More stories

  • in

    What hope does Labour have of fixing the National Health Service?

    Your support helps us to tell the storyFind out moreCloseAs your White House correspondent, I ask the tough questions and seek the answers that matter.Your support enables me to be in the room, pressing for transparency and accountability. Without your contributions, we wouldn’t have the resources to challenge those in power.Your donation makes it possible for us to keep doing this important work, keeping you informed every step of the way to the November electionAndrew FeinbergWhite House CorrespondentA special “rapid investigation” of the National Health Service was commissioned by the health secretary, Wes Streeting, shortly after he came to office in July, and it has now reported. Headed by Ara Darzi, Baron Darzi of Denham, a highly distinguished surgeon and former Labour junior health minister, it highlights the problems faced by the NHS, and their causes. The report will help form the basis of policy for the next few years as the government sets about fixing what Streeting calls a “broken” service. In the words of Keir Starmer, the report is “raw and honest”. It is also highly embarrassing for the Conservatives…What does Lord Darzi say?He is especially concerned about how failures across the system, such as in general practice and social care, have led to a “workload dump” onto the hospitals, and about the way in which the weaknesses in the NHS have led, in some cases, to poorer clinical outcomes. For example, he finds that “once adjusted for age, the cardiovascular disease mortality rate for people aged under 75 dropped significantly between 2001 and 2010. But improvements have stalled since then and the mortality rate started rising again during the Covid-19 pandemic.”Who is Lord Darzi?The Rt Hon Professor the Lord Darzi of Denham OM KBE FRS FMedSci HonFREng is a man of immense learning, skill and experience, and is widely respected. He has produced numerous other reports, including a previous review of the NHS for the then prime minister, Gordon Brown, in 2008. Born in Baghdad of Armenian heritage, Darzi trained as a surgeon and has become a senior medical academic. He served as a minister under Brown and has been the recipient of multiple honours for his dedicated work. He is a longtime Labour supporter, but resigned the whip in 2019 over the antisemitism scandal.What’s gone wrong?There are three major factors: the Covid-19 pandemic; the major disruption during and after the 2012 NHS reorganisation under the then health secretary, Andrew Lansley; and, especially, the “decade of austerity from 2010”. Darzi concludes – as have many other experts, for example during the Covid inquiry – that the NHS was creaking even before the coronavirus outbreak. He says it was underfunded by a cumulative £40bn or so during the 2010s, with infrastructure budgets being raised to pay for day-to-day services – which is how the frontline NHS services were “ring-fenced” from cuts during the Conservative-Liberal Democrat coalition, but obviously, the cuts to investment were going to have deleterious long-term consequences. In addition, the Johnson administration’s hospital-building programme, with its promise of 40 new hospitals, wasn’t fully completed. So, to put it bluntly, it’s the Tories’ fault.What about Brexit?Not mentioned, to the surprise of some, given its baleful impact on economic growth, tax receipts, and, most pertinently, the supply of skilled and semi-skilled workers from the rest of Europe, NHS vacancies now being at an all-time high.How will it be put right?With difficulty, given the state of the economy and the tremendous demands on the NHS, exacerbated by demographic trends. Darzi warns that lifestyle trends and cuts in public health budgets are also causing problems – “There has been a surge in multiple long-term conditions, and, particularly among children and young people, in mental health needs. Fewer children are getting the immunisations they need to protect their health and fewer adults are participating in some of the key screening programmes, such as for breast cancer.”For his part, Streeting stresses the need for reform as well as funding, and has identified three “strategic shifts” for the NHS: moving care from “hospital to community”; abandoning paper to go from “analogue to digital”; and a change in the focus from “treatment to prevention”.Will it work?The sheer scale of the task is daunting, but in Streeting, the health department has a highly intelligent, articulate and effective operator with a “failure is not an option” attitude. He is focused on both reform and delivery, but he will need the backing of the prime minister and the chancellor if the Labour government is to avoid falling into the same traps as its predecessor did. The danger is that the promises made to fix the NHS don’t yield sufficient palpable progress in care, or in patient satisfaction, to convince the public that the NHS is the best way to secure quality healthcare. The fortunes of the Labour Party, not to mention those of Streeting, are tightly attached to the recovery of the NHS. It was, in large part, what Starmer and his colleagues were elected to do, and what the tax hikes should really be all about. More

  • in

    Why Clacton is the perfect place for Farage to launch his bid to eclipse the Tories

