In the spirit of praising best practice when it arises, I feel it incumbent upon me to record that, for once, the BBC’s radio and online reporting of Wednesday’s Queen’s Speech was exemplary in pointing out when the proposed legislation related solely or mainly to England and not the whole of the UK. The news broadcasts I heard on Radio 4 pointed out explicitly that the key measures for schools, the NHS and social care applied to England alone: something quite unprecedented for the BBC. And the summary of the legislative programme on the BBC website indicated for each item which UK nations they related to. E.g. Children, Schools and Families Bill, “Whole bill applies to England. Other parts cover Wales and extends in part to Northern Ireland”; Personal Care at Home Bill, “Applies to England only”; and Health Bill, “guaranteeing cancer patients in England a consultation within two weeks, a free health check for all over-40s and that no-one will have to wait more than 18 months [I think that should read 'weeks'] between a GP referral and hospital treatment”. Well done, BBC!

I can’t comment on the TV news or on other news media, as I didn’t see them. But I was further encouraged yesterday by Radio 4’s reporting on the farcical row that has broken out about the proposals for free personal care, with some Labour MPs complaining they have pre-empted the conclusions of a consultation that ended only this week (a blatant case of electioneering, then). The Radio 4 report, on ‘Today In Parliament’, was prefaced by the mention that the proposals related to England only.

If the BBC can make it clear in this way which parts of the UK the government’s legislative programme relate to, then there’s hope that, come the general election, it will similarly make an effort to point out which of the UK’s nations are affected, and which are not, by the policies the parties present and debate during the election campaign. In any case, I’m keeping a watching brief and will be bashing off further emails of complaint should the occasion arise. I nearly did so the other night, in fact, when I heard a BBC World Service discussion on the work of NICE (the National Institute for Clinical Excellence): the body that decides whether to approve drugs for the NHS in England and Wales based on a cost-benefit analysis. The World Service report failed to mention NICE’s geographical remit, implying that its work related to the whole of the UK; whereas we know that Scotland enjoys better per-capita funding than England for drug treatments and is not under NICE’s thumb. But it was kind of late; and I need to get out more!

I have, however, received a holding reply to my last complaint, about the misreporting of the government’s proposals for ten new nuclear power plants, all but one of which are to be located in England – and none in Scotland (wonder why). So watch this space.

I’ve been trying to work out why the Queen’s Speech detailing the Labour Party’s so-called programme for government up until the general election is so vacuous. Apart from the obvious things, that is: no mention of unemployment or immigration; no indication of precisely how the government – and which government – will fulfil its new statutory obligation to halve the UK’s fiscal deficit in four years at the same time as meet its pledges on public services; referring to all of the proposed bills as if they applied to the whole of the UK in a blanket fashion, whereas many of the key measures relate to England only; the complete lack of the word ‘England’ from the Queen’s speech, indeed, whereas Scotland, Wales and Northern Ireland were promised increased devolution; the total absence of references to reforming parliamentary expenses, let alone the thoroughgoing political and constitutional reform that all the parties paid lip service to back in May and June of this year; and the reality that virtually none of the legislative programme will actually make it onto the statute books before the election, and that what does become law may well be reversed by an incoming Conservative administration. What a pointless exercise, which illustrates how irrelevant and remote from people’s lives Westminster has become.

And I suppose that, in essence, is why it is all so vacuous: a process of British governance merely going through the motions and becoming almost self-referential rather than engaging dynamically and honestly with the people on whose behalf the work of government is supposed to be carried out. British law rather than government of, for and by the people of England. I guess that’s why the government feels it needs to legislate – or at least put forward legislation – for its commitments on public services and fiscal policy rather than just make those commitments and engage in debate about them. It’s as if the reputation and legitimacy of Parliament and this government have fallen so low that it’s no longer enough simply to promise to do something: you have to make those promises binding in law. But legislating for something doesn’t make it legitimate. This is British-parliamentary law making instead of real government and leadership, which involves engaging with people’s real lives, concerns and needs. In this sense, the absence of any verbal reference to England is the symptom of an unwillingness and lack of competency – in both meanings of the term – to be a government for England, even though that is what the British government is supposed to be in so many areas.

