It’s as if devolution never happened and we were back in the ‘good old days’ when there genuinely was only one National Health Service. Not one single item – not one – in all of the news coverage I saw or heard yesterday on the reaction to Tory MEP Daniel Hannan’s criticism of the NHS on US TV correctly referred to the organisation in question as the ‘English NHS’ (or, at least, the ‘NHS in England’), which is what they were actually talking about.

At least, David Cameron, Andrew Lansley (the Conservative Shadow Health Secretary (for England)) and Andy Burnham (the actual Health Secretary in England) can only have been referring to the NHS in England in their comments following Hannan’s contribution, as that’s the only NHS they either will have (if the Tories win the general election) or presently have responsibility for. But you couldn’t tell that from what they said.

David Cameron: “Just look at all the support which the NHS has received on Twitter over the last couple of days. It is a reminder – if one were needed – of how proud we in Britain are of the NHS. . . . That’s why we as a Party are so committed not just to the principles behind the NHS, but to doing all we can to improve the way it works in practice.”

Andrew Lansley: “Andrew pointed out that many of the NHS reforms promised by Labour, including practice-based commissioning, Foundation Trusts, patient choice and independent sector investment, have stalled under Gordon Brown. And he stressed, ‘All those who care about the NHS know that these are the kind of reforms that will enable us to achieve the combination of equity, efficiency and excellence which should be the hallmark of the NHS’.”

Andy Burnham: “I would almost feel . . . it is unpatriotic because he is talking in foreign media and not representing, in my view, the views of the vast majority of British people and actually, I think giving an unfair impression of the National Health Service himself, a British representative on foreign media”.

Let me note in passing what a complete and utter joke those last remarks of Andy Burnham’s are. Has Burnham suddenly transmuted into an English patriot, as it’s only the English NHS that he and the government of which he is a part has anything to do with? I don’t think so. Hannan’s not a ‘British representative’, i.e. a representative of the British government or parliament. But if he was, then doubtless Burnham feels his job would be to do what Burnham himself does: not so much misrepresenting the ‘British NHS’ abroad but misrepresenting the English NHS to the English public as the British NHS!

And as for that Twitter stream, don’t waste your time checking it out. It’s full of junk now, and I had to click down a couple of hundred entries before I got any reference to England that wasn’t either a porn link or a job ad, or indeed practically any reference to the political debate.

But actually, Twitter is quite a good metaphor for the debate: full of sentimental waffle but very little substance. It’s easy to prattle on about the NHS as a great British institution of which the people of Britain are rightly proud and keen to defend from unfair criticism from abroad. But the reality is that as a national-British institution, the NHS already no longer exists. It’s New Labour, not the Tories, that did away with it through devolution. And its the New Labour British government that did far more than the Tories ever did to privatise the NHS in England, with things like public-private partnerships to build and run new hospitals, the introduction of internal health-care markets, Foundation Trusts, and competition between GP surgeries and the new supposedly ‘consumer-friendly’ polyclinics, etc. Admittedly, while all of that was going on, the NHS’s of the other UK nations were – for good or ill – remaining more faithful to Labour’s traditional socialist principles, with fully public sector-based organisations amply subsidised by the English taxpayer.

Does it matter, though, whether you call it the ‘English NHS’ or the ‘British NHS’? Isn’t this just semantics? Well, I think the English believe in the principle of calling a spade a spade: if you are talking about something that relates to England only, you should at least have the honesty and courtesy to let people know that’s what you’re doing. Of course, on one level, it’s legitimate to refer to the ‘British NHS’ even when discussing policy for its English variant; i.e. when talking about the founding principles that are said to inform the NHS throughout Britain to this day: fully public-funded health care free at the point of delivery. But the point is those principles are not applied evenly, and equally, across the whole of the UK. There is no longer a single UK model for how public-sector health care should be funded and organised. And the model presently applied in England has moved further away from the NHS’s original principles than that in any of the other UK nations.

This does matter for the political debate going forward into the general election. Daniel Hannan has helpfully exposed a vulnerability of the Tories in England, because it’s clear that the Tories do support further reform of the English NHS along the lines set out by New Labour. Those Tory reforms mentioned above in the context of Andrew Lansley’s reaction to Hannan’s remarks (“practice-based commissioning, Foundation Trusts, patient choice and independent sector investment”) are precisely New Labour policies that the Tories claim the government has failed to deliver. If the Tories pursue them, they will indeed drive further marketisation of the NHS – but only in England. By appealing to the founding ‘British NHS’ principles, and by promising to increase NHS funding in real terms, the Tories are trying to make out that they back the traditional, fully nationalised model for health-care delivery in the UK. They may well support a generously public-funded health-care system; but in England, at least, the delivery model will involve a much greater role for private companies and market competition, which will inevitably lead to inequalities and increased variations in the availability of high-quality NHS treatment for different conditions in different parts of ‘the country’ – England, that is. But the more they talk up their allegiance to the traditions of the ‘British NHS’, the more they hope we won’t read the English small print.

Plus the Tories are also addressing the non-English electoral ‘market’, of course, and are hoping that the uninformed (misinformed) public there – again, through the emotive appeal to the NHS as a national-British institution – will be deluded into thinking that a Conservative government will have direct influence on health-care policy in their countries (which it won’t) and will stand guarantor for traditional NHS values there – which it may do, through acquiescence with the policy variations and funding inequalities that have flowed from asymmetric devolution and the Barnett Formula. But actually, a real-terms increase in public expenditure on health in England will not necessarily deliver corresponding and proportionately greater increases in NHS funding in the other countries of the UK. This is because public expenditure overall under the Tories is set to decrease, so that increases in the health budget will have to be paid for by cuts elsewhere. And a decrease in overall spending in England will result in even greater proportionate decreases in Scotland, Wales and Northern Ireland. In other words, increased investment in the NHS in England may actually result in the need to cut the NHS budget in the other nations. While some of us in England might derive malicious satisfaction from what would in effect be a levelling out of healthcare apartheid (and, after all, the Tories have promised, dishonestly, to improve equality of NHS care throughout the UK), this is a wilful deception of voters in Scotland, Wales and Northern Ireland: the Tories appear to be promising to increase NHS funding throughout the UK; but actually, they’re talking about England only; and increases in the English health-care budget may indirectly lead to decreases in the health-care budget in the other parts of the UK.

But Labour can’t talk, either. This system of unequal funding and differing delivery models throughout the UK is the one that they set up; and to claim that they support a uniform UK-wide NHS organised along traditional lines is a pure, downright lie. Well, they might emotionally support it, with misty-eyed reverence towards Nye Bevan and the post-war settlement; but in practice, the New Labour government has already broken up that British NHS beyond repair. The truth of the matter is New Labour has run out of policy ideas for the NHS in England but has supported a traditional-type NHS in the other UK countries. So all it can do is appeal to ‘patriotic’ and nostalgic support for a great British institution that is no more (in England, at least) in the hope that it can deceive enough of the English people for enough of the time to secure another election ‘victory’ that will enable it to continue to cross-subsidise a traditional NHS in Scotland, Wales and Northern Ireland through further privatisation of the system in England – as they have done since 1997.

Well, the English people won’t fall for that one again. But they might fall for the similar trap the Tories are laying. The English people need to have an informed debate on the type of health-care system they want in England; because that’s what the whole argument is really all about. Health care in Scotland, Wales and Northern Ireland is dealt with separately by the devolved administrations. So it’s only the English system that the Westminster politicians can do anything about. By claiming, as David Cameron did yesterday, that the Conservatives are the “party of the NHS”, the Tories are trying to reassure the English people that the NHS is safe in their hands. But that’s not the point. There will still be an NHS; but what sort of NHS will it be in England, as opposed to the doubtless very different NHS’s that are developing along divergent lines in the rest of the UK? The Tories need to be honest and up front about the small print of their plans for England, and not obfuscate the whole discussion by misleading references to a monolithic British NHS that is no more. But so do the politicians of all parties.

After all, Mr Cameron, Brown and Co., you can’t fool all of the English people all of the time, even if you think you can.

In what is, on one level, an astonishingly insulting and complacent article in the Daily Record yesterday, commemorating the tenth anniversary of Scottish devolution, our hapless unelected First Minister unwittingly demonstrates the case for an English parliament. He achieves this feat not only by extolling, as successes of the Scottish parliament, the very things that most embitter the English about their democratic deficit and fiscal inequality compared with the Scots (“free personal care for the elderly, tuition fees, free travel for the elderly and prescription charges”) but by advancing arguments in favour of the Scottish parliament that undermine the very integrity of the Union and can logically be applied to England in just the same way as to Scotland.

For a start, though, the above list of benefits that devolution has secured for Scotland really is rubbing English noses in it – does he not realise that these are the very stuff of English grievances about the Barnett Formula and the lack of an English government accountable to the English people? If he does realise this, then this can only be described as indulging in Anglophobic schadenfreude. Brown has the gall to imply that the absence of such benefits in England reflects a different political culture and national priorities: he calls these policies “Scottish solutions to Scottish issues”, as if they weren’t issues in England and the different policies that apply to England were somehow the expression of England’s democratic choices – whereas we know that top-up fees for English students in particular were passed into law only with the support of Scottish MPs whose constituents are not affected by them.

This law, and the equally unjust fact that elderly persons in England have to meet the cost of their personal care, which is provided free of charge in Scotland (only yesterday the government was proposing a new system where English people only will have to pay into an insurance scheme – effectively, a top-up tax – or else pay a lump sum on retirement to cover the costs of their care in old age), are perfect examples of the kind of “unpopular decisions [that] were made on health, education and policing”, which Brown brings forward as justification for a Scottish parliament.

Well, just because a government’s policies are unpopular, that doesn’t make them illegitimate if the government is properly democratic and accountable. But Brown implies that the policies for Scotland of successive Westminster governments were insufficiently democratic and responsive to the wishes of the Scottish people, and that they were not only bad policies but bad government: “people now often forget . . . how poorly Scotland had been dealt with in the past. People rightly felt frustrated in recent decades as unpopular decisions were made on health, education and policing. Scotland could be governed better. People deserved better”. Well, if this is the case for Scotland, then it is equally valid for England: New Labour’s policies for England only on health, education and policing are not only unpopular with the people they affect but are an instance of deficiently democratic, unaccountable government, with decisions being made for England by Westminster politicians that are not answerable to the English people.

In fact, the situation now is even more unjust than that which applied to the Scots before devolution. At least then, the legislative activity of non-Scottish MPs affecting Scotland was democratically legitimate, as Britain was a fully unitary state at that time; so there was in principle no distinction between Scottish and non-Scottish MPs, as there was just one national government accountable to all the people in the Kingdom. Ironically, though, the fact that Brown singles out these policy areas is indicative of the fact that, in his thinking, Scotland was not an integral part of a unitary kingdom even before devolution.

Ever since the Acts of Union in 1707, Scotland has maintained distinct policies and systems in education and justice; or rather, the Union state has seen fit to allow Scotland to hold on to its different approaches and traditions in these areas. And this in essence is why Brown views the pre-devolution settlement as unfair to Scotland: the differences between Scotland and England in these regards, and with respect to the Kirk (an aspect of Scottish culture that is highly familiar to Brown), are seen as constitutive of a Scottish national identity that is distinct from that of ‘mainstream Britain’ (aka England). Consequently, the Scottish parliament, when it started its work in 1999, was truly Scotland’s ‘own’ parliament precisely because it handed back to the Scots the responsibility for legislating about those aspects of Scottish life that had always remained distinctive and defining of Scottish identity. So it wasn’t so much that devolution opened up a breach in the unitary British state but rather it acknowledged the pre-existing fact of the difference between Scotland and Britain. As Brown says: “For the first time in 300 years, Scotland once again had its own parliament”.

