.

And then there is the administration cost. New Statesman revealed that the chair of the Royal College of GPs, Claire Gerada, has warned that the cost of administrating the new system could outweigh the savings, while also increasing public health problems such as TB by deterring temporary migrants from seeking treatment when they first fall ill. This gives rise to the possibility that we are facing another Tory policy that could have deadly consequences for the population.

This is not a plan to deal with health tourism at all. This is an attempt by an increasingly-desperate Conservative Party to claw back some of the voters who have (themselves) migrated to UKIP because of fears that have been planted in their minds by political spin-doctors, rather than any real threat – the phantom problem of immigrants getting benefits they haven’t earned.

Health tourism is not costing the UK £2 billion a year, and the measures outlined by the government will not stop it, or save any lost money. If anything, it will cost the country millions of pounds.

But then, when has Jeremy Hunt bothered with the facts, when he can have his way simply by playing on people’s fears and manipulating their beliefs?

This is why reference was made, at the top of this article, to Iain Duncan Smith – another Tory minister who won’t let thousands of possible deaths interfere with his beliefs.