Look at the actual commitments the government is making to England (without saying so) in the form of statutory obligations that mostly won’t become statute anyway, and so aren’t worth the parliamentary Order Book paper they’re written on: binding commitments for suspected cancer sufferers to see a specialist within two weeks of a referral, and that no one should have to wait more than 18 weeks between a GP referral and a hospital appointment for other conditions; a commitment to provide one-to-one tuition to schoolchildren who need extra help; free personal care at home for the 280,000 most needy individuals plus other measures to help those already receiving free care or for those entering care homes. All very worthy commitments in themselves, but they come across as rather random. Why the priority on cancer referrals, as cancer is already comparatively well funded, rather than other aspects of health care that urgently need attention, such as strokes, the standard of personal care health professionals are able to provide patients in hospital, hospital hygiene, mental health, etc. etc.)? And what is the vision for the school system and for education as a whole in England, and, in particular, how is the government going to address the problem of failing schools, let alone that of failing pupils? The truth of the matter is the government doesn’t have a vision for English schools, in part because it can’t even acknowledge the name of the country for whose education system it is responsible. No vision of England means no vision for England’s NHS or health-care system.

And don’t even get me on to the subject of personal care, where the government still isn’t doing anything like what the Scottish government has been doing for years thanks to its generous funding via the Barnett Formula: free personal care at home for all who need it, irrespective of their financial means. Now, I’m not saying that we could afford such a level of provision in England, especially in these straitened financial times; but then, can we afford it in Scotland, either? How about drawing up a ‘Fairness In Government Bill’ specifying the minimum and maximum levels of public-service provision across the whole of the UK that are appropriate to different degrees of fiscal deficit – free personal care needing to be capped at a certain level, for all UK citizens, once the national debt reaches a specified amount? Oh, but I forgot: despite giving the impression that it could do something like that, the government can’t because of devolution. Well then, better still, give us an English Parliament, and then the fairly elected representatives of England could decide the level of taxation, borrowing and social-care provision that England can afford for its own people.

Because that’s what’s lacking in all of this: any kind of attempt to formulate policy for England that reflects English people’s priorities and preferences. Do we actually want the government’s nebulous ‘National Care System’, affiliated to the NHS, to be the centrally managed channel for government funding for and provision of social care? Wouldn’t we in England rather have a system that was managed and funded closer to the people it was aiming to help: through local authorities, communities, private providers, voluntary organisations, and direct financial and practical support to individual carers, rather than through some Whitehall-managed bureaucratic machine? But we’re not having this discussion because the government has given up, or perhaps has never wanted to be, this sort of genuine government for England.

But the Labour Party does have a vision for Britain. Except it’s a Britain of the past, not the Britain of the present, or a Britain and England of the future. On the same day as this most inconsequential of Queen’s Speeches, the Labour Party aired an extraordinary party-political broadcast:

In this embarrassing act of self-praise, the Labour Party identifies with Britain itself and with every major progressive movement of the 20th century, of which Britain is portrayed as having been in the vanguard. Well, perhaps not every movement: I’m sure there’s a brief flash of a CND march accompanying the commentary on the anti-apartheid movement – an intentional subliminal reference, perhaps, to give heart to socialist idealists that the Labour Party still represents them; but better not refer to this explicitly. And, needless to say, there is absolutely no reference to England even in the bits of the broadcast that refer to the England-only policies: the commitments about NHS treatment times; “free personal care for those who need it” (what, all of them?); the creation of a National Care Service (for ‘Britain’? no, it’s England only). Oh, of course, and no reference to the ‘achievement’ of devolution or to any of the actual policies the Labour government has carried out in England only: NHS prescription charges, parking fees, and life-prolonging drugs withheld, where these either do not apply or are provided respectively elsewhere in the UK (healthcare apartheid, in short); a target- and performance-driven education system that still has not demonstrably improved standards or focused on the needs of the economically and educationally disadvantaged – compared with a radical reform of the educational philosophy and system in Wales; free personal care in Scotland only.

Instead, Labour’s vision is a misty-eyed view of a past in which people did genuinely believe that Labour could deliver real change, and greater social equality and opportunity, for everyone across Britain; and in which it possessed the tools to deliver much of that agenda when it was in government. But Labour has in reality given away and abandoned that holistic vision of a united ‘British nation’, of social solidarity across the whole of the UK, and of concern for the needs of working people and those who cannot work, for one reason or another. And it’s also given away the levers of government to realise that vision. And so it retreats into a sterile sham of UK-wide law making underpinned by a dreamy re-writing of British history that places it at the centre of all meaningful social reform over the last 100 years: as much as to say that if it is elected into government again, it will continue the fight for progress in Britain.