    Sign up for the View from Westminster email for expert analysis straight to your inboxGet our free View from Westminster emailNigel Farage today announced that he is standing in the Essex seaside town of Clacton in an eighth attempt to win a seat in the House of Commons (as was first revealed in The Independent).After seven previous failed attempts in Eastleigh, Bexhill and Battle, Salisbury, Thanet South (twice), Bromley and Chislehurst, and Buckingham, Mr Farage and his supporters believe that this time he stands a real chance of winning the seat in the Commons that has always eluded him.But why Clacton? What is it about the quiet seat filled with pensioners, with its pier and arcades, that makes it the perfect place for the former Brexit Party and Ukip leader to stand?After all, this was the seat that delivered Tory MP Giles Watling, a former actor who was in the sitcom Bread, a massive 24,702 majority in 2019.Nigel Farage confirms he will stand as Reform UK candidate in the general election: ‘I can’t let down millions of people’ More

  • in

    Could a pact between Scottish Labour and Tories oust SNP?

    For free real time breaking news alerts sent straight to your inbox sign up to our breaking news emails Sign up to our free breaking news emails The idea of Labour and Tory strategists working together at the next general election – plotting over tactics and where to place their resources – sounds like an […] More

  • in

    A constitutional clash looms on gender reforms

    For free real time breaking news alerts sent straight to your inbox sign up to our breaking news emails Sign up to our free breaking news emails To set aside sensitive moral questions and competing human rights is the best way to analyse the purely political aspects of the Gender Recognition Reform (Scotland) Bill. It […] More

  • in

    Is Boris Johnson doomed after heavy losses in the local elections?

    Senior Conservative MP David Davis has warned that Boris Johnson’s premiership faces “death by a thousand cuts”. Heavy losses in the local elections have inflicted yet another blow on the wounded prime minister. Are we watching his slow and painful demise?Johnson appears to have survived the bruising results – close to 500 Tory seats lost – without a loud clamour for his resignation from Tory backbenchers. We have not seen a significant number of new MPs turn against him in public.But there are signs of another precarious period ahead for the PM. Tory MPs in the “blue wall” heartlands in the south of England are spooked by results that were worse than expected. They now have clear evidence of how much voters loathe the idea of law-breaking parties in Downing Street.As one senior critic says, mistrust in the prime minister over Partygate now seems “baked in” among traditional Tory voters. Some of the griping about results has come from his usual opponents. But some who have not previously spoken out against Johnson now appear to be wrestling with the leadership question.David Simmonds, the Tory MP for Ruislip, Northwood and Pinner, has wondered out loud whether “a change of leader” could be one way of restoring confidence in the party. Marcus Fysh, MP for Yeovil, said colleagues would have to discuss whether Johnson was “the right person” to lead the new approach that is needed on the economy.No 10 is pointing to the fact that the Tories fared better in the Midlands and the north of England, where Labour made precious few gains in red-wall territory, and where Brexit appears to have created a lasting problem for Keir Starmer’s party.Johnson can also take heart from Starmer’s “Beergate” problem. It may only offer a brief breathing space for the prime minister, however, if the Labour leader manages to avoid a fine over the takeaway meal enjoyed with colleagues during a campaign event in Durham last April.Regardless of Starmer’s woes, there are some huge and dangerous hurdles ahead for the PM. With the elections now over, Scotland Yard could announce fresh fines over parties. And the publication of senior civil servant Sue Gray’s report – said to be damning – awaits the conclusion of the police inquiry.There are potentially difficult by-elections in Wakefield, Tiverton and Honiton still to come in the next six weeks or so, with Labour confident of overturning the Tories’ 3,000-plus majority in the West Yorkshire seat.Would a reshuffle help? Johnson is thought to be considering a shake-up of his top team before the summer recess starts in late July. The prospect may keep ministers on their toes for a while. But with an already compliant cabinet, the real threat will continue to come from the back benches.It’s difficult to see how Johnson wins new allies in the parliamentary party in the months ahead. Even if he survives until the autumn without the threshold of 54 no-confidence letters being reached, he has the run-up to conference season to contend with.Many who are sitting on the fence could use the period to ask themselves whether he is the right person to lead them into the next general election.Once a few dozen existing rebels decide to send in their letters to the 1922 Committee chair, it takes a simple majority – around 180 MPs – to force a change of leader. If the contest took place tomorrow, the smart money would be on Johnson’s survival.But if a vote were to take place after the messy period of new fines, fresh apologies, and the full-fat Sue Gray report, more Tory MPs may be more inclined to take the long view and consider whether a new leader might have a better chance of restoring the party’s fortunes. More