Well, I’m sorry, no: for 300 years (i.e. ever since the Acts of Union), Scotland did have its own parliament – the Union Parliament. If Scotland and England are parts of a genuine Union – two nations merging into one state – then the parliament for that state is the only legitimate parliament for each of those nations. You can’t have it both ways: either Scotland, before devolution, was part of an integral Union, so that devolution brought about something fundamentally new (a distinct Scottish-national polity); or it was never truly integrated into the United Kingdom state, so that Holyrood was in fact the restoration of something that had been lost for 300 years: a properly Scottish parliament. This is clearly how Brown sees it. But if this is the case, it undermines the legitimacy of the Westminster parliament to act as a parliament for England and, indeed, it undermines the foundations of the Union itself. If the Union Parliament’s jurisdiction in properly Scottish domestic matters has never been legitimate – if it has never been ‘Scotland’s own parliament’ – then how can we accept its legitimacy in English domestic policy and legislation? But, more fundamentally, the assertion of a distinct Scottish polity that is said to have continued in a suppressed form throughout the duration of the Union implies that the Union has never been authentic or complete: not the two nations merging to form one but remaining two separate entities merely governed through a common system that did not really belong to either of them – a common-law (indeed, Commons-law) partnership and marriage of convenience, rather than a true marriage of equals on the basis of which there is no longer any distinction between the spouses, who hold everything in common after they are married.

Either that, or the model is that the Westminster parliament – despite being avowedly the parliament for a unitary state – remained fundamentally the English parliament it had historically been, to which Scotland was effectively subordinated through the Union: a situation that the present Scottish parliament remedied. This indeed seems to be the model that Brown adopts with all of his talk about “how poorly Scotland had been dealt with in the past”: as if Scotland were something that the Westminster parliament merely ‘dealt with’ as an object of policy, rather than being a nation that governed its own affairs through the parliament of a Union of which it was an integral part. This model undermines the assumptions of the Union just as much as the idea of Scotland and England remaining separate entities while governed by a common system: in this instance, the Union is merely the political instrument of an English nation that ruled Scotland essentially in its own interests; as opposed to a common structure of government that belonged to neither of the distinct nations.

Well, if the Westminster parliament has always in essence remained the English parliament, let it become an authentic English parliament once more, just as Holyrood, in Brown’s view, is an authentic Scottish parliament: English-elected MPs only making the laws that apply to England; rather than England being ruled, as now, in the interests of the ‘Union’ (i.e. of the devolved nations) by a parliament that is not accountable to the English people. This is a direct reversal of the historical situation that Brown adduces as the justification for creating the present Scottish parliament: a Union parliament (effectively, the proxy of England) ruling Scotland undemocratically in a way that placed the needs of the ‘Union’ above the wishes of the people of Scotland.

But, in such a restored English parliament, there would be no place for unelected (non-English-elected) prime ministers such as Gordon Brown: there would be no opportunity for gravy train-riding Scottish politicians to have their Westminster cake and eat devolved government or, as I would put it, have their own Scottish cake and eat England’s, too. The way Brown puts it, in his article, is: “devolution gives Scotland the best of both worlds”. Well, yes. That statement comes after Brown has reeled off a list of ways in which the fact of being part of a ‘Union’ works to the advantage of Scotland (and very often to the corresponding disadvantage of England), such as: the bail-out of “Scotland’s two main banks” (I thought they were financial institutions vital for the British economy), which “saved thousands of Scottish jobs and protected Scots’ hard-earned savings” (what about the HBOS jobs in Halifax? Well, you see, as the Scots are so hard-working and thrifty, they deserved it more than us spendthrift English); and preferential treatment of Scottish shipyards in defence contracts building two “state-of-the-art aircraft carriers” whose actual benefit for the Armed Forces, in terms of providing capabilities that are needed (as opposed to offering subsidies to Scottish industry), is highly questionable.

And that’s to say nothing of “the [Scottish] parliament’s £35billion annual budget” that enables Scottish people – good luck to them – to enjoy 20% higher levels of per-capita public expenditure than the English: those free university and personal-care places being subsidised by the lack of them in England. No wonder that Brown affirms, towards the end of this homily to Scottish self-interest, that “I’m proud that this Government [i.e. the UK government] has never stopped focusing on delivering for the Scottish people”.

Well, perhaps it’s time we had an English government that would focus a bit more on delivering for the English people. And we know who wouldn’t be in charge of it.

I was struck last night by how the panellists of BBC1’s Any Questions displayed a rare unity in condemning the ‘nationalism’ to which they imputed the recent assaults on Romanian migrants in Northern Ireland. ‘There can be no place for nationalism in modern Britain’, they intoned to the audience’s acclaim.

Apart from the fact that statements such as this articulate a quasi-nationalistic, or inverted-nationalist, pride in Britain (‘what makes us “great as a nation” is our tolerance and integration of multiple nationalities’), this involved an unchallenged equation of hostility towards immigration / racism with ‘nationalism’. This was especially inappropriate in the Northern Ireland context where ‘nationalism’ is associated with Irish republicanism, and hence with Irish nationalism and not – what, actually? British nationalism à la BNP; the British ‘nationalism’ of Northern Irish loyalists (no one bothered to try and unpick whether the people behind the violence had been from the Catholic or Protestant community, or both); or even ‘English’ nationalism?

Certainly, it’s a stock response on the part of the political and media establishment to associate ‘English nationalism’ per se with xenophobia, opposition to immigration and racism. But this sort of knee-jerk reaction itself involves an unself-critical, phobic negativity towards (the concept of) the English – and certainly, the idea of the ‘white English’ – that crosses over into inverted racism, and which ‘colours’ (or, shall we say, emotionally infuses) people’s response to the concept of ‘English nationalism’. In other words, ‘English nationalism’, for the liberal political and media classes, evokes frightening images of racial politics and violence because, in part, the very concept of ‘the English nation’ is laden with associations of ‘white Anglo-Saxon’ ethnic aggressiveness and brutality. English nationalism is therefore discredited in the eyes of the liberal establishment because it is unable to dissociate it from its images of the historic assertion of English (racial) ’superiority’ (for instance, typically, in the Empire). But the fact that the establishment is unable to re-envision what a modern and different English nationalism, and nation, could mean is itself the product of its ‘anti-English’ prejudice and generalisations bordering on racism: involving an assumption that the ‘white English’ (particularly of the ‘lower classes’) are in some sense intrinsically brutish and racist – in an a-historic way that reveals their ‘true nature’, rather than as a function of an imperial and industrial history that both brutalised and empowered the English on a massive scale.

This sort of anti-English preconception was built into the design of New Labour’s asymmetric devolution settlement: it was seen as legitimate to give political expression to Scottish and Welsh nationalism, just not English nationalism. Evidently, there is a place for some forms of nationalism in modern Britain – the ‘Celtic’ ones – but not the English variety. While this is not an exhaustive explanation, the anomalies and inequities of devolution do appear to have enacted a revenge against the English for centuries of perceived domination and aggression. First, there is the West Lothian Question: the well known fact that Scottish and Welsh MPs can make decisions and pass laws that relate to England only, whereas English MPs can no longer make decisions in the same policy areas in Scotland and Wales. This could be seen as a reversal of the historical situation, as viewed and resented through the prism of Scottish and Welsh nationalism: instead of England ruling Scotland and Wales through the political structures of the Union, now Scotland and Wales govern England through their elected representatives in Westminster, who ensure that England’s sovereignty and aspirations for self-government are frustrated.

It might seem a somewhat extreme characterisation of the present state of affairs to say that Scotland and Wales ‘govern England’; but it certainly is true that a system that involves the participation of Scottish and Welsh MPs is involved in the active suppression not only of the idea of an English parliament to govern English matters (which would restore parity with Scotland and Wales) but of English-national identity altogether: the cultural war New Labour has waged against the affirmation and celebration of Englishness in any form – the surest way to extinguish demands for English self-rule being to obliterate the English identity from the consciousness of the silent British majority. In this respect, New Labour’s attempts to replace Englishness with an a-national Britishness – in England only – are indeed reminiscent of the efforts made by an England-dominated United Kingdom in previous centuries to suppress the national identity, political aspirations and traditions of Scotland and Wales.

This notion of devolution enabling undue Scottish and Welsh domination of English affairs becomes less far-fetched when you bear in mind the disproportionate presence of Scottish-elected MPs that have filled senior cabinet positions throughout New Labour’s tenure, including, of course, Gordon Brown: chancellor for the first ten years and prime minister for the last two. And considering that Brown is the principal protagonist in the drive to assert and formalise a Britishness that displaces Englishness as the central cultural and national identity of the UK, this can only lend weight to suspicions that New Labour has got it in for England, which it views in the inherently negative way I described above.

However, the main grounds for believing that devolution enshrines nationalistic bias and vindictiveness towards England is the way New Labour has continued to operate the Barnett Formula: the funding mechanism that ensures that Scotland, Wales and Northern Ireland benefit from a consistently higher per-capita level of public expenditure than England. One thing to be observed to begin with is that Barnett is used to legitimise the continuing participation of non-English MPs in legislating for England, as spending decisions that relate directly to England only trigger incremental expenditure for the other nations.

But New Labour has used Barnett not only to justify the West Lothian Question but has attempted to justify it in itself as a supposedly ‘fair’ system for allocating public expenditure. It seems that it is construed as fair primarily because it does penalise England in favour of the devolved nations, not despite this fact. This sort of thinking was evidenced this week during a House of Lords inquiry into the Barnett Formula. Liam Byrne, the new Chief Secretary to the Treasury, described the mechanism as “fair enough”, only to be rounded on by the Welsh Labour chair Lord Richard of Ammanford: “It doesn’t actually mean anything. Look at the difference between Wales, Northern Ireland and Scotland – is that fair?” So it’s OK for England to receive 14% less spending per head of population than Wales, 21% less than Scotland and 31% less than Northern Ireland; the only ‘unfairness’ in the system is the differentials between the devolved nations!

The view that this system is somehow ‘fair to England’ – except it’s not articulated as such, as this would be blatantly ridiculous and it ascribes to England some sort of legal personality, which the government denies: ‘fair for the UK as a whole’ would be the kind of phrase used – exemplifies the sort of nationalistic, anti-English bias that has characterised New Labour. It’s as if the view is that England ‘owes’ it to the other nations: that because it has historically been, and still is, more wealthy overall and more economically powerful than the other nations, it is ‘fair’ that it should both pay more taxes and receive less back on a sort of redistribution of wealth principle. But this involves a re-definition of redistribution of wealth on purely national lines, as if England as a whole were imagined as a nation of greedy capitalists and arrogant free marketeers that need to pay their dues to the exploited and neglected working class people of Scotland and Wales: the bedrock of the Labour movement.

In short, it’s ‘pay-back time’: overlaying the centuries-long resentment towards England’s wealth and power, England is being penalised for having supported Margaret Thatcher and her programme of privatisation, disinvestment in public services and ruthless market economics. ‘OK, if that’s how you want it, England, you can continue your programme of market reforms of public services; and if you want a public sector that is financially cost-efficient and run on market principles, then you can jolly well pay yourselves for the services that you don’t want the public purse to fund – after all, you can afford to, can’t you? But meanwhile, your taxes can fund those same services for us, because we can’t afford to pay for them ourselves but can choose to get them anyway through our higher public-spending allocation and devolved government’.

Such appears at least to be the ugly nationalistic, anti-English backdrop to the two-track Britain New Labour has ushered in with asymmetric devolution. This has allowed Scotland, Wales and Northern Ireland to pursue a classic social-democratic path of high levels of funding for public services based on a redistributive tax system; that is, with wealth being redistributed from England, as the tax revenues from the devolved nations are not sufficient to fund the programme. Meanwhile, in England, New Labour has taken forward the Thatcherite agenda of reforming the public sector on market principles. In a market economy, individuals are required to pay for many things that are financed by the state in more social-democratic and socialist societies. Hence, the market economics can be used to justify the unwillingness of the state to subsidise certain things like university tuition fees (an ‘investment’ by individuals in their own economic future); various ‘luxuries’ around the edges of the standard level of medical treatment offered by the state health-care system (e.g. free parking and prescriptions, or highly advanced and expensive new drugs that it is not ‘cost-efficient’ for the public sector to provide free of charge); or personal care for the elderly, for which individuals in a market economy are expected to make their own provisions.