But what will it actually do for England? And is it even bothered to ask the people of England what they want? Until it does, all its British law making and myth making will just be so many hollow words and fantasies.

Below is the text of an email of complaint I sent to the BBC yesterday:

By the way, while I’m on the subject, the website for the Infrastructure Planning Commission is a classic example of the way many websites for England-specific government departments or quangos contain very few up-front references to the actual name of the ‘nation’ they’re supposed to be serving. If all you look at are the home page and the general ‘about’ pages, often the only way you could be sure these are UK organisations of any sort is by looking at the web address or by other indications such as language and web-site design. Other classic examples of the genre include the (English) Department of Health and the Department for (English) Children, Schools and Families, whose website proclaims: “The purpose of the Department for Children, Schools and Families is to make this the best place in the world for children and young people to grow up” – ‘this’ being the way they refer to England. I wonder what cyber visitors from other countries make of this shame-faced way of suppressing references to your own country, whereas their government websites plaster the name and symbols of their nations all over the place; contrast the French Health Ministry or the German Environment Ministry. I suppose at least they have the decency not to stick the Union Jack on all the pages and refer to ‘the country’ as Britain on these websites; instead, they avoid explicitly naming the country at all.

Yesterday, I also received a reply to my earlier complaint about an episode of BBC1’s ‘One Show’:

In essence, this response amounts to dismissing my complaint about the programme’s failure to clarify that the government’s proposal related to England only as a personal preference rather than a substantive criticism that the lack of such an indication was fundamentally misleading: in this instance, perpetuating the ignorance of English viewers that the government’s education policies apply to England only; and, in the case of non-English viewers who are not especially well versed on the effects of devolution, potentially alarming them about something that in fact does not affect them. Note the sheer ignorance and complacency of the sentence, “some mention of the fact that the Governments proposal is limited to England at the moment”: no, it’s not ‘at the moment’, you utter ignoramus – any UK government proposal on these matters can only ever relate to England only, unless there are plans to reverse devolution. Trouble is you can’t reply to these BBC emails, but you have to do a whole new complaint. So this is effectively my response.

I also note that Ruby Wax talked only to people on English streets and English education specialists. Why not go and talk to people in Glasgow or Cardiff if the programme was merely mooting a general idea? Well, that’s because this would make the (intended?) implication that the government’s ideas were relevant to the whole of the UK far more explicit; and hence would make the programme more vulnerable to accusations of misleading inaccuracy when reporting on England-specific affairs.

Clearly, the item was relevant to Britain only in one of the modern meanings of the word ‘Britain’, which is ‘England’. But the One Show is predicated on the lie that there is still just One Nation in political terms.

Oh well, we’ll keep chipping away.

As a kind of neat synthesis of and addendum to my previous three posts, relating to multi-culturalism and the BBC One Show’s failure to say ‘England’ when England is meant, I stumbled across this One Show article about ‘multicultural Roman Britain’.

The report, by black presenter Angellica Bell, focuses on the discovery in York of a fourth-century skull which, an expert explains, must have been that of a black-white mixed-race woman. And not a slave, either; but a wealthy person with a comfortable lifestyle – perhaps the wife of a Roman soldier stationed in the city.

But the bit that I find really hilarious is that the whole report is framed at the beginning by shots of Hadrian’s Wall: the northern frontier of the Roman Empire, and the original border between Caledonia (Scotland) and Roman Britannia. This makes it quite clear that when the report that follows refers to Roman ‘Britain’, it actually means what we – or some of us – now like to call England (and Wales): the territory that constituted the Roman province of Britannia. Later, the report refers to York as a vital northern fortress city for Roman ‘Britain’; but in fact, it was a frontier city only by virtue of the fact that the Britain of that time corresponds to the England of now.

From a single skull, the report extrapolates to a picture of a highly multi-ethnic, cosmopolitan Roman Britannia, which is then explicitly compared with the multi-cultural character of ‘Britain’s’ cities today. But the report has gone out of its way to indicate that the ‘territorial extent’ of that multi-cultural Britain – then as now – is actually England (and Wales). As much as to say that ‘”Britain” has always been multi-cultural, even from Roman times’, i.e. from before the Anglo-Saxon invasions that transformed it temporarily into an apparently mono-cultural and mono-ethnic ‘England’.