  • in

    Carrie Johnson and the pitfalls of being the PM’s spouse

    Like a few other high-profile roles in public life – Prince of Wales, Olympic gold medal winner, stand-up comedian – there isn’t much of a job description for the role of prime-ministerial spouse.Hence, misunderstandings and controversies have enveloped Carrie Johnson since she took up with the prime minister a couple of years ago. It’s fair to say that few other partners have faced the same sort of intense scrutiny and criticism, with its strains of misogyny – but it is not unprecedented.Interestingly, the last spouse to be bullied and abused to anything like the same extent as Ms Johnson was Cherie Blair.Cherie Booth QC, to give her her professional title, was another career woman, whose work, broadly speaking, touched on political matters. She was, like her husband, a lawyer. They met as pupils under Tony Blair’s future lord chancellor, Derry Irvine, and her career led her to undertake human rights work. Some of her enemies in the press cooked up a theory that the New Labour pledge to introduce the Human Rights Act was a thinly disguised scam to generate more fat fees for Booth’s chambers. The truth, of course, was that the act only brought over to the British courts the work that was being done by British lawyers in the European Court of Human Rights, but they didn’t let that spoil the fun.Ms Blair was also supposedly less deferential to royalty than was her husband – hardly a crime – and possibly a bit more of a socialist. She was supposedly manipulating him towards left-wing extremism, or what is nowadays called “wokery”. It was almost as though she was using hypnotism or sorcery. This was enough for her to be labelled “the wicked witch”. For some reason, perhaps her well-known working-class roots (her father was the actor Tony Booth), her very existence seemed to enrage the Daily Mail in particular. She was also supposed to be too keen on freebies, which is a bit rich coming from a load of journalists, and she invested in property – partly for the benefit of her children, and again, hardly the sort of thing to which Tories are averse. Cherie Blair is an interesting precedent because, like Carrie Johnson, and very unusually among spouses, she was “political”. Indeed, Cherie would probably have gone on to become at least a Labour MP, had Tony not made it first and had she not been such a successful lawyer. It’s the very idea of a woman having independent political opinions and ideas, and discussing them with her husband – an inevitable consequence of their sharing such a lifestyle – that seems to horrify some. By contrast, men with political opinions of their own have been treated very differently. Philip May, who met the young Theresa Brasier through a shared interest in Conservative politics, was almost deferentially referred to as her “most trusted adviser”, and nobody seems to have minded her discussing, say, the merits of the Irish backstop with him over an evening drink. Indeed, it was thought useful for her to get another point of view – that of a typical Conservative activist, and someone with no axe to grind or favours to seek. No one nicknamed him “Prince Philip” or seriously accused him of interference or undue influence. It would also be surprising if the pair of them didn’t occasionally mention, let’s say, her wayward foreign secretary, Boris Johnson, in conversation. After Philip had put the bins out, obviously.The same goes for Denis and Margaret Thatcher, though in that case the pair were both such instinctive Tory reactionaries that they agreed on most things anyway. To the extent that Mr Thatcher did have influence, it was a matter of mild curiosity and gentle satire rather than scandal. Denis was sympathetic to apartheid-era South Africa, where he had business interests and friends, and he perhaps influenced his wife in that direction when it came to sanctions in the 1980s. He thought the BBC, the trade unions and the teaching profession were all infested with communists, and so did she. He backed her in her tussles with powerful figures such as Nigel Lawson and Michael Heseltine. He was partisan. At the end, though, when she was facing a final leadership crisis, he was instrumental in persuading her to resign. Imagine if it got out that Carrie had told Boris the game was up and he ought to quit!Most prime ministers meet their wives or husbands long before they get to No 10. Many know exactly what they are getting involved in, although Mary Wilson thought she was destined for a quiet life as the wife of an Oxford don when she married Harold. In any case, most pairs are well used to each other by the time they get to Downing Street; but Carrie and Boris have had much less time to develop that same sympathy. Carrie has contacts, causes and interests of her own, and unfortunately for her they are viewed with suspicion by some in her party and in government.Far better, in that sense, for Carrie to stick to charity work or a non-political business activity, as Sarah Brown and Samantha Cameron did – but why should she? She’s not a lobbyist. She’s not on staff. Nor is any husband or wife of a prime minister, but they are central to the life of their spouse, and they will make a difference to it.The only prime minister not to have had to worry about their other half’s opinions, or what the press thought about his or her behaviour, was Ted Heath, the lifelong batchelor. Once when Heath was prime minister, or so the story goes, his arch-rival Wilson was walking past No 10 of an evening and looked up at the light on in the flat. Wilson reflected on how lonely poor old Ted must be up there, playing his piano, with no one to share the burdens of a long, wearisome day. By the same token, Carrie doesn’t seem to be given much credit for the sacrifices she makes and the support she gives to her husband. You may recall the coverage of the infamous row the Johnsons had in her flat in June 2019, before Boris became PM, when the police had to be called. Apparently, he told her to “get off my f**king laptop”, and she told him: “You just don’t care for anything because you’re spoilt. You have no care for money or anything.” Living with Mr Johnson is a type of high-pressure public service, if you think about it. It can’t be easy. More

  • in

    Are we headed for a Brexit trade war after the DUP mess?

