It would be unfortunate if the febrile speculation over the identity of the BBC presenter at the centre of inappropriate conduct allegations and the email related to George Osborne’s conduct were allowed to overshadow what have been important events this last fortnight.
As we enter the second half of the year, Rishi Sunak’s government continues to crumble, his MPs becoming restless at the five priorities not ‘cutting through’ to the public and thinking of ditching him for their third unelected leader within 14 months. The party chairman Greg Hands’s incessant tweeting about the letter left at the end of the last Labour administration indicates a desperation we’ve not seen before, though some still don’t see that they’re finished. Media advisers have suggested focusing on segmented messaging to different sectors of the population, but no amount of messaging is going to convince most of us that the priorities are progressing when they’re manifestly not. ‘Despite its best efforts, however, the government appears stuck in limbo in the run-up to recess and three looming byelections (with a further two possibly on the horizon). A lack of legislation means the Commons is missing its buzz, a deliberate tactic to let MPs spend much-needed time shoring up support in their constituencies’. One frontbencher characterized it as ‘malaise’ and ‘zombie government’. It also doesn’t help that Rishi Sunak has now missed more Commons PMQs than any other Prime Minister, giving pretty inadequate excuses for his absence from these sessions and key votes. If you haven’t seen it it’s worth catching the excellent interrogation of Sunak by the Liaison Committee’s Chris Bryant.
The government has suffered some humiliating blows during the last fortnight, primarily the court ruling against the Rwanda plan and losing the judicial review it had requested concerning release of Boris Johnson’s unredacted WhatsApps and diaries to the Covid Inquiry. The Cabinet Office now has until tomorrow to comply. Astonishingly, the CO declared itself satisfied with the result, begging the question as to why it took such an arrogant step in the first place. It seems pretty clear that there’s compromising material there and the Inquiry Chair should be seeing this. ‘The judicial review was criticised as “a desperate waste of time and money” by Deborah Doyle, a spokesperson for the Covid-19 Bereaved Families for Justice UK campaign group’. Quite right, too. The weak rationale used by the government (confidential material eg about a child’s schooling arrangements) for withholding the messages has led to an absurd misuse of public money and yet again Cabinet Secretary Simon Case is in the frame here. It won’t happen but we should actually see the CO prosecuted for wasting judicial time. Despite the government’s pledge to ‘work fully’ on complying with the judgement, there are concerns that material could be unaccountably ‘lost’ in transit. Perhaps the shredders and techies will be busy this weekend.
Additional humiliations are the upheavals in the debt-ridden water industry including the collapse of Thames Water; the Privileges Committee supplementary report into contempt of Parliament committed by Dorries, Rees-Mogg and others (to be debated on Monday) and the decision (finally) of the Met Police to reopen their investigations of some Partygate events. Not the Chequers and Number 10 ones (still running scared of the government?) but primarily the drinks gathering for Sir Bernard Jenkin’s wife and the CCHQ bash (the subject of the notorious video). And how pathetic is this? ‘More than 18 months into the Partygate scandal, the latest move means that questionnaires will be sent out to those who were present at either of the events, asking if they had a “reasonable excuse” to attend a gathering under the Covid laws in place at the time’. If this is the extent of this force’s investigatory powers we’re in serious trouble. (Yes, well, we already knew that).
And inflation remains stubbornly high despite Sunak’s assurances that he ‘gets it’ and that he’s ‘100% on it’. Confidence in the Bank of England (some are even calling for its independence to be reconsidered) is at an all time low, at least one commentator suggesting that inflation isn’t caused by ‘cheap money’ but by things the BoE can’t do anything about, ie shortage of goods and labour, Covid, Brexit, people prematurely leaving the workforce and the war in Ukraine. Now that this PM has had 6 months to address his top priorities, how much more time should be allowed before someone or something decides that the current strategy isn’t working? The findings last weekend that supermarkets were indeed profiteering on their petrol sales will now prove a further challenge to outfits like the British Retail Consortium, which has maintained all along that massive food inflation is due to the supply chain, Ukraine etc.