And so the ‘multi-cultural Britain’ that has replaced the distinct, homogeneous, national and cultural identity of England under New Labour is projected by the programme back to pre-English times, making it appear somehow more authentic and historically rooted than the English tribe itself – now seen as just one of the many ethnic groups that have migrated to ‘Britain’ over the centuries and continue to do so. And yet what is referenced by the term ‘multi-cultural Britain’ is England only.

No wonder the One Show can’t seem to be able to say ‘England’ in relation to present-day English matters: for them, it seems, the country has only ever been ‘Britain’.

Below is the text of an email of complaint I’ve just sent to the BBC regarding tonight’s One Show programme on BBC1:

“I am complaining that the feature in tonight’s One Show about the government’s proposals to provide elementary careers advice to seven-year-olds in schools completely failed to clarify that the proposals affect England only. Schoolchildren in Scotland, Wales and Northern Ireland will not have such ridiculously premature careers guidance imposed upon them; but this was not mentioned. Nor was it indicated that the direct activities of the ‘National’ Children’s Bureau (a name implying UK-wide responsibilities), whose spokesperson was interviewed in the feature, relate to England only.

“The subject matter of this specific complaint relates to a general complaint about the failure of the BBC to indicate when policy matters being discussed relate to England only, for which I received a reply from Paul Hunter only this week. Evidently, this is an endemic issue at the BBC.”

The reply to my previous complaint to which tonight’s email referred was the Corporation’s final response to my Open Letter to the BBC calling on them to ensure that English policy matters are clearly indicated as such during coverage of the forthcoming general election. It read as follows:

"Dear Mr Rickard

"Thank you for your recent e-mail.  Please accept our apologies for the
delay in replying.  We know our correspondents appreciate a quick response
and we are sorry you have had to wait on this occasion.

"I must explain that your original complaint contained a link to your open
letter, as featured on an external website.  However as this was you own
material and published on an external website, we aren't obliged to open
the link.

"Despite this, I can assure you that we have noted your comments on this
issue and I fully appreciate that you feel strongly about this matter.
Therefore I would like to assure you that we have registered your comments
on our audience log. This is the internal report of audience feedback which
we compile daily for all programme makers and commissioning executives
within the BBC, and also their senior management. It ensures that your
points, and all other comments we receive, are circulated and considered
across the BBC.

"Thanks again for taking the time to contact us with your views.

"Regards

"Paul Hunter
BBC Complaints"
__________________________________________
www.bbc.co.uk/complaints

I’m going to keep on sending these complaints Paul Hunter’s way from now on. Feel free to do the same!

What follows is something of a ‘thought experiment’, as trendy ‘critical-theory’ lecturers might call it. It’s an attempt to logically think through some of the paradoxes of the British establishment’s present ways of describing itself and referring to its affairs. This is not intended to be a comprehensive analysis, by any means; just an attempt to expose an underlying structure and get inside the establishment mindset.

Case 1: the infamous conception of Britain / the UK as a ‘Britain of nations and regions’. This is obviously closely associated with Gordon Brown, who coined it. But it’s still for many the guiding template for the ‘new Britain’ of the post-devolution era, which requires further constitutional and political reform, including regional / local ‘devolution’ in England. And it even seems to have transformed the way in which ‘the Conservative Party of Britain’, as Gordon Brown erroneously but revealingly referred to it last week (technically, it’s the Conservative and Unionist Party), thinks about the Union, if the participants in that party’s debate on the Union or its proposed ‘Council of the Isles’ are anything to go by: representatives from all the (devolved) nations and from (the Conservative Party of) Britain, but not from England.

The limited question I want to ask here is this: if this new ‘Britain’ is composed of nations (Scotland and Wales, for sure; and more controversially, Northern Ireland) and of regions, what sort of entity is this Britain itself? This is intended as a purely logical question, in the first instance: what is the name for a territory, jurisdiction or sovereign state that has two sorts of subdivisions – nations and regions? A ‘union’ or grouping of nations into a single state tends to be designated as a federation or confederation. As examples of such a union, you can’t really count federal or confederal ‘nation-states’ such as the US or Switzerland respectively, since their subdivisions aren’t nations as such. You’d have to take discontinued states such as the USSR or Yugoslavia, whose subdivisions comprised formerly distinct (though historically variable) national territories that subsequently reaffirmed their status as nation states when the union-states of which they had been a part broke down. The prospective Federal EU that some dream of would be another example.

