“The reason Labour politicians are so off-beam seems to be because they are developing policies without reference to NHS staff, the health unions, or the many campaigners who have been fighting for years to defend the NHS”
By John Lister
Anyone who knows anything about the current, unprecedented crisis of the NHS will know that the workforce is an essential component of any solution. Sadly, Labour doesn’t seem to get it.
133,000 key posts are vacant including almost one in eight nursing posts – and demoralised and burned out staff are leaving – for better pay, or simply to escape the constant stress and frustration of being unable to deliver the quality of care they were trained for. Those still holding on and keeping services running have seen the real terms value of their pay slashed since 2010 – many NHS trusts are now running food banks to help nursing and other lower paid staff.
But it’s not just nurses. Junior doctors are under-paid and grossly over-worked. GP numbers have fallen, while their workload has increased – with the equivalent of just fully qualified 27,000 GPs in England delivering a staggering 36 million appointments (more than half the UK population) in October alone, almost three quarters of them face to face.
We expect government ministers to downplay and deny the scale of these problems. Their policies since 2010 have created the crisis, by slamming the brakes on NHS spending, and maintaining it at an average rage of increase of just 1.4% per year in real terms between 2010 and 2019 – much less than half the previous average level. If NHS spending had kept growing at previous average levels the budget would be an extra £35 billion per year.
But what we don’t expect is for Labour, as the main opposition party, to effectively reinforce the Tory line, by refusing to highlight the level of underfunding, refusing to promise to increase it, refusing to support staff striking for more money, attacking and denigrating the work done by GPs, and focusing on their own ill-judged and even downright dangerous “reforms” (including self-referral for internal bleeding), and the long-discredited wasteful Blairite nonsense of increased use of the private sector, rather than rebuilding and expanding the NHS.
The reason Labour politicians are so off-beam seems to be because they are developing policies without reference to NHS staff, the health unions, or the many campaigners who have been fighting for years to defend the NHS and its principles. Unlike his predecessor Jonathan Ashworth, who listened to and worked with campaigners, Shadow Health and Social Care Secretary Wes Streeting remains aloof.
Policy pronouncements from Streeting and Keir Starmer have been made to right wing think tanks or to pay-walled right wing newspapers bitterly hostile to the NHS, notably the Daily Telegraph. Polly Toynbee in the Guardian may believe this has “ambushed the Tories,” but for many it seems more like a surrender to them.
GPs have suffered a double whammy, with Streeting telling the Times that their funding is “murky and opaque” (in fact it’s administered by the NHS) and joining with Starmer to claim that they are a “bureaucratic” obstacle to swifter treatment. Toynbee has dressed up Starmer’s argument as a proposal to revive Lord Darzi’s ill-fated, costly and unpopular plan for “polyclinics” – but without much more funding this is even less credible than it was first time out.
It appears Labour’s whole focus is on a forlorn attempt to win over the Tory right – who keep showing how they despise the NHS – rather than speak up for the 1.3 million NHS staff, the millions of patients, the Labour party members and campaigners who want desperately to hear policies that give hope of light at the end of the tunnel, and offer ways to keep and improve it.
What makes this even more absurd is that a recent opinion poll in the i newspaper found that 73% of Tory voters blame the government for the crisis.
Even if the Tories are lagging now in the polls it’s by no means a given they won’t recover some ground, or that health workers and those who care about the NHS will vote for an opposition party that ignores them and seems set to make things worse rather than better if they win power.
A change of course is needed: Labour must join the public in backing the health workers, and join the majority in nailing the blame for the crisis firmly on the Tories and austerity.
Labour leaders must back the letter from Sir Robert Francis (who chaired the Mid Staffordshire Hospitals Enquiry) and Rachel Power, CEO of the Patients Association demanding the government declare a ‘national incident’ and take steps to protect patient safety.
Ministers must be told to sit down with NHS and social care unions to negotiate pay increases sufficient to make it possible to fill a combined 300,000 vacancies.
And Labour must commit to a major immediate NHS cash injection, followed by a decade of continued investment to revive and rebuild the NHS, promising that ALL of that investment is to build the NHS for the future rather than line the pockets of private hospitals and contractors.
Labour needs to remember its votes will come primarily from the poorer 90% of the population, most of whom who would welcome such policies, rather than vain appeals to the richest 10%. On NHS care it needs to show it values patients, not profits.
- John Lister is the joint editor of The Lowdown and joint author of NHS Under Siege (Merlin Press 2022).
- You can follow John on twitter here and follow Keep Our NHS Public on Facebook and Twitter.