Although it’s hard to prove ‘greedflation’, major multinational brands have kept their profit margins between 14% and 16%, when it could be argued that the current situation demands that they reduce this. Again, we are powerless to do much about any of this when the government won’t address it, which can make us feel like helpless victims of unbridled capitalism. But never mind, as our Prime Minister has told us we just have to ‘hold our nerve’.
It’s no wonder, then, that there are further splits within the Conservative Party, the rump now threatened by the rise of the New Conservatives. Sketch writer John Crace lampoons key participant Danny Kruger (Oxford educated) railing against the Establishment. ‘The levels of denial were terrifying. He genuinely has no idea that he and the Tories are the Establishment. That they have been running the country for the past 13 years. It’s as though he believes the government has been under the control of some unspecified blob. The lengths he will go to absolve himself of any responsibility’.Wikipedia tells us that the New Conservatives are a parliamentary group of predominantly red wall Conservative MPs aiming to shape the Conservative Party’s policies ahead of the next general election. They want to return to the Party’s 2019 manifesto, with the primary goal of reducing immigration to its 2019 level. The main suspects are the extreme right wingers who’ve brought shame on themselves and their Party, eg Lee Anderson, Jonathan Gullis, Nick Fletcher and others – now creating an additional headache for the embattled PM.
Andrew Rawnsley in the Observer is one of several journalists describing the Tories’ descent into ‘fear of impending doom’. ‘The obvious source of their despondency is that they are trailing Labour in the opinion polls by about 20 points. That unpopularity will be confirmed when the Tories take a pummelling in the trio of byelections which will take place on Thursday week. A fourth threatening byelection is in prospect after the damning verdict on Chris Pincher by the cross-party standards committee. There will be a fifth if Nadine Dorries ever gets round to making good on her cry-baby threat to quit parliament because, boohoo, she didn’t get a peerage….. To further deepen their sense of impending doom, many of their traditional friends in the City, business and the media have read the runes and are preparing for a Labour government’. And most of them can see that changing leader is a non-runner.
‘Tory MPs may be addicted to plotting, but the great majority of them can sense that they would look utterly absurd to change prime minister three times in one parliament. Even more importantly, they can’t see any available substitute who would make a better leader’.
Perhaps the most significant events of last week were the publication of the delayed NHS WorkForce Plan and the NHS 75th birthday on Wednesday, both giving rise to zillions of column inches. The Plan seems to have been considered rather threadbare, lacking any coverage of key issues like staff retention, pay disputes and lack of social care planning. The news that NHS England could have 12,500 extra doctors and nurses a year by 2028 under the service’s first long-term workforce plan seems pure fantasy when we know how hard it is now to attract people into these roles given the pay, the challenges they face because of underinvestment and the debt they end up with (typically there was nothing on the removal some years back of the nurse’s bursary scheme either). Typically for this bragging, hyperbolic government, the Plan was presented as ‘the largest single expansion in NHS education and training in its history’, without, of course, mentioning that it was successive Conservative administrations which (like police numbers) cut the number of training places, not to mention thousands of hospital wards. ‘The NHS will receive £2.4bn in extra funding over the next five years to pay for the planned increase in health professionals, which will also include the training of many more dentists, midwives and physiotherapists’.
But medical schools will not start admitting the extra students until September 2025 and the Department of Health and Social Care failed to answer the question about when the trainee nurse admissions would begin. Needless to say, this kind of kicking the can down the road will cause big problems for whoever wins the next election. It comes to something when NHS leaders cite staff shortages as being an even greater concern than funding but ‘official NHS figures show that the number of vacancies in the service in England have almost quadrupled from the 21,351 seen in March 2010 to the 112,498 recorded at the last count. That included 8,549 doctors and 40,096 nurses’. A truly shocking situation. One leader also pointed out that there was no detail about how the money would be phased in: ‘This money is vital to the plan delivering. But there are still so many unanswered questions about it’. Rather than boosting morale as possibly intended, this could have the opposite effect by creating even more uncertainty.