These sorts of market principle, which have continued and extended the measures to ‘roll back the frontiers of the state’ initiated under the Thatcher and Major governments, have been used to justify the government in England not paying for things that are funded by the devolved governments: public-sector savings made in England effectively cross-subsidise the higher levels of public spending in the other nations. Beneath an ideological agenda (reform of the public services in England), a nationalist agenda has been advanced that runs utterly counter to the principles of equality and social solidarity across the whole of the United Kingdom that Labour has traditionally stood for. Labour has created and endorsed a system of unequal levels of public-service provision based on a ‘national postcode lottery’, i.e. depending purely on which country you happen to live in. Four different NHS’s with care provided more
free at the point of use in some countries than others, and least of all in England; a vastly expanded university system that is free everywhere except England; and social care offered with varying levels of public funding, but virtually none in England. So much for Labour as the party of the working class and of the Union: not in England any more.

There’s an argument for saying that English people should pay for more of their medical, educational and personal-care needs, as they are better off on average. But that’s really not the point. Many English people struggle to pay for these things or simply can’t do so altogether, and so miss out on life-prolonging drug treatments or educational opportunities that their ‘fellow citizens’ elsewhere in the UK are able to benefit from. A true social-democratic- and socialist-style public sector should offer an equal level of service provision to anyone throughout the state that wishes to access it, whether or not they could afford to pay for private health care or education but choose not to. The wealthy end up paying proportionately more for public services anyway through higher taxes. Under the New Labour multi-track Britain, by contrast, those English people who are better off not only have to pay higher taxes but also have to pay for services that other UK citizens can obtain free of charge, as do poorer English people. One might even say that this extra degree of taxation (higher income tax + charges for public services) is a tax for being English.

But of course, it’s not just the middle and upper classes that pay the England tax; it’s Labour’s traditional core supporters: the English working class. On one level, it’s all very well taking the view that ‘middle England’ supports privatisation and a market economy, so they can jolly well pay for stuff rather than expecting the state to fund it. But it’s altogether another matter treating the less well-off people of England with the same disregard. It is disregarding working people in England to simply view it as acceptable that they should have to pay for hospital parking fees, prescription charges, their kids’ higher education and care for their elderly relatives, while non-English people can get all or most of that for free. What, are the English working class worth less than their Celtic cousins?

How much of this New Labour neglect of the common people of England can truly be put down to a combination of Celtic nationalism, anti-English nationalism, and indeed inverted-racist prejudice towards the white English working class? Well, an attribution to the English of an inherent preference for market economics – coming as it does from a movement that despised that ideology during the 1980s and early 1990s – could well imply a certain contempt for the English, suffused with Scottish and Welsh bitterness towards the ‘English’ Thatcher government.

But an even more fundamental and disturbing turning of the tables against the English is New Labour’s laissez-faire attitude to job creation, training and skills development for the English working class. The Labour government abandoned the core principle that it has a duty to assist working people in acquiring the skills they need to compete in an increasingly aggressive global market place, and to foster ‘full employment’ in England; and it just let the market take over. It’s as if the people of England weren’t worth the investment and didn’t matter, only the economy. And it’s because of Labour’s comprehensive sell out to market economics that it has encouraged the unprecedented levels of immigration we have experienced, deliberately to foster a low-wage economy; and, accordingly, a staggering nine-tenths of the new jobs created under the Labour government have gone to workers from overseas. Is it any wonder, then, that there is such widespread concern – whether well founded or not in individual cases – among traditional Labour voters in England about immigration, and about newcomers taking the jobs and housing that they might have thought a Labour government would have striven to provide for them?

How much of the liberal establishment’s contempt and fear of English white working-class racism and anti-immigration violence is an adequate response to a genuine threat? On the contrary, to what extent has that threat and that hostility towards migrants actually been brought about and magnified by New Labour’s pre-existing contempt and inverted racism towards the white working-class people of England, and the policies (or lack of them) that flowed from those attitudes?

Has New Labour, in its darker under-belly, espoused the contempt towards the ‘lazy’, ‘loutish’, disenfranchised English working class that Margaret Thatcher made her hallmark – and mixed it up in a heady cocktail together with Celtic nationalism, and politically-correct positive economic and cultural discrimination in favour of migrants and ethnic minorities?

One thing is for sure, though: English nationalism properly understood – as a movement that strives to redress the democratic and social inequalities of the devolution settlement out of a concern for all of the people residing and trying to earn a living in England – is far less likely to foster violence against innocent Romanian families than is the ‘British nationalism’ of the BNP or the various nationalisms of the other UK nations that have seen far lower levels of immigration than England.

But is there a place not just for English nationalism but for England itself in a British state and establishment that are so prejudiced against it?

It would be easy to undertake a nit-picking, petulant reading of the long-awaited Final Report of the Commission on Scottish Devolution chaired by Professor Sir Kenneth Calman, which was finally published yesterday. The report does not review the Scottish devolution settlement in the round, either in relation to its effects on the UK-wide tier of governance that provides government for England, nor on devolution in Wales and Northern Ireland. This was explicitly not the remit of the Commission; therefore, it cannot be reproached for not making explicit recommendations about devolution for or within England, or for how Scottish devolution can be made more compatible with the interests of England alongside ’serving Scotland better’: the actual title of the report.

However, it is legitimate, I think, to criticise the Commission on grounds of inconsistency. The essence of its approach to devolution is to arrive at improvements to the way the reserved and devolved powers, governments and parliaments interact and complement each other in practice. Consequently, to be consistent, the Commission should have considered the effects of Scottish devolution on the workings and legitimacy of national-UK governance just as much as it reviews in depth the way the Scottish Parliament and Executive work and interact with the UK government, and how their accountability to the people of Scotland can be enhanced.

In its omission of any review of the broader consequences of devolution for the UK as a whole, and particularly for its largest constituent part (England), the Commission perpetuates and entrenches the asymmetrical approach that has been taken towards Scottish devolution from the Scottish Constitutional Convention of 1989 onwards: considering only what is in the best interests of Scotland-within-the-Union, not a more equitable and accountable constitutional settlement and system of governance for the whole of the UK.

Indeed, the issue of asymmetry is integral to Calman’s conception of the Union itself, and the concept is frequently referred to in the report. The way Calman seeks to circumvent the criticism that devolution for Scotland, Wales and Northern Ireland has brought about an egregious asymmetry in the governance of the UK – with England being the only UK nation that is denied any political expression of its national identity – is to suggest that this asymmetry has always been a fundamental characteristic of the Union: “The territorial constitution of the United Kingdom is therefore radically asymmetrical. This reflects the history and geography of these islands, and like many other aspects of the UK constitution has grown and developed rather than being designed”.

But elsewhere, the report makes it clear that the present-day asymmetry of the UK constitution has very much been brought about – or, at the very least greatly extended – by the deliberate design of the devolution settlement: “The creation of the Scottish Parliament was part of a larger policy of devolution instituted by the Labour Government after its election victory in 1997. This was applied in different ways to Scotland, Wales and Northern Ireland . . . . The result is that the United Kingdom now has a quite distinctive form of partial and asymmetric devolution – partial in that there has so far been no devolution to the largest component nation of the UK, England (other than to London); and asymmetric in that devolution differs in nature and extent in each of the nations and territories to which it has been applied.”

Notice the subtle but significant semantic shift here: according to the report, the fact that there has been no national-level devolution for England is not what makes the present devolution settlement asymmetric, but rather this asymmetry is in relation to the differing nature and extent of devolution in each of the nations to which it has been applied. As if the fact that it has not been applied at all to England is not the epitome of the asymmetry and the difference described! But no, this just makes devolution ‘partial’.

On the contrary, it is the partial nature of devolution, in both senses (biased and unfinished), that makes devolution asymmetrical. And the raison d’être for the Calman Commission is to examine ways in which devolution can be extended and enhanced – but for Scotland only, making it by definition more partial (limited to one part of the UK only, and hence one-sided in both senses) and asymmetrical. The work of the Commission is therefore directly and deliberately engaged in making the political Union that is the UK itself more asymmetrical in its structures of governance.

The report deploys a classic rhetorical trick to suggest that this intolerable asymmetry is not just ‘organic’ to the Union (having evolved in some sense naturally over the course of history, rather than having been deliberately engineered at a particular point in history, such as the passing of the 1998 Scotland Act) but that it reflects the distinct needs and aspirations of the different nations of the UK, including England:

“Although the Government’s programme of devolution marked a substantial change from the earlier Westminster-based status quo, it can also be seen within a longstanding tradition in the UK of making constitutional change organically in response to particular pressures, rather than by sweeping reforms. It is a means for the UK to provide varying degrees of regional autonomy to match the differing needs and circumstances of its component parts, without the more fundamental restructuring of the constitution that a move to a fully federal structure would entail.”

The report tries to make out that the fact that there is no distinct national layer of governance for England – that the UK government is also the de facto English government – has evolved organically and historically in this way out of the separate relationships England has had with the other UK nations, and that the present situation is somehow adequate to the needs and wishes of the English people. Indeed, the report goes so far as to suggest that:

“This unique asymmetry is not a problem [my emphasis]. If anything, it is something to be proud of – Scotland’s constitutional arrangements have grown or evolved in response to need, like many other aspects of the constitution of the UK. Their asymmetry reflects the underlying reality: Scotland is a small nation sharing islands, and a Union, with a much larger neighbour. The UK’s territorial constitution reflects the radical asymmetry of its geography and demography. Not only do the smaller nations in the UK each have different levels of decentralised power; but there is no equivalent of devolved institutions for England. The UK Parliament at Westminster is also England’s parliament, and the UK Government is England’s government too.”

There you have it: the ‘UK-is-England-is-the-UK’ moment. Historic, organic, set in stone: the UK parliament is England’s parliament, and the UK government is England’s government; the one perfectly adequate to the other. No difference, no disconnect. A ‘territorial constitution’ that makes the territory of England, in political terms, none other than the (vestigial) unitary UK, while devolution for the ‘nations’ is defined in terms of the degree of political difference and divergence that they, and only they, enjoy from the central power, i.e. effectively from England. No asymmetry of devolution, then, from England’s perspective, because England is one and the same as the UK: the founding symmetry that counterbalances the asymmetry; the centre of the system that assures its continuing unity and coherence even within a framework of increasing divergence from that centre on the part of the periphery. In short, England’s non-differentiation from the UK is what assures the continuing existence and identity (sameness, continuance) of the UK across difference and across history; and it is what prevents the presence of radical asymmetry – the absence of any constituent part and nation of the UK that actually is the UK in any fundamental sense.

No wonder, then, that it is at this point in the report (sections 2.12 to 2.15, to be precise) that it touches upon the only sort of devolution for England that it is prepared to countenance: “It is not for us to discuss where or how power might be decentralised or devolved in England – whether, as has been proposed in the past, to regional level, or by giving more power to local institutions”. Well, by very virtue of describing devolution for England in these terms, the report is prescribing the form it should take: not national but regional or local, as there can by definition not be any devolution and divergence of England as a nation from the UK if the basis for the UK’s supposed unity as analysed above (England’s non-differentiation from the UK) is to be preserved.

Having said this, and to its credit, the report does acknowledge that England is a nation, and that the governance of the UK (and of England as the cornerstone of the UK) cannot remain unchanged in the context of devolution:

“Devolution to Scotland (and Wales and Northern Ireland) created political institutions that exercise many of the powers of central Government for a significant proportion of the UK. That inevitably has meant that the governance of the rest of the UK cannot continue unchanged.

“It is not sufficient for Scots (or indeed Welsh or Northern Ireland citizens) to dismiss this as simply a problem for the English: the internal arrangements of the Union are a matter for all of us. The UK now has a territorial constitution, and it needs, in our view, to be more fully and clearly set out.”

This idea of making a new constitutional statement regarding the basis for the union between the different nations of the UK in the context of devolution has its fullest expression in the Calman Report in the idea of the UK as a ’social Union’. In particular, this pertains to shared ’social rights’:

“The most important of these [social rights] are that access to health care and education should be, as now, essentially free and provided at the point of need. And when taxes are shared across the UK they should take account of that need. Our first recommendation is therefore that the Scottish and UK Parliaments should confirm their common understanding of what those rights are, and the responsibilities that go with them.”