The USSR is quite a useful example. When it was still in existence, we tended informally to call it just ‘Russia’, because Russia was by far the largest and most dominant nation within the Union. After the break-up of the USSR, Russia itself is now formally known as the ‘Russian Federation’: a Union of many federal states or regions. Applying this analogy to ‘Britain’, it is also the case that throughout most of its history prior to devolution, the United Kingdom was often informally referred to – by English people and foreigners alike – as ‘England’, for similar reasons to those for calling the USSR ‘Russia’. Now, post-devolution, the national territories that had been assimilated into a unitary state (Scotland, Wales and Northern Ireland) have reasserted a status as ‘nations’, albeit not fully sovereign nation-states like the former Soviet Republics.

On this analogy, then, the residual ‘British regions’ would be like the Russian Federation (i.e. effectively, English regions) but without reasserting their identity as a distinct nation as Russia has done. Applying the British model to the USSR (or however it would be renamed), it would be as if the Russian Federation had continued to be called the USSR, and the break-away Republics continued to be affiliated to the USSR but with recognition of their distinct nation status. The ‘new USSR’ would effectively be a ‘Union of Soviet Socialist Nations and Regions’. Such a state would be a ‘multi-national confederation’: a union of nations and subdivisions of nations (regions) having different relationships to the central state and each other, and so therefore not qualifying as a federal nation-state, in which each of the subdivisions would be equal to one another under the constitution.

If such a state had been formed (and the short-lived ‘CIS’, or ‘Commonwealth of Independent States’, was a prototype of something similar), it would doubtless have been imagined by the Soviet-Russian establishment as the means for Russia to maintain control and sovereignty over ‘its’ satellite nations within a single political structure without appearing to do so. But as a condition of achieving this, Russia itself would have had to forego the right to call and run itself as a separate nation, which would have lain bare the realpolitik behind the creation of the new USSR: that it was a means for one nation – Russia – to continue to dominate a number of dependent nations. Instead, officially, the name and nation status of ‘Russia’ would have had to disappear altogether, becoming merely a collection of ‘Soviet regions’ run directly by Moscow and the central-Soviet state, while the ‘nations’ enjoyed a degree of autonomous self-rule.

But what kind of thing would such a state of affairs, or affairs of a state, make the USSR? A ‘multi-national confederation’, yes. But the ‘regions’ within that confederation (i.e. the Russian regions) would actually also be the USSR: run by the state in a fully direct, unitary way; and identified with it, both formally (being called the ‘USSR’) and informally, in that the Russian population would be encouraged to transfer their identification with and allegiance to Russia to the new USSR, which would be the instrument and vehicle for the continuation of a powerful, imperial Russia under another guise.

In other words, the way in which a nation that has previously dominated a number of other nations through a supposedly equal, unitary political system can imagine that its unitary control continues to prevail once those nations start to break away is to re-group those nations into a new unity (new USSR or new ‘Britain’) with which it itself identifies. The former real unitary state (the USSR or Great Britain / the UK) that was often given the name of the dominant nation (Russia or England) becomes a confederation (no longer one nation but multiple nations) the unity of which is maintained in the mind of that dominant nation by a form of mental sleight of hand or fantasy denial of reality: the dominant nation identifies with the confederal state itself – thereby mentally transferring its own identity and personality as a united nation on to the confederal state. A union of multiple nations within a self-identical, homogeneous ‘nation-state’ is replaced by the identification of the leading nation with the new multi-national state. But in that process, the original dominant nation loses sight of its own distinct identity.

Hence, for the British establishment in the post-devolution world, England has become simply ‘Britain’: a Britain imagined as identical to – or co-terminous with – the devolved nations and the state itself. The ‘Britain of nations and regions’, therefore, is a UK [Britain] of [British] nations and English [British] regions: the state, the nations and the regions united in a single identity (Britain) whose ‘existence’ for the English is constituted by a process of identification – transferring English identity, nationhood, values, culture, history, tradition, etc. over to ‘Britain’. In reality, Britain is no longer a unitary state dominated by, and often designated as, England. But the way the establishment has reacted to the loss of the former English-British political union is to replace it with a psychological, existential union (i.e. a ‘union of identity’) between England and the new confederal Britain. But to be considered as a single entity, such a union can have only one name; and ‘Britain’ is the single name adopted for this new confederal structure into which England has been absorbed: disappearing in the process of becoming one-with-Britain, and thereby being the imaginary place in which Britain remains one.