The government may have thought it clever to release this long awaited Plan just before the key event of the NHS’s 75th birthday, but it increasingly looks like an own goal. Said commentator Simon Jenkins: ‘Everyone agrees that Britain’s 75-year-old NHS needs rescue and overhaul. But what does this mean? Surgery, therapy, the oxygen of cash, a slap in the face or just a hip replacement? And how is this to be decided? At that point agreement ends. There is silence’. (The hip comment reminds me of a jokey birthday card, with doctor and patient sitting in a consulting room, the former telling the latter: ‘We’ve decided we’re not going to replace your hip, we’re going to replace the rest of you instead’).
Former Health Secretary Sajid Javid has said the NHS is unsustainable as it is and should be the subject of a royal commission but many disagreed with him, including, surprisingly, former Test and Trace boss and long AWOL Dido Harding. (Quite why she was interviewed about it by Radio 4 when £37bn disappeared without trace (!) under her watch is anyone’s guess). So many of those blithely accepting the ideological and cynical argument that the service isn’t working so it needs privatizing don’t see the false logic being employed here and don’t see the consequences of what an insurance-based scheme would actually be like. The NHS isn’t intrinsically failing – it’s failing because of longstanding underinvestment and zero attention to staff recruitment and retention. That’s not to say there’s no need for reform – many would agree that there’s a need to reform the way the service operates because of outdated administrative and management systems. But this isn’t a rationale for privatisation, which the Labour Party also seems to be considering in part.
Jenkins again: ‘Serious debate about reform is dead in the water because political dogma and point-scoring are the order of the day…Party antagonism will always triumph over consensus or compromise….Politicians regard their role as simply defending or attacking the status quo. There is no leverage behind effecting reform….. We can apparently spend £100m debating what went wrong during Covid, yet all the while the NHS is crumbling in the here and now. It should not require a commission to answer these questions. The health sector is crammed with ineffectual thinktanks and foundations. Yet serious debate is dead in the water’. So we end up with stalemate, a logjam it seems impossible to extricate ourselves from under the current political system. There’s some consensus that political decisions have led to the current crisis and the Tories, despite their too frequently unchallenged spiel, can’t deny that Britain spends lower than average on healthcare as a proportion of GDP, and its per capita spend is well below the EU as a whole. At the same time, demands made upon the NHS are far greater than during its early years, there’s a lack of attention to preventative medicine, the growth of technology has massively raised expectations and rather than trying to blame ‘managers’ or ‘pen pushers’, it’s been shown that the NHS is under-managed and this is when systems can break down. Also, those who’ve not worked in the NHS may not realize how much admin is caused by the regulatory regime – it’s an enormous amount of work and all hands on deck when the Care Quality Commission comes to inspect.
A poll carried out for the Health Foundation found that ‘Despite almost three in four people saying the NHS in its current free form is “crucial”, 51% say they expect to pay for some services within the next decade, while 13% think most services will need to be paid for upfront and 7% anticipate charges for all services’. Of course, this kind of thinking will be exacerbated by NHS strikes. ‘With five days of junior doctors’ strikes followed by two days of consultants’ strikes scheduled for the middle of the month, data shows industrial action has already led to more than 648,000 cancelled appointments, procedures and operations, exacerbating backlogs’. But these findings are also the product of cynical Tory messaging, creating a narrative that the NHS can’t go on as it is, softening it and us up for further privatization. ‘Further’ because although not everyone realizes, there’s been privatization by stealth (increasingly in plain sight) for years now, especially in primary care, with quite a few GP practices run not only by the private sector but also American companies. As usual, we get the usual disingenuous statement from the Conservatives: ‘The NHS is our most treasured national institution and we are fully committed to its founding principle of healthcare for all, free at the point of delivery’.