This statement, which is indeed the first recommendation the report makes, is implicitly a criticism of the failure of the UK to put these principles into practice, in particular through the inequitable distribution of the UK’s tax revenues via the Barnett Formula that has meant that the other nations have been able to deliver these ’social rights’ (e.g. free access to expensive life-prolonging drugs, no tuition fees in higher education, free social care for the elderly, etc.) far more comprehensively than has the UK government acting supposedly in the interests of England. The Report notably does not recommend that the Barnett Formula should be scrapped until a fair determination of a more needs-based system for distributing tax revenues in pursuit of these social rights can be made. But in principle, the report recognises that the Barnett Formula does not adequately reflect real social needs across the UK.

Up until now, devolution may well be said in practice to have undermined this social Union that the Report describes as an integral characteristic and purpose for the political Union that is the UK itself. By recommending a stronger commitment to implementing the social Union across the UK, the Report is seeking to strengthen and reaffirm that political Union. However, it is far from self-evident that the Report’s principal recommendations – much greater fiscal autonomy for Scotland; in particular, a substantial reduction in Scotland’s block grant from the UK Treasury linked to an enhanced ability to vary the level of income tax in Scotland – will advance these goals without reform of the Barnett Formula, and without political reform for England.

In essence, Scotland will have even greater freedom to pursue these social objectives, which will still be inequitably cross-subsidised by the English taxpayer. The block grant and the Barnett Formula that underpins it are not being abolished. If the Scottish Government decides not to change the level of income tax that Scots are currently paying, Scotland will get absolutely the same deal as now: about 25% higher per-capita public expenditure. In fact, the Scottish government could, if it chose, now cut its income tax – procuring a significant competitive economic advantage over the rest of the UK – and only have to reduce its public expenditure to the same level as England, thanks to the Barnett consequentials. More likely, the Scottish government will only tinker with tax rates: why rock the boat when it’s worked so well to Scotland’s advantage up till now?

The primary avowed purpose of Calman’s recommendation of greater fiscal autonomy for Scotland is to improve the accountability of the Scottish Parliament for the revenue it raises and spends on the country’s behalf. Fair enough. But what is fundamentally unfair and inequitable – over and above the unequal distribution of public expenditure – is the fact that there is no such accountability on tax and expenditure in England. Decisions on expenditure in departments that now deal with England only (in devolved areas such as education, health and transport) are made by the whole UK parliament and government, including MPs not elected in England. Here we have the asymmetry of devolution that really aggravates people and undermines the standing of the Union in England: if Calman’s recommendations are implemented, Scotland will be able to make its own decisions not just on how to spend the public finances but how to raise them, free from the participation of English MPs; but England has no such freedom, and Scottish MPs support and vote through measures that result in the relative under-funding of England to the deliberate benefit of Scotland.

Yes, as the report says: devolution has indeed succeeded for Scotland and is ’serving Scotland better’. Further enhancement of Scottish self-government may well result in an even stronger Scotland. But if this is done by continuing to serve England so ill, then it will not result in a stronger Union. England will not for ever sustain asymmetrical devolution by accepting to be governed as the UK and for the UK. But devolution as presently constituted relies on this asymmetry and inequality: allowing Scotland to both have its own cake and eat England’s.

But what happens to a ‘United’ Kingdom built on such uneven foundations when the people of England demand their own slice of the cake and a form of government best suited to their needs?

I first came across this story on the BBC News website on Wednesday morning last week. According to the report: “The number of stillbirths and deaths shortly after birth remains stubbornly high, claiming 17 babies every day on average in the UK, a report reveals. Every year in the UK nearly 4,000 babies are stillborn and another 2,500 die within four weeks. The stillbirth rate has not changed for a decade.”

The article then went on to quote a comment from the “Department of Health in England”, saying “there had been an increase in midwives and consultant obstetricians, and increased investment in the field”. This combination of statistics supposedly relating to ‘the UK’ and reaction from the DoH England [give them their due, the BBC do now more consistently make it clear when a UK government department has England-only responsibilities] immediately registered on my Britology radar: ‘are these UK figures actually England-only figures?’, I asked myself. Otherwise, why gauge reaction only from the English department concerned without any further comment relating to the rest of the UK? Such a practice usually is code for England-only information passing under the generic UK / Britain label.

The report about stillbirths and neonatal deaths was produced by the charitable society of the same name, the Stillbirths and Neonatal Deaths Society, or ‘Sands’. In fact, the document was due to be launched at the House of Commons later the same day, so it was not yet available for download. I scoured the Sands website in vain for information about whether the research and the activities of the charity were focused on England only or on the whole of the UK. The website talked only of UK-wide facts and figures, and in fact, it did not mention the word ‘England’ once anywhere. After more extended web research, I did manage to confirm that Sands is the established UK-wide charity organising emotional support and raising funds for research on the topic.

Later on in the day, I caught the BBC1 lunchtime news, where there was a more extended version of the report than had appeared on the BBC News website. This was an absolute masterpiece of ambiguity, which managed to completely avoid mentioning whether the Sands report related to England or to the whole of the UK, failing to (or perhaps succeeding in not) utter(ing) any of the words ‘England / English’, ‘Britain / Britain’ or ‘UK’. Any casual viewer would undoubtedly have been left with the impression that the information related to the whole of the UK; but this was never explicitly stated, even though Sands was calling for a ‘national’ [by implication, UK-wide] action plan to reduce the number of stillbirths and deaths in early infancy.

By now, I was getting really intrigued, and really frustrated. ‘Does the Sands report relate to England only or not; and if it does, why do they seem to want to suppress this fact rather than drawing comparisons between the situation in England and elsewhere in the UK, which would almost certainly be more embarrassing to the government?’, I wondered. I checked the Sands website in the evening – and still no report available to download. I was so irritated that I fired off the following email to the organisation:

“Dear Ms Duff [Sands' Communications Officer],

“I followed with interest the press coverage today surrounding the launch of your Saving Babies’ Lives report. Will this report be available for download from your website soon?

“I am also interested to know whether its findings and recommendations relate to the whole of the UK or to England only, as the UK government and the Department of Health are responsible for healthcare and the NHS in England only. The media coverage (e.g. on the BBC1 lunchtime news) was somewhat unclear on this point. On your own website, you call for a nationally co-ordinated action plan (implying across the UK). But clearly, the government can only really co-ordinate all the measures required to reduce the number of stillbirths and neonatal deaths in England – unless your report recommends some sort of high-level, UK-wide co-ordination involving the participation of the governments of Scotland, Wales and Northern Ireland.

“I look forward to your reply.”

I don’t know whether this letter was viewed as a nuisance or irrelevance, or whether they were just plain too busy, but I haven’t yet received a response. In fact, it may well have been too close to the bone, as became evident when the report did finally appear on the website on Thursday and I was able to download it.

This is where I have to throw in a disclaimer. In some respects, I’m reluctant to critique this report, which is full of heart-breaking pictures of would-have-been parents cradling their stillborn infants, and desperate accounts of the devastating effect that stillbirths and neonatal deaths have on individuals and families. I’m not blaming Sands for the approach they’re taking, which is completely consistent and conscientious. I blame the UK-cum-de facto-English government and the effects of poorly managed, asymmetric devolution. So, as they say, the views expressed in this post are mine and do not necessarily reflect the opinions of Sands.

Apart from all the detailed data on stillbirths and mortality in early infancy, and the recommendations for alleviating the situation, a clear underlying message that emerges from the Sands report, for me, is that the failure to reduce the incidence of these traumatic events is closely connected with asymmetric devolution. Sands don’t spell this out because they want to encourage government to develop a co-ordinated cross-UK strategy and set of policies that strongly prioritise the issue. Hence, their tactic appears to be that of taking the moral high ground and arguing that this is such a critical social issue (responsible for far more deaths, for instance, than road accidents or cot death) that the government should rise above the political obstacles and start dealing with it.

But the political barriers are evidently key. As the report itself says:

“In the UK a combination of problems means we fail to identify many babies who are at risk, and to ensure their best possible chance of life:

• We lack knowledge, data and research into why babies die.

• We have no reliable way to predict which pregnancies are at risk of stillbirth or death early in life.

• There is little awareness of the extent of the problem or what the risks are.

• We don’t have the resources in maternity care to ensure optimal care for every baby.

Above all there is no political will to make things change [my emphasis].”

Why is there no political will to make things change? The problem, it seems to me, is twofold:

1. The UK government – which is the primary intended audience for this report – lacks the political will and, more importantly, the political muscle and power to co-ordinate and implement a UK-wide strategy in this area. Post-devolution, the remit of the UK Department of Health stops at the borders between England and Scotland, and England and Wales. And there’s been a failure, precisely, to develop mechanisms to co-ordinate strategy, share knowledge and implement best practice in areas of social policy, including healthcare and the (four) NHS(’s), across the four nations of the UK. (See my discussion of this elsewhere.) And this sort of co-ordination is especially critical with respect to stillbirths and neonatal deaths, according to the Sands report.
2. The UK government has even been unwilling to own and embrace its responsibilities to formulate priorities and develop social policies for England as England, and has tended to wash its hands of its duties as the de facto English government by passing on or outsourcing the setting of healthcare priorities to Primary Care Trusts and an increasingly marketised healthcare sector. This has also resulted in a failure to set adequate priorities and co-ordinate measures to deal with stillbirths and deaths in early infancy, as emerges from the report; although Sands does not link this explicitly to the contrast between the situation in England and the devolved UK nations.

One area where the government could co-ordinate action at a UK-wide level, and which is vital according to Sands, is in research into the causes of stillbirths and neonatal deaths. As the report says, “A serious lack of direct funding for scientific research to understand and prevent stillbirths is holding back progress that could be made in reducing the numbers of deaths”. Scientific research is a reserved power, so the UK government could directly fund research in this area; and Sands is calling on the government to match the £3 million it is raising for this purpose. £3 million: absolute peanuts compared with the billions the government is pumping into the banking sector. But, as I said in that previous discussion, as the UK government has retained the responsibility for managing the economy but not the ability to formulate joined-up social policy throughout the UK, it tends to prioritise the economic over the social: in England, that is, as the devolved administrations do have a social vision for their respective nations.

Indeed, one of the problems about a direct-funded research programme is that it has to be underpinned by co-ordinated cross-UK data gathering. As the Sands report says in its next recommendation: “Data collection on pregnancies is limited in the UK, the exception being in Scotland. We need nationally collated, detailed and standardised data about all pregnancies and outcomes on which to base research”. Well, yes, that says it all, doesn’t it? In fact, before devolution, there was a ‘national’ (i.e. UK-wide) programme for gathering data on the issue, called CESDI: Confidential Enquiry into Stillbirth and Deaths in Infancy. But, as the report indicates, “these enquiries have stopped since the formation of the Confidential Enquiries into Maternal and Child Health (CEMACH) which has less funding to cover a far wider remit of work. We would like to see resources to enable a return to enquiries into all stillbirths, in particular those which are unexplained”.

The last CESDI report was published in 2001; and from 2003, its work was taken over by CEMACH, which looks into maternal and childhood deaths (up to the age of 16) alongside perinatal and neonatal mortality – and does in fact have a much smaller budget than did CESDI alone. In England, Wales and Northern Ireland, that is. In Scotland, on the other hand, as the report reiterates elsewhere, “detailed information about pregnancies and outcomes is available”. Why? Because the CEMACH work in Scotland is separately funded by a body known as NHS Quality Improvement Scotland (NHS QIS), which in fact will be taking over the whole CEMACH survey in Scotland from October of this year. (I add that this particular gem of information is not contained in the Sands report; I trawled it up from the CEMACH website.)

So let’s summarise. Research in Scotland is still focused on the specific problems of stillbirth and neonatal deaths; it enjoys superior funding to England, Wales and Northern Ireland, which are dependent on the CEMACH process; and until as recently as 2007, the CEMACH survey was also using a flawed methodology. As Sands informs us: “From 2007 CEMACH has adapted [the Wigglesworth] classification system to address its widely recognised limitations, particularly in gathering information about conditions associated with a death”. On top of this, the Scottish NHS is abandoning the CEMACH process altogether from later this year. And no political will exists to sort out these disparities and ensure that rigorous data gathering of the kind that still takes place in Scotland is co-ordinated across the UK. Surprise, surprise.

A similar lack of political will seems to prevail with respect to ensuring the dissemination of best clinical practice. For example, the report states: “The Royal College of Nursing and other stakeholders are currently working on a UK-wide framework for the education and training of neonatal nurses. But this framework must be adopted in order to be effective”. Well, clearly, there has to be the ‘political will’ to standardise processes and share knowledge across the four national NHS organisations. And there would have to be a commitment to make the necessary investments to raise standards, which would be particularly costly throughout England, whereas this is easier to achieve in Scotland owing to its smaller scale and higher per-capita level of public expenditure, guaranteed through the Barnett Formula. I’m reading between the lines here; but it stands to reason that if there were enough political will to introduce the improved training framework in England, then there would be no problem about standardising it across the other UK countries owing to their higher proportionate share of the public finances. So the issue must be that the government is unwilling to spend the extra money in England (with the Barnett consequential of even greater expenditure in the other countries), while the devolved administrations presently do have the financial and political latitude to roll out improvements in this area.

And evidently, to judge from the Sands report, these improvements are desperately needed. At times, the report reads like a catalogue of failure to learn from avoidable mistakes in antenatal care, childbirth and neonatal intensive care, resulting in babies continuing to die unnecessarily from the same causes. And there is not just a failure to disseminate best practice, share knowledge and prioritise the issue but also a lack of resources: insufficient antenatal healthcare personnel, such as midwives and other specialists, who might be able to help detect problems earlier on in pregnancy; inadequate staffing levels in intensive-care units for premature babies, such that only 14 out of 50 of such units ‘in the UK’ are able to provide the one-to-one nursing care that the British Association of Perinatal Medicine (BAPM) regards as a minimum standard.

The fact that the statistics are aggregated across the whole of the UK in this way is one of the shortcomings of the Sands report. This prevents one from being able to gauge whether the problems are significantly worse in England than in the other UK countries, which would be linked to the funding inequalities and strategic issues (lack of UK-government focus on this as a serious social issue in England) resulting from asymmetric devolution. I have no way of knowing how many of those 14 under-resourced intensive-care units are located in England; but I’d be willing to bet that none of them are in Scotland. It has to be said that all the specific examples of bad practice and inadequate resourcing, and all of the references in the body of the report to comments from clinical experts or to other reports on the issue, are drawn from England.

Another aspect of this topic that is exclusive to England is the way that the processes of funding the NHS contribute to the inadequate priority and insufficient resourcing that are given to stillbirths and neonatal deaths. These are described by the report as follows:

“Newly implemented commissioning structures between the Primary Care Trusts (PCTs) and hospital trusts have been evolving to meet new government structures. While this brings more focus to what is required from maternity services in each hospital, contracts may omit any proactive remit to reduce perinatal deaths. An issue that is not highlighted in a contract for funds is less likely to attract specific focus or resources.

“As the contracts come into place hospitals can negotiate additional funds for posts or for focus as they see fit. However, many hospitals see contract negotiations as being driven by the PCTs and only a few have seen the opportunities provided by being able to focus on local issues.

Tariffs

“It is unclear what is or is not included in the tariffs paid to trusts for obstetric services, with a great deal of room for interpretation on whether or not tariffs have been adjusted to allow for the funding of quality improvements. For neonatal care there is no nationally mandated funding system and health economies are left to make their own local arrangements which leads to an inevitable variability in the level of care provided.”

What the report doesn’t state explicitly at this point is that these funding mechanisms that have evolved to meet ‘new government structures’ and this lack of a ‘nationally mandated funding system’ for neonatal care exist in England only; as it is only in England that the government is still calling the shots when it comes to NHS funding and healthcare priorities. The system described above has been developed deliberately to allow a greater role for market forces, with individual hospital trusts competing for funding from PCTs based on their proven record to meet government targets and treat larger numbers of patients with different types of medical need. What this leads to is the creation of centres of excellence and a concentration of investment in particular ‘generic’ areas (such as maternity services, as described here), which can then more successfully bid for funding. But this means that certain specialisations within those generic areas (such as neonatal care) are not prioritised in a strategic way, as the focus is more on generating a critical mass in more ‘fashionable’, headline-grabbing areas of care that can attract funding in a bidding war, rather than on actual clinical and social need: in this case, more resources for preventing and dealing with stillbirths and neonatal deaths. By contrast, as is evident from the dedicated resources allocated to the issue at a national level through NHS Quality Improvement Scotland (referred to above), stillbirths and neonatal deaths are a nation-wide NHS priority in Scotland.

Conclusion

For me, one of the things that emerges clearly from the picture of failure painted by the Sands report is a demonstration of the harmful consequences of asymmetric devolution. No progress has been made in improving clinical outcomes in ten years: the ten years during which devolution of healthcare has been in place, with different systems, and levels and mechanisms of funding, in place in each of the UK’s four nations. This has led to an absence of strategic UK-wide focus on stillbirths and neonatal deaths, with the consequence that there has been inadequate funding of scientific research, and a failure to disseminate best practice and drive through better training of specialist nursing staff. This is clearly linked to the funding inequalities built in to the asymmetric devolution settlement. The report cites Scotland as the only example of adequate data gathering on the causes of stillbirths and neonatal deaths, after the successful pre-devolution information-gathering process (CESDI) was abandoned in favour of a more poorly funded and less specifically focused system (CEMACH) in England, Wales and Northern Ireland (but not Scotland) under the auspices of the infamous NICE (National – e.g. English – Institute for Clinical Excellence).

Meanwhile, there has been a lack of strategic focus on the issue in England, which in my view is linked to a general unwillingness on the part of the UK government to assume its responsibilities as the de facto English government in most areas of social policy, including the NHS. Instead, funding and prioritisation in England has been left in the hands of PCTs as part of a process designed to foster the development of a competitive healthcare market within the NHS. But, as we know, markets lead to winners and losers, and stillbirths and neonatal deaths have lost out to more market-friendly areas of obstetric and paediatric medicine where it is easier to demonstrate a return (improved patient outcomes) on investment, compared with the difficulties in making gains in stillbirths and neonatal deaths, where the causes of mortality are still often a mystery. But unless the resources are devoted to greater research and improved clinical care in this area, no improvements will ever take place.

Where I take issue with the Sands report is with its tactic of treating the issue purely at a UK-wide level, without differentiating between the nation-specific circumstances that are contributing to the ‘postcode lottery’ of varying standards of care and prioritisation throughout the UK. The report correctly identifies that the political dimension is key. And one absolutely fundamental aspect of this is that the UK government, in this area as in so many other aspects of healthcare, is unwilling to commit the levels of investment and to prioritise the issue at a national level (that is, an England- and hence UK-wide level) in the same way that it is prepared to enable the devolved governments to do so on a more limited scale. The pattern is: cut expenditure in England, and hand the thing over to the market as a supposedly more efficient way to deliver healthcare in line with patient customer demand, in order to release higher levels of funding on a smaller scale for Scotland, Wales and Northern Ireland.

Until these structural and national inequalities are removed, there can be no integrated UK-wide strategy for beginning to reduce the number of stillbirths and neonatal deaths. Perhaps we may never be able to reinstate a coherent UK-wide strategy in this area given the lack of political will to reform the present asymmetric devolution settlement. But the government at least has a duty to drive a strategy on stillbirths and neonatal deaths for England. However, I doubt this will ever happen until there is a proper elected English government, genuinely accountable to the English people.

It was the best of times, it was the worst of times. To the north of the border, the citizens were protected from the worst effects of the gathering storms. The provisions were as plentiful as an RBS senior executive’s bonuses – in good times and in bad. The difference was really not that great up there, in any case.

South of the border, by contrast, things were slowing down so much they were grinding to a halt. The climate had deteriorated to such an extent that workplaces and schools were shut down; and people were in any case unable to get to them, even if they were still employing the locals. There was nothing for it but to head into the streets and the parks, and fight it out.

And that’s only talking about the weather, the grit and the snowball fights! Yes, we’ve shown true Brit grit this week, even – or especially – where the grit has run out. Desperate folk have still battled their way into work (there is, after all, a lot of job insecurity about) and have ensured that the essential services kept running; apart from one or two refineries and power stations that we’ll talk about elsewhere, perhaps. Where necessary, selfless individuals have gone out into the bleak conditions on their own initiative to help pull cars out of snow drifts, and bring comfort and relief to stranded motorists. Whole communities have rallied round and shown their best side, providing emergency accommodation to those who were caught out unprepared. It’s the blitz spirit all over again; except this time, perhaps we should call it the ‘blizzard spirit’.

Where have these epic tales of dire emergency, valiant rescue and communal cheer been played out? Where indeed? The media, whose staff miraculously managed to make it into work this week (again, keeping those ‘essential’ services going), would have you believe it was in some place known as ‘Britain’ or ‘the UK’. ‘All across the UK’ they chimed, and ‘across the eastern parts of the UK’ they echoed. By my reckoning, though, almost all the places mentioned were in England, with a few incidental allusions to parts of Wales and Northern Ireland. But 95% of it has referred to England. Not one mention of Scotland until this evening; it appears that the poor climate may finally have caught up with them there, too, after all.

OK, not even I can try to lay blame for the relatively clement weather in Scotland on asymmetric devolution and the Barnett Formula, tempting though that might be in a bloody-minded sort of way. But I do blame these things for the way the weather was reported and, more importantly, for the way the media has dealt with the right-royal English farce of our being once again unprepared for wintry weather and running out of grit, of all things.

Yes, it’s an English farce, not a British one – just as the snow has fallen mostly on England and hardly at all on Scotland. Or rather, it’s a farce that has unfolded in England but been orchestrated by the (English) Department of Transport. I listened with not inconsiderable schadenfreude this evening to the report on BBC Radio Four’s PM programme on the too-little-too-late efforts of the “English Transport Secretary” to co-ordinate the distribution of the English counties’ dwindling reserves of gritting salt amongst themselves, with those that had more supplies sharing them out with the less well provisioned areas. Yes, they actually described the hapless minister as ‘English’, which I notice that the PM programme now does regularly when referring to a UK-government minister whose portfolio is limited to England, owing to devolution. Well done, BBC – you’ll be calling yourself the English BBC next!

What a fiasco that the English counties should be having to ration their gritting operations precisely as winter is winding up to its climax because the English government-that-isn’t-a-government-for-England has neglected to put in place proper processes and supplies to deal with all contingencies. Ah, rationing – that blitz spirit again!

But why, I asked myself, aren’t the English counties looking to their northern-British ‘compatriots’ who, we learnt earlier this week, have absolutely plentiful supplies of grit as well as armies of gritters on stand-by should they be needed. Needed in Scotland, that is. Oh yes, there’s no danger of them running out of grit up there! Why? Because they have a national government that is genuinely accountable to the people and who can, and would, be voted out if they endangered people’s lives and let everything grind to a halt because they neglected their duty to prepare for severe weather conditions. And because, thanks to the generosity of the English taxpayer, they have more of a budget for that sort of thing.

Well, after all, the Barnett Formula is about ‘need’, isn’t it; and, in respect to snow and ice, the needs of Scotland are undoubtedly greater, aren’t they? Usually, maybe; but not this time. So, given that the English counties are in danger of running out of grit, and their teams of gritter drivers were in danger of collapsing with exhaustion at their wheels, why didn’t we hear of generous blitz-spirited offers of grit and gritters from the Scottish counties to their English counterparts? Even if they wanted paying for them, which would have been a bit like paying for them twice over, quite frankly.

Well, it’s a different system, you see; and a different country. Why should one country whose government has taken the necessary precautions sacrifice its own precious resources to help out another whose government (or what passes as it) has neglected its duties? Why indeed? You can see their point.

But the media can’t, apparently. For the media, it was a time of extreme weather for all of Britain; and they made no reference to any idea of English counties borrowing or purchasing salt from the Scottish or Welsh ones that weren’t in danger of running out – though that fact was also not generally reported. No, the media was about as blind to the devolutionary aspects of the gritting crisis as were those English motorists battling their way to work and home through the drifting snow. Well, we don’t want the people of England becoming too aware of the superior provisions made by the respective governments of Scotland and Wales – backed by English taxpayer pounds – compared to the negligence towards England of the English UK government. Better to turn a blind eye to it.

Now that reminds me of someone! Idiot he isn’t; Scottish he most certainly is. And blind to the injustices his unelected English government heaps upon the English people like a snowstorm coming in from the continent of Europe, while the Scottish people yet enjoy good times at their expense.

Are we sure it wasn’t a snowball that blinded him in one eye: the one pointing towards England, that is? Well, at least I know who I’d like to chuck my snowballs at!

Trevor Philips, and the Equality and Human Rights Commission (EHRC) he chairs, were in the news again on Friday. Mr Philips was threatening to take legal action against local authorities that fail to convince the Commission that they have adequate plans to redress their insufficient, or totally absent, provision of services for women who have been victims of violence or sexual assault. If the EHRC’s figures are reliable – and they do seem to have been quite thorough in their research – then the absence of provision in some parts of ‘the country’ are indeed truly deplorable: nearly one in four local authorities in Britain with no specialised support services at all.

What the EHRC and the media reporting on Mr Philips’ declaration of intent yesterday did not emphasise, however, is that the gaps in funding and provision exist almost entirely in England and, to a lesser extent, Wales. Why is this? Because, as it says almost at the end of the EHRC’s press release: “In Scotland, the Government has extended provision through a national Violence Against Women fund for over five years”.

Why should ‘the Government’ create a ‘national Violence Against Women fund’ in Scotland while no such provision exists in England or Wales? Rhetorical question, of course; because this is not in fact referring to the UK government, as you could be forgiven for thinking, but the Scottish government. So the EHRC’s criticisms are not in fact directed at local authorities throughout the UK, because Scotland is performing significantly better. Why? Because in Scotland, they have a devolved government that has made the provision of care for women victims of violence a national priority. And it doubtless helps that Scotland has superior funding to back this up through the higher per-capita public spending guaranteed by the Barnett Formula.

The fact that the EHRC itself believes that the ability to deliver an adequate level of provision in this area results from its being set as a national priority is evident from what the EHRC’s press release goes on to say about the Scottish fund: “But this fund is now at risk since some of the work previously ringfenced has been lost because of delegation of responsibility for part of the fund to local authorities, a system which, as this year’s report shows, isn’t working for victims of violence in the rest of Britain”.

Well, yes; so if the problem in the ‘rest of Britain’ is the delegation of responsibility to local authorities, doesn’t this logically imply that the EHRC’s criticism and actions should be directed against the national English government, which should be taking ownership of the issue and driving the improvements – as has the national Scottish government – and not against the local authorities Mr Philips is now menacing with his clunking fist? But there’s a problem with that, of course: there is no national English government. Consequently, there is no government department, or combination of departments, specifically tasked with looking after the welfare and rights of English women victims of violence; no English government, answerable to the English electorate, that has the needs and situation of English women sufficiently at heart that it takes responsibility for ensuring that their human rights are looked after and that the local authorities of England do their job in this area. And one of the reasons why English local authorities are failing to a greater extent than their Scottish counterparts is that they receive less funding for the job.

But you wouldn’t know that from the EHRC press release, from the media interviews with Trevor Philips on Friday or from the wider media coverage. The funding and political inequalities between Scotland and England were never once mentioned as a possible factor in the variations in provision. Instead, the EHRC press release talks of a “postcode lottery” of inconsistent services throughout Britain – a phrase which is increasingly used nowadays to gloss over the primary discrepancy in public-service provision in the UK, which is that between England and the other UK nations.

In fact, the press release revealingly uses the phrase “regional postcode lottery”. This refers to a map of differential provision throughout Great Britain (the ‘map of gaps’) that has been drawn up by the EHRC in partnership with the charity grouping End Violence Against Women (EVAW), in which Great Britain has been divided up into 11 ‘regions’ – two of the ‘regions’ being Scotland and Wales. So it’s not a regional postcode lottery, as such; but a lottery of superior provision in the nations of Scotland and Wales compared with (the regions of) England.

This map is interactive; and you can indeed search for the provision in your local area by individual postcode. However, you can also search the availability of different types of care for women victims of violence across the whole of Great Britain, with colour coding indicating the number of individual services that are available in the local authorities concerned. In the generic category, ‘violence against women services’, all of the red-coded areas (no provision) are in England: no red in either Scotland or Wales.

If you click through all the sub-categories, the only ones where Scotland and Wales are predominantly coloured red are where England is mostly red, too; e.g. ’services for black minority ethnic women’ or ’specialist domestic violence courts’.

Indeed, the section of the map of gaps site entitled ‘Postcode Lottery’ gives the whole game away. It states “Over a quarter of local authorities in GB offer no specialised service at all”. Then, at the end of a set of bullet points on the key findings of the EHRC / EVAW research, it says: “All Local Authorities in Wales and Scotland have at least one service but 30% (109) in England have no service”. QED: the ‘quarter of local authorities in GB’ with no specialised service are the same local authorities as the 30% of English ones with no service, because every single authority in Scotland and Wales has at least one service. And that’s why there’s no red colouring on the ‘regional’ map for Scotland and Wales under the search term ‘violence against women services’.

This is the real news story and the real scandal of inadequate care to vulnerable women that the media totally failed to pick up on on Friday. I first spotted the story in the print version of the Guardian, where there was nothing to indicate that the local authorities with serious deficiencies were almost all located in England until some way into the report, where it referred to the EHRC report’s statistics about provision in England and Wales – Wales being included because it is lacking in certain types of care, such as rape crisis centres. The rat that I was already smelling positively stank me out when I watched the Channel 4 News report where, again, no mention was made of the fact that England was the only UK country where there were local authorities without any form of provision – despite the fact that they showed the ‘map of gaps’ (as above), with red bits only in England. And the Channel 4 report mentioned that the best-performing local authority in ‘Britain’ was Glasgow – surprise, surprise. Could the reason for this just perhaps be because it was a Scottish local authority, benefiting from superior funding and the political backing of the Scottish government, which appeared to be the reason why there were no red bits on the Scottish part of the map?

But, as I said above, the specifically English dimension of deficient provision simply wasn’t on the EHRC’s radar. Or perhaps, rather, it was being deliberately obfuscated in the usual way: by referring to everything as ‘Britain’ this and ‘the country’ that; ‘regional’ and postcode lotteries, not national. What interest would the EHRC have in obscuring the real economic and political issue here? After all, as an organisation, it’s supposed to have a UK-wide remit and should therefore be concerned to get to the bottom of any obvious apparent nationwide pattern of inequality and discrimination, no matter how politically awkward this might be.

Well, in theory, yes; but the UK government pays the EHRC’s wages and is its political master. In order to truly do justice to the inconsistencies in levels of provision across the different nations of the UK, the EHRC would have almost no alternative other than to point out that a major factor – perhaps the most fundamental one of all – is asymmetric devolution coupled with funding inequalities affecting the UK’s nations. They would have to emphasise that, whereas Scotland and Wales have national governments that have made the issue a priority, England is governed by the UK government that does not see it as part of its role to develop social policy specifically for England and to meet the needs of the English people as such. Hence, that government has delegated responsibility in the area of care for women victims of violence to local authorities – an approach which the EHRC itself says results in inadequate prioritisation and channelling of resources. Resources which are in any case more limited in England because of the funding disparities.

So the EHRC ought to be directing its fire against the UK government that is providing such inadequate and unequal care for the women of England – as it is for the people of England as a whole in so many other areas. But that would be too difficult, too likely to incur the wrath of its UK-government masters and threaten its ‘independence’. And so Trevor Philips’ imperious anger is directed at the English local authorities as an easier target: one which enables the blame that should be aimed at the UK government to be deflected, so the EHRC can be seen to be doing something while not getting to the real root of the problem – the fact that England itself is the victim of structural discrimination, resulting in lack of care towards its people’s needs and unequal treatment compared with the other UK nations.

Until the EHRC addresses this most egregious of violations of the principles of equality and human rights within the UK, it cannot have the credibility that it deserves as a defender of the rights of vulnerable people. In fact, rather than the EHRC threatening legal action against inadequately funded and politically unsupported English local authorities, it seems to me that the EHRC itself would be a suitable candidate for legal action. In this instance, at least, it is failing in its statutory duty to defend the principles of equality and human rights for all in the UK without discrimination. And English women are the losers as a result.

Email of protest sent to EHRC (info@equalityhumanrights.com) - feel free to borrow it or the arguments above if you want to write, too:

“Dear Madam or Sir,

“I am writing to express my dismay at the failure of the EHRC and the media to address one of the most fundamental aspects of the question of inadequate provision of care for women victims of violence, which was the subject of prominent media coverage last Friday.

“It was completely obvious to me – and therefore must have been evident to thousands of others – that the local authorities with no provision at all were all located in England; while Scotland was the best-performing ‘region’. This is, as the EHRC’s press release itself acknowledges, because the (Scottish) government has made the issue a priority. There is also the additional fact that a higher per-capita level of public funding is available to the Scottish government on this issue, as on many others, owing to the inequalities of the Barnett Formula.

“This aspect of the question was barely touched upon in the media coverage; nor is it addressed in the EHRC’s own material on your website. However, it is fundamental to any consideration of inequalities and discrimination in social-service provision in the UK. England is discriminated against in two respects here: 1) no national government to drive the issue, as in Scotland and Wales (a key factor in the superior provision in Scotland, according to the EHRC itself); and 2) inferior funding.

“Instead of bullying and threatening the English local authorities over this issue, the EHRC should direct its fire at the UK government that is failing the English people by not exercising its responsibility to set policy and priorities in England – as there is no England-specific government to do this equivalent to those in Scotland and Wales. In fact, the EHRC itself should perhaps be the object of legal action, as it is failing to defend the people of England against the political and financial discrimination of which it is a victim at the hands of the UK government and as a result of asymmetric devolution. And, as inadequate provision of care for vulnerable women is a direct consequence of this structural discrimination, the EHRC as much as English local authorities are to blame for the present deficiencies so long as you persist in not calling the UK government to account.”

Just had a listen to GB’s 4.30-minute long speech yesterday, introducing the British government’s consultation on social care in England. At least, I assume it related to England only, for two reasons: 1) England is the only ‘part of the country’, as GB would say (and did say, in fact – but I’ll come on to that) where the Scottish-elected PM has any say over social care; and 2) the BBC and other media reports – to their credit – did state up front that the consultation was designed, in the BBC’s words, to “reform the social care system for England’s ageing population” – which does rather make it sound as though ‘England’s ageing population’ are making themselves an increasing nuisance and causing an inconvenient budgetary shortfall, in contrast to a more neutral phrase that could have been used, like ’social care for the elderly in England’.

In passing, a brief description of those reforms as outlined yesterday: the usual New Labour mix of no new money from the public purse for England, coupled with incentives for individuals to save for their later social-care needs (so they don’t have to sell the family silver to pay for it – but they’ll still have to pay for it); plus more ‘efficient’ (cost-effective) co-operation between the health and social services, and more help to assist people to lead independent lives at home (less of a burden on social services, although probably many people would genuinely benefit from that until their condition becomes too debilitating).

So I had to gather from the context that the reforms being proposed related to England only: GB certainly didn’t say so. Yes, not a dicky bird on England: not one single measly mention of the ‘E’ word from the unelected Scottish English First Minister. However, I did spot a particularly pernicious circumlocution that just about summed it up. As usual with GB’s utterances, you had to be alert to pick up on it, as he passed quickly on. The offending passage, about three minutes into the speech, was:

“We know that differences in entitlement between different areas of the country create uncertainty and anxiety for people when they are most vulnerable. Of course, those who have the most need are given the most support”.

What are these ‘differences in entitlement between different areas of the country’? This can mean only the difference between the entitlement to free social care in Scotland compared with the means-tested systems in England, Wales and Northern Ireland. GB tries to gloss over this in the second sentence I’ve quoted by implying that the ‘difference in entitlement’ is the same as the means-tested system itself, which ensures that ‘those who have the most [financial as well as care] need are given the most support’. But there isn’t a ‘difference in entitlement’ between different areas in England: everyone has the same level of entitlement relative to means. By contrast, the difference in entitlement in Scotland is not proportionate to individuals’ means or care needs: all elderly people who are thought to need personal or nursing care in Scotland are offered it free of charge regardless of means or the severity of their condition.

As a result, GB is reiterating two deceits here: 1) that the Barnett Formula, which guarantees the higher levels of public expenditure in Scotland that enable the provision of free personal care there, is a reflection of genuine social need and of greater poverty in Scotland; 2) that his remit as PM in the social-care area extends to ‘the country’ (the whole of the UK) and not just England. So he can try to make out that he is a reasonable UK PM trying to ensure a fair distribution of stretched public finances across the whole of ‘the country’, rather than a Scottish-elected PM who needs to make the English social-care budget stretch as far as possible so as to subsidise the superior and more expensive system for his constituents. Well, us wealthy, property-owning English shouldn’t whinge so much, should we? We should be glad that we do have assets we can sell to pay for our social care – unlike so many of our northern cousins, apparently – and if we’re worried about the future, we should just save for it now like the thrifty Scots!

Approval ratings:

• BBC: four out of five – well done for being up front about the fact that the measures related to England only. Docked one point for suggesting it was almost the ‘fault’ of the ageing English population that the public purse for social care was so stretched – rather than the truth, which is that the English would probably be more than happy to pay for better social care through their taxes if they were given a democratic say in the matter, as opposed to wasting many more billions on futile fighting in Afghanistan and Iraq, for instance.
• GB: zero – say England when you mean it, man!

I’ve been privately participating in the fever of speculation there’s been over the past few days – particularly since Labour’s local election debacle on Thursday – as to whether the tide of political fortunes has now turned back in the Tories’ favour, meaning they’ll win the next general election. Initially, I was sceptical about David Cameron’s prospects, as the Tories’ resurgence seems to be dependent more on people rejecting New Labour and Gordon Brown [GB] than on support for the Conservatives’ programme – whatever that might turn out to be. However, after the local election results, which saw Labour drop to third position on share of the votes behind the Liberal Democrats, and a consistent nationwide swing towards the Tories, I feel that, maybe, Cameron could just pull it off at the general election, which will take place probably in 2010.

Thinking about it further, there’s another reason why I think Cameron will win. This is my theory of generational evolution of society, or, putting it more simply, the way social changes are influenced by successive generations. I’m sure professional sociologists have developed a more scientific version of this idea, presumably with a technical name to boot; so I’m pretty sure this is not an ‘original’ theory, if such a thing exists in any absolute sense. However, if it is, I hereby dub it the ‘political generation game theory’, on the analogy of the amateur contestants of the immortal Bruce’s show who had to imitate the dazzling skills of professionals of one sort or another.

What the idea is, in essence, is that particular periods of a nation’s history – often defined or named in relation to the dominant political personality associated with it – have a character that is determined to a large extent as a function of the periods that immediately preceded them and the period before that. More precisely, each period is a reaction to the one before, which draws its inspiration in large part from the period before that. And it does this because the people who are most influential in shaping the character of any given age – the political, business and media opinion formers and decision makers – spent their most formative years (say, between the ages of about 10 and 19) in the period preceding the period in relation to which they are defining themselves.

An example: ‘the Blair years’ and New Labour were clearly in part a reaction to / against ‘Thatcherism’ and the period of ruthless market economics that is denoted by that term. And it was a reaction that represented in part a reprise of the social-democratic Labour that had been in power for much of the 1960s and 1970s, which was precisely the period in which the leaders in society during the Blair years spent their formative years. With the difference that the New Labour period was also a continuation of Thatcherism, which had in a sense laid the economic and political foundations for Blair’s social-democratic ‘redistributive capitalism’ to actually work – whereas the economic stagnation and political / union antagonisms of the 1970s had thwarted Labour’s ambitions to create a successful, prosperous welfare state. So what we got under Blair was a new blend of social democracy and market economics: social-market economics; equality of opportunity mutating into ‘equality of market opportunity’: the goal of government being to free up people to participate more fully in, and reap the rewards from, the market society (society as a market).

Similarly, you could say that Thatcherism itself was a reaction against the whole political and social model of the Wilson and Callaghan years: initially, the idealistic 1960s, with the vision of a socially and morally freer and more equal world, underpinned by economic prosperity and technological developments that enabled people to have a bloody good time, and enjoy hitherto only dreamt-of material and physical pleasures; later, collapsing into the cynicism and recriminations of the 1970s as the downward economic cycle and spiralling inflation caused industries to collapse, and engendered strife in the workplace, on the football terraces and in the inner cities as people sought scapegoats for the fact that living the good life was increasingly unrealistic.

The Thatcherite reaction to all that was indeed a reinstatement of the Tory values from the 1950s, when many of the leaders of the 1980s were in their ‘tens’ (aged 10 to 19): the individual standing on their own two feet and creating prosperity through their own hard work and enterprise – rather than just expecting a good standard of living to be handed to them effortlessly on a plate by their employer or the state. And yet, Thatcherism also carried forward much of the ethos and attitudes of the 1960s and 1970s: the anti-union and anti-industrial-working-class antagonisms on the part of the Thatcher government were in a sense the continuation of the 1970s industrial unrest, with the difference that Thatcher took on and saw off the unions, whereas Callaghan tried to instil reason in them through comradely beer and sandwiches at No. 10. Similarly, the materialistic individualism and hedonism of the ‘I’ve-got-money’ 1980s was a continuation, in the selfish-capitalist Thatcherite mode, of the increasingly cynical, materialistic direction that originally idealistic 1960s explorations of self-fulfilment and sexual freedom had followed in the 1970s.

So what of David Cameron, then? Are we about to enter into the ‘Cameronite’ reaction against Blairism and its feeble successor / continuation that is GB; just as the ineffectual Major saw out the dying phase of the Thatcherite period, and Callaghan stood watch over the waning of the initially optimistic Wilson Labour years – all prime ministers that took over mid-term from leaders that had really set the political tone for a whole period, but whose increasing unpopularity was a sign, perhaps, that one period was on its way out and the new epoch was about to begin?

If so, then a putative Cameron era, following my theory, should be both a continuation of some aspects of the preceding period (the Blair / Brown epoch), and a harking back to and blend of some aspects of the period before that, during which the leaders of the new age were growing up – which, in the case of Cameron’s relatively youthful team, was mainly the Thatcher years. Incidentally, the fact that it is now being said that people are no longer ’scared’ of the Tories, for all Cameron’s charm, probably owes more to the fact that the people in the worlds of politics, business and the media who are, as it were, ‘of the same age’ as Cameron (or younger, as are many in his team) and are preparing his coronation grew up under Thatcher and would have regarded her attitudes and politics as normal, not as a grim assault on so much that my generation (growing up in the 1970s: the latter end of the ‘Blair generation’) held dear.

But we’ve already had the Thatcher ‘revival’: that was Tony Blair – Thatcherism with a socially caring face. And that’s part of the problem faced by David Cameron’s Conservatives (the ‘New Tories’ in all but name): they want to be ‘Conservatism with a caring face’ but Blair has already done that. So perhaps they’ll just have to reverse the paradigm and become ‘a caring society with a Thatcherite face’, perhaps?

The difference between these two terms can perhaps best be illustrated by the ambiguity of the ‘tag line’ – as the marketing bods might put it – for Cameron’s party philosophy: ‘modern compassionate Conservatism’. ‘Modern’ and ‘compassionate’: here are two words that could have been plucked straight from Blair’s vocabulary; and they sit comfortably – naturally almost – alongside ‘Conservatism’. Indeed, Conservatism has always been associated with the idea of compassion (of the wealthy) for the poor, and with social, philanthropic responsibility towards them. So this conveys the idea of classic, one-nation Conservatism (the Conservatism before Thatcher) – which in one sense was the space in the political spectrum that Blairism inhabited – but modernised in keeping with the challenges of today.

On the other hand, if you just insert a comma into the phrase, as follows – ‘modern, compassionate Conservatism’ – it changes the whole meaning. Syntactically, ‘modern compassionate Conservatism’ suggests a ‘compassionate Conservatism – single concept: one-nation conservatism – that is modern’. ‘Modern, compassionate Conservatism’, on the other hand, implies a ‘modern Conservatism, one of whose distinguishing features is that it is also compassionate’; in contradistinction to a previous form of Conservatism – Thatcherism – that is perceived as having lacked compassion. But by implication, this could suggest that the modern, compassionate Conservatism is also an updated, more compassionate version of Thatcherism itself. So this tag line is appealing to all three strands: modern, ‘Blairite’ care and compassion for the poor and disadvantaged in society (in keeping with the traditions of one-nation Conservatism) that also draws on all that was ‘good’ about Thatcherite Conservatism – its effectiveness, leadership qualities, appeal to English-British people’s distrust of state interference and ‘nannying’, and their wish to provide the best for themselves and their families, using their own skills and hard work, whether in material comforts, housing, health or education.

This in essence is the appeal of Cameron. On the one hand, he’s Blair Plus: embodying all that’s ‘good’ about Blair (the concern to alleviate society’s ills), but if anything pushed even further. Instead of Blair’s reform agenda, which in essence was economic reform (instilling market principles into the public services), we have a social reform policy. Instead of merely tinkering with the benefits system, attempting to provide more efficient public services and carrying out a bit of inner-city regeneration, Cameron’s Conservatives have set out their stall as a party that’s really trying to get to the bottom of what has caused the collapse of stable, responsible society in so many of our cities, and have so far come up with a rather traditional Conservative answer: that it’s about the break-down of the two-parent family, the absence of father figures, and the lack of discipline at school and in the home. And what is seen as being absent in such social contexts are the very values that Cameron is trying, in more neo-Thatcherite mode, to invoke as being at the heart of his political programme: individual and collective responsibility for making things better, rather than relying on central targets and the nanny state to deliver the improvements.

The initial outline of the vision that we were given at the Tory party conference last autumn suggested that one of the forms this new affirmation of the Thatcherite principles of personal moral responsibility for improving the things that matter to you in life could take was that of ‘local privatisation’: rolling back the frontiers of government and public-sector ownership and control not just at a national level but at the local level where people are users – ‘consumers’ – of services. So, for instance, rather than the Blairite approach of setting out a single blueprint for introducing market principles into schools and hospitals, which often meant putting them directly or indirectly in the hands of major corporate enterprises, the Cameron policy could well involve local people themselves taking managerial responsibility for their schools and hospitals – whether in the form of continuing public ownership of some sort (for instance, through trusts), or by actually establishing new schools (or taking over existing ones?) as businesses in which local people could take out shares and which would genuinely have to compete for private and public funding – while service levels were guaranteed, perhaps, through some form of charter and contractual agreement with local authorities.

To some extent, the finer details of this are just speculation, as the Conservatives have yet to outline their specific policies. But it’s informed speculation based on Tory statements, and reports into things like the family and the problems of the inner cities they’ve already produced; but also based on this generational theory of mine: that the Tories have this dual motivation to carry out the social-market agenda of Tony Blair more effectively and profoundly, and to do so in a way that resurrects the best principles of the Thatcherism they grew up under. This involves the idea of empowering and motivating ordinary individuals and communities to take responsibility for improving their lives by giving them a stake and a real say in the things that are most important to them. I think that however these fundamentals of ‘Cameronism’ are translated into tangible policy, they will help the Tories to win the next election because the people who are most influential in shaping public opinion were formed under Thatcher and want to see a return to her values of self-reliance and of the public taking private ownership of, literally, their own public services.