    Understanding the politics of Northern Ireland is not easy. The Democratic Unionist Party’s weird manoeuvres and internal machinations can make Tory party plots look as tame as a Sunday-school picnic.The DUP staged a strange piece of political theatre this week by announcing that the party’s agriculture minister, Edwin Poots, would halt checks on goods moving from Great Britain to Northern Ireland. Simultaneously, DUP first minister Paul Givan quit in protest at the UK government’s failure to bring the legal checks agreed with the EU to an end.What is the DUP playing at? How badly has it messed up the Northern Ireland protocol arrangements forged in the Brexit deal? Could the latest developments even spark a trade war between the UK and the EU?It’s hard to say exactly how London and Brussels will respond in the days ahead, given that we still don’t know how the DUP’s radical move will play out.But we do know that the party’s actions have raised the stakes, as UK foreign secretary Liz Truss and her EU Commission counterpart Maros Sefcovic wrestle with a potential compromise deal over the protocol, which would ease the rules on checks.Civil servants have continued to carry out agri-foods checks this weekend amid legal uncertainty, while Mr Poots’s order for border officials to stop the checks is being challenged in the courts.It remains unclear whether the checks will be halted next week – or whether the order will be stuck in legal limbo for many weeks to come. Trade bodies are advising companies to carry on as normal, for now.Sinn Fein, not unfairly, have described the DUP’s moves as “stunts” purely aimed at improving the party’s chances at the forthcoming May elections. But the radical electioneering has intense and potentially catastrophic real-world consequences.The Republic of Ireland’s foreign affairs minister, Simon Coveney, has said that the ending of the checks required by the protocol would be a “breach of international law”, and would violate the terms of the Brexit deal.Top EU officials are keeping calm for now, but are deeply unimpressed that Ms Truss and other ministers are refusing to condemn the DUP or otherwise get involved, with the UK government taking the line that the mess is a “matter for the executive” in Belfast.Mr Sefcovic has said that the UK government has a “responsibility” for the checks agreed in the protocol, and can’t blame the failure to meet these obligations on the naughty children running the show in Northern Ireland.But Ms Truss and Team UK will try to argue that the facts on the ground show exactly why the EU needs to give way and ease up on the checks.It’s unlikely that the EU would look at the end of agri-food checks as amounting to the triggering of Article 16 – the means by which Downing Street has threatened to suspend parts of the protocol – by default.But the ending of checks would put considerable pressure on the UK to agree to a deal with the EU quickly. And in the absence of an agreed London-Brussels compromise, the DUP’s incendiary move could light the fuse on the dispute, hastening a breakdown in talks and pushing Boris Johnson’s government into triggering Article 16.This takes us into trade-war territory, in which the EU takes a series of retaliatory measures for the suspension of protocol arrangements.Brussels chiefs have previously been said to have a “nuclear” option of terminating the Brexit Trade and Cooperation Agreement (TCA), forcing the UK to trade with the EU on World Trade Organisation terms – essentially a “no-deal” Brexit scenario.But Brussels experts think it’s more likely they would consider retaliating through a lesser-known part of the TCA: Article 506. The moves could range from stopping fishing in EU waters to tariffs on UK fish going into the EU, and then move on to tariffs on other goods.Alternatively, the two sides could see sense and do a deal that would ease much of the red tape on agri-food products through an agreed list of certain goods that would still require stricter checks.Sam Lowe, a trade expert at the Centre for European Reform, said that there is another scenario in which the whole rotten mess rumbles on indefinitely – one in which the UK “continues to engage in low-level non-compliance” while “negotiations begin, stall, and begin again”.What about Mr Johnson? What does he want to do now? It’s hard to say if the embattled prime minister, fighting to stave off a Tory rebellion over Partygate, has given the problem much thought in recent days.Sir Jeffrey Donaldson, the DUP leader (yes, there is actually someone in charge), has claimed Mr Johnson told him privately that there was only a “20 to 30 per cent chance” of negotiating a new protocol deal with the EU in the next few weeks.Make of that what you will. Mr Johnson makes a lot of promises that turn out to mean very little. So we are left hoping there are still enough grown-ups around to sort the whole thing out. For a while, at least. More