It’s useful to read the views of five health experts on their ‘recipe’ for the NHS’s future, these including much more emphasis on primary care and preventative medicine, greater use of technology and robotics, the need for a holistic health policy which recognizes the social conditions giving rise to sickness and reduction in damaging salt and sugar consumption via changes to the tax system. Trouble is that this government is only capable of gimmicky short-term sticking plaster solutions and all of these interventions would require a great deal of nuanced thinking and planning across different political portfolios. What’s clear, though, is that something needs to change as in this allegedly developed country reduced life expectancy has been attributed to NHS underinvestment.
As we’ve long known, what this government is primarily interested in is lining its own pockets and those of their friends and donors. Some of this approach can be seen in the latest shocking news (though it’s been going on for years) about the extent of Big Pharma incursions into the NHS. Clearly, some clinicians are guilty of massive conflict of interest. The Observer has reported: ‘Pharmaceutical giants are pouring tens of millions of pounds into struggling NHS services – including paying the salaries of medical staff and funding the redesign of patient treatment – as they seek to boost drug sales in the UK. Drug firms are simultaneously funding groups that lobby for greater investment in their disease areas, and in some cases are paying generous consultancy fees to influential healthcare professionals, including GPs who have worked as clinical leads for NHS England and have received as much as £480,000 each from industry since 2019’. One GP tweeted that he stopped seeing medical reps years ago and was surprised that this was still going on.
‘Payments to UK health professionals and organisations, including donations, sponsorship, consultancy fees and expenses, reached a record £200m in 2022, excluding R&D with companies seeking to promote lucrative drugs for obesity, diabetes and heart conditions among the biggest spenders. The total spending was almost double the £108m paid by the drugs industry in 2015, while payments to healthcare organisations in the same period nearly tripled to £156.5m’. We have to ask ourselves why this highly dubious collusive system has been allowed to develop to this extent. These drug giants should not be influencing and shaping patient care in this way. Needless to say, NHS England said collaborations with industry helped patients ‘benefit from faster access to innovative treatments’, tried to normalise the situation and maintained that strict safeguards were in place for managing conflict of interest. They must think we’re stupid.
When the NHS celebrated its 75th birthday on Wednesday, the BBC told us that this was marked by a service at Westminster Abbey (the same service which ‘prevented’ Rishi Sunak attending PMQs). What they did not report was that a vociferous protest organised by Unite and Keep our NHS Public took place outside London’s swish Carlton Club on Wednesday evening, where senior Tories including Steve Barclay, party Chairman Greg Hands, Theresa May and others were attending a £150 a head dinner. The sickening hypocrisy of Tories ‘celebrating’ the very NHS they’re actually dismantling is hard to stomach. It was inspiring taking part in Protest the Party and good to note the presence of some media (not the BBC) and get plenty of support from passing motorists. When we started there were just a couple of regular police but these were later joined by white capped officers, apparently members of the Public Order unit. It’s sobering to think that such units would not have existed or at least in this form prior to the Tories’ draconian Public Order Act.
We’re unfortunately having to get used to nothing working properly in this country but since we increasingly rely on the internet we certainly need our broadband to operate effectively. But again we see an example of private sector exploitation, with the news that more than half of UK customers are experiencing connection problems at the same time as being hit by rising costs. ‘Many of the UK’s mobile and telecoms companies have been accused of ‘greedflation’ for pushing through mid-contract price increases of up to 17.3%. A report by consumer champion Which? found that 53% of broadband customers experienced problems with their connection – from slow speeds, outages and connection dropouts – in the year to January 2023’. Apparently Sky, Virgin Media and EE were found to be the worst offenders – I’m surprised TalkTalk has not been cited as a number of us have had problems with them despite costs going up. Needless to say the hopeless regulator, Ofcom, despite launching an ‘investigation’, hasn’t managed to achieve anything.
Finally, it was interesting to learn that people no longer have to suffer the discomforts associated with the Glastonbury festival, though some would argue that this very discomfort is central to the experience. One entrepreneur created a facility consisting of tent ‘hotel’, with swimming pool, showers and flushing loos, the downside being a price tag of £25,000 a night. We’ll have to see what happens over years to come to see whether this and other such developments change the whole nature of this unique event!
Politics and mental health - the missing link? 