Looking at the massive nationwide swing to the Tories in this week’s local elections, the psephologists have come out with their usual meaningless predictions about how a general election would turn out on the same shares of the vote: a Tory landslide, with a possible 150-seat majority. What if this did happen, though? Would this mean, as Anthony Barnett of the OurKingdom blog put it, that “any democratic reform agenda is now in jeopardy”? The point is, if Cameron did win a comfortable outright parliamentary majority, he could – and probably would – ignore all the widespread support and calls for constitutional and institutional reform, such as a more accountable parliament (better still an English parliament), reform of the House of Lords, PR, a genuine bill of rights that protects civil liberties, and even an English Grand Committee to discuss England-only bills (why bother if the Tories have a majority both of English and UK-wide MPs?). Cameron might be a social and economic reformer at local level, but at national political level, it would not be in the perceived interests of his government or his party to do a single thing.

Cameron is no more interested in addressing the English Question, nor even in uttering the word ‘England’, than is GB. When Cameron talks of ‘our nation’, he means ‘Britain’ not England, even if the policies that are being discussed relate to England alone. Indeed, he has gone on record, in a Telegraph interview a few months back, as saying he’s not interested in being a PM for England – even though that’s what he effectively will be in most of his domestic agenda. And there seems little difference in the Tories’ description of their ‘responsibility agenda’ below from Brown’s emphasis on Britishness and his bringing together of the formulation of citizens’ rights with prescriptions about, and enforcement of, their responsibilities: “To make the most of the new world of freedom, we need to strengthen the structures which bring stability and a sense of belonging: home, neighbourhood and nation. Our Responsibility Agenda will therefore include Green Papers on welfare reform, health, marriage and relationships, addiction and debt, responsible business, social care, cohesion, and National Citizenship Service” (my emphases).

Like I said, the Cameron era will in many respects be a continuation of the Blair / Brown period. And it seems that the efforts to articulate, formalise and impose prescriptive definitions of (British) national identity and citizenship / responsibilities will be part of the baggage that is carried forward. I suppose that that’s also part of the Conservative unionist tradition and the British-nationalist Thatcherite legacy that the Cameron era will reaffirm; so there’s a ‘natural fit’ there between Brown’s wrapping of himself in the Union Flag and the New Conservatives.

There’s no doubt that the Conservative values, and the generational swing back to them, that Cameron appeals to are also in many respects English values: self-reliance, freedom from government interference, private ownership and enterprise, social responsibility and neighbourliness, and fairness towards the ‘poorest’ in society – as the Conservatives’ website continually refers, somewhat patronisingly, to the working class. And, in this respect, if English voters are largely responsible for electing a Conservative government with a large majority next time, then they can hardly complain when that government ignores the demand for an English parliament – except, of course, that government won’t have been elected by a majority of English voters; and if none of the major parties are even vaguely talking about the possibility of an English parliament, then the English people aren’t being offered the chance of voting for one.

This raises the possibility that the best hope for representative democratic English governance, accountable to the people of England, could again come from Scotland. Scotland and, to a lesser extent, Wales are unlikely to swing towards Cameron’s Conservatives to the same extent as the English. This could mean an increasing polarisation between ‘Tory England’, and nationalist and Labour Scotland and Wales, potentially resulting in growing antagonism and political divergence between England and the rest of the UK. Together with pressure in England to reduce the Barnett differentials (the formula guaranteeing Scotland and Wales a higher per capita level of public expenditure than the English), this could really give the Scottish-nationalist cause a massive shot in the arm. And, who knows, there might yet be a Scottish referendum that would say ‘yes’ to independence.

Cameron’s Conservatives, by continuing Brown’s Britishness crusade, might well yet set the seal on the Union’s demise. In which case perhaps, in ten years’ time, we might all be saying, along with Bruce (the English one, that is), “didn’t they do well?”

He said it! As a matter of fact, GB [Gordon Brown] said the word ‘England’ four times in his nearly 12-minute-long interview on BBC Scotland’s The Politics Show on Sunday. The nature and context of those references reveals the heart of the dilemma GB is wrestling with in relation to devolution: his lack of accountability to the people of England for the decisions he takes on their behalf.

In this respect, the first of GB’s mentions of England, about three minutes into the interview, was hugely significant. He referred to the recent vote in the Scottish Parliament that “we should review the arrangements which govern the relationship between Scotland and England, particularly the financial accountability relationships”. You have to be on the alert to spot this one, as GB says ‘England’ quickly and under his breath, not articulating the word properly – a not uncommon syndrome on the part of New Labour politicians when forced to acknowledge the existence of England.

So GB’s almost physical difficulty in spitting out the word ‘England’ arises in the context of ‘financial accountability’. This also means democratic accountability: GB is talking about the idea, to be discussed in the proposed devolution review, that the Scottish Parliament should have the power to raise more of the tax income it actually spends, making it more accountable to the Scottish electorate for that expenditure. In the interview, GB evades the possible implication of this, which is that the Scottish Parliament might have to increase certain taxes from their current amounts in order to maintain the relatively high level of public expenditure per head of population in Scotland, and so reduce the subsidisation of that expenditure by the central UK government.

What the rather extraordinary, if barely audible, reference to England (rather than the UK or Britain, as usual for GB) in this context involves is an almost literally tacit acknowledgement that it’s England, more especially the English people, that subsidises Scottish public expenditure; and that, consequently, there’s a problem of financial / democratic accountability for this to England. This problem could come into even starker relief if the Scottish Parliament were responsible for raising the majority of its own revenues. Such a situation would increase the incongruity and injustice of the fact that Scottish Westminster MPs are allowed to vote on government expenditure in England, while English MPs (and, in fact, those Scottish MPs) would have even less input than now into determining the level of public expenditure in Scotland. And this would doubtless lead to more pressure for Scottish MPs either to voluntarily desist from exercising this right (through an English Grand Committee) or for this right to be withdrawn from them. The consequence: MSPs gaining more control over Scottish policies and expenditure; Scottish MPs having even less influence in Scotland, and now even less to do at Westminster, as they could not participate in England-only business. The rationale for Scotland continuing to participate in the Union and its parliament would be eroded still more and Scotland would be one step further down the road to independence. Meanwhile, the position of GB and his government would be further compromised: as a Scottish MP, what right would GB have to formulate policies and dictate expenditure for England? His government would be, and would be revealed as being, in even more respects an England-only government; and how can that be led by someone not even elected in England?

So why does GB appear to be accepting the possibility that the Scottish Parliament should have greater tax-raising powers? In fact, this is a ploy, and he doesn’t want to do this. Actually, GB is implicitly threatening the Scottish Parliament and the SNP with having to increase taxation in Scotland in order to finance their programme. In other words, it’s more a question of Scotland having the power (i.e. no other choice than) to raise more taxes, rather than having more tax-raising powers. In this context, it is significant that two of the other references to ‘England’, towards the end of the interview, arise in connection with a possible re-evaluation of the Barnett Formula: again, the critical ‘financial accountability relationships’, in GB’s words, between Scotland and England. Here, however, as in the rest of the interview, GB’s explicit reference is to the UK-wide impact of any changes to the devolution settlement, rather than to bilateral Scotland-England relationships – although these are clearly implicated. The PM states that the Barnett Formula doesn’t just affect Scotland or England but the whole of the UK and all its constituent parts. Then, in a response to the interviewer’s question about comparisons between public expenditure in Scotland and some of the English ‘regions’, GB makes passing reference to the existence of statistics setting out the level of expenditure in the regions of England – without acknowledging that these reveal that Scotland is getting a better deal than any of them, with the possible exception of London.

By referring to the Barnett Formula in this way towards the end of the interview, GB is clearly expressing a reluctance to abolish it altogether, simply because of pressure from the Scottish Parliament to have more responsibility for raising its revenues. He’s effectively reminding his Scottish audience that it’s the Barnett Formula that guarantees Scotland a higher level of public expenditure per head than the Scottish people could possibly afford if they lacked the subsidies provided by the central UK government. This is part of a benign appeal by GB, throughout the interview, to the benefits Scotland receives from being part of the Union. Another example of such benefits is in the area of security. In relation to terrorism, GB said there could be “no Scotland-only, no Wales-only, no England-only solution [the fourth reference to 'England']“. In other words, Scotland benefits not only from the financial patronage of a benevolent UK state but also from its power as a force for protection from external threats. However, this reference to security is in fact given in response to the questioner’s somewhat half-hearted attempts to tease out of GB what he meant by saying that devolution was not a “one-way street”, i.e. that some powers could be taken back by the Westminster government, such as in the area of justice and security.

The fact that policing and the legal system in Scotland is the responsibility of the Scottish Government does of course have implications for the national security of the UK, as was evidenced two weeks ago by the decision in principle to admit phone-tapping evidence in terrorist cases in England and Wales, which, as it stands, cannot be implemented in Scotland. But this is not the point here: GB is effectively threatening the Scottish Parliament and the SNP that if it presses the point about having greater powers in some areas (e.g. raising taxes), it may be necessary to remove some of its powers in other areas (e.g. justice), ostensibly in the interests of the whole of the UK, and of Scotland as part of the UK. The use of anti-terrorism as an example is calculated to appear more reasonable and benign than if other perhaps more expensive areas of Scottish governance had been singled out, such as the heavily subsidised healthcare and education systems. But the underlying implication is that, basically, anything could be up for grabs and no area of Scottish self-rule is sacrosanct; after all, it’s devolution not definitive separation, which means that the Westminster government’s prerogative to take back any powers at any time remains in place.

The message to Scotland is, if you want to raise more of your taxes, you might have to raise more taxes; and if you want to offset some of the increased tax burden on Scotland this would involve, you might have to cede certain areas of government back to Westminster. Such an outcome would mean:

• more accountability on the part of the Scottish parliament to its electorate for the portion of public expenditure for which it was directly responsible
• a reduction of the scope, and hence the amount, of this expenditure through a reduction of the powers of the Scottish government
• an increase in the proportion of public expenditure in Scotland for which the Westminster parliament was directly responsible, with the consequence that Scottish Westminster MPs were more relevant again, in that they had more input into policy and expenditure for Scotland
• a reduction in the English sense of injustice about the Barnett Formula and the West Lothian anomaly, even while these inequalities remained in effect. This would be because more of the decision making about Scottish public expenditure would be rolled up into the decisions and voting about expenditure for the UK as a whole, from which it would not be so clearly differentiated. And if Scottish MPs were not voting so obviously on England-only matters but on UK-wide matters (even if these involved continuing to favour Scotland and Wales over England in the distribution of the public purse), this would be seen as more democratically legitimate and accountable than the present state of affairs.

I’m sure that GB would like to move in this direction, in that essentially his whole model of governance is one of a central UK government making decisions for the whole of Britain in the name of the ‘British people’, of which the Scottish people in his view are an integral and (merely) devolved part. Towards the end of the interview, GB refers several times to “the people”, the “British people” and the “Scottish people” – but never once to the “English people”. Of course, he doesn’t: he’s not governing in their name, after all. In his concluding rhetorical flourish, GB makes great play of how important and integral to him are Scotland and the Scottish people, and their continuing place in the UK for which he effectively positions himself as the guarantor.

But what of England and the English people? The interview makes it clear that the devolution review is going to be run from Westminster, even though it involves (no more than) the participation of representatives from the Scottish parliament – and despite the fact that GB makes great play of the fact that it was the Scottish Parliament that voted for it. And it’s a review for Scotland, parallel to the review concerning a possible extension of the powers of the Welsh Assembly, as GB himself points out. But there’s to be no such review or discussion about devolution for England.

So Scotland is being told that if it pushes too hard for more tax-raising powers, it may need to lose some of its political powers – and do so, perhaps, simply to remain viable. GB is saying, ‘if you want to raise proportionally more of your own budget, the UK government will withdraw some of its subsidies unless you cede control of more items within your current budget back to the UK government – otherwise, the political and financial cost to the rest of the UK (and of “England”, under the breath) of the present devolution settlement will be unsustainable’. Perhaps best, then, not to rock the boat too much and continue with the cosy arrangements of the Barnett Formula, which in its fundamentals the government is not calling into question.

Either way, the English people won’t need to be consulted. After all, accountability to England for the government’s actions taken on behalf of ‘Britain’ and of ‘Scotland’ is the last thing anyone wants – least of all, the MP for Kirkcaldy.