But am I any nearer to answering my original question: what sort of entity is the ‘Britain’ that is subdivided into nations and regions? There’s no real logical answer to that question: you can’t easily call this Britain a ‘nation’, because then you’d have a ‘nation of nations and regions’, and you’d have all sorts of difficult questions about what the relationship was between the ‘mother nation’ Britain, and her national and regional children; and you’d have to explicitly acknowledge the non-inclusion of England as such within the system. But in addition to this logical and political dilemma, the reason why no one can satisfactorily answer this question is the same as the reason why the British establishment is incapable of referring to England as an entity distinct from itself: it’s because what this new Britain ‘really’ is, is England. On the analogy with the imaginary ‘continuity-USSR’ discussed above, England has been identified with the new effectively confederal British state (England ‘becoming’ Britain-as-the-UK; Russia becoming the new USSR) at the same time as that state is a sovereign body conferring a distinct national identity on its other parts, which thereby remain semi-autonomous parts of ‘Britain’. So the new ‘Britain’ is the way an essentially English perception of the former unitary UK as an extension of itself (as ‘Greater England’) is re-imagined as a new multi-national union with which England itself is identified – thereby preserving in imagination the old unity of England and Britain, and the ‘ownership’ of Britain by England; though at the expense of calling England ‘Britain’.

In this sense, England exists (or perhaps ’subsists’ or ‘persists’ would be better) within the Britain of nations and regions not as an ‘object’ that can be described in rational, realistic terms (i.e. as a ‘nation’ or the collective name for a group of regions) but as its subject: it’s the hidden, nameless ‘national’ personality of the trans-national, confederal state – its inner psychological identity. England is in the mind of those English people – politicians or ordinary citizens – that have lived out the state’s identification of England with itself psychologically: in terms of their own personal sense of identity. ‘England’ is the unnamed, suppressed, subjective national identity of those English people who now explicitly identify as British first and foremost: who are content to regard the ‘Britain of nations and regions’ as a description of their ‘country’ and nation. It is, and can only be, English people who identify with the ‘nation’ of ‘Britain’ from which they are content to recognise that three other ‘nations’ have branched out (i.e. separated themselves from English control) and who also recognise that the ‘regions’ in question are regions of ‘their country’: in a more intimate and direct relationship with their country than that with the nations – because they are English regions (regions of their country England) even though it is not permitted to refer to them as such. The whole system only makes sense as an articulation of an ‘English’ point of view: the English ‘I’ (and eye) as it views the new British landscape – nations that are still really ‘ours’ (i.e. British) and regions that are even more so (i.e. English). England is the ‘we’ of Britain; but this fact must not and cannot ever be acknowledged, because then the realpolitik of the new Britain would be blown apart and exposed as an attempt by an England-centric establishment to retain power over a group of ‘other’ nations by re-imagining itself and them as a single entity known as Britain.

This relates to case 2, which I (mercifully) will not have time to explore in such depth: the articulation by national politicians of English matters as British. It is a cause of considerable exasperation to myself and many others that politicians whose ministerial portfolio or responsibilities are relevant to England only, because of devolution, continue to talk as if their policies and actions related to the whole of ‘Britain’. We’ve witnessed this tendency time and time again in this year’s party-conference season: none of the three established parties seems willing or able to refer to English matters as English matters. While it is true that this is a deliberate attempt to blind English people to the differences between English and devolved governance and policies, it is not enough in my view simply to hammer on endlessly about wilful deceit and insulting ignoring of England – which I’ve done frequently enough myself in these pages.

At one level, the fact that politicians and the media refer to English matters as British also reflects the fact that they genuinely don’t perceive the difference. And this is not even the same as saying that they are simply ignorant about devolution: of course, journalists and politicians are rational human beings (relatively so, perhaps!), and they’re aware about devolution in the part of their brains that deals with reality and facts. But rationality and realism are not what’s going on here because, quite simply, carrying on as if matters that relate to just one part of the Union related to all of it is irrational and at times not a little mad – like the recent row over parties’ commitments to the NHS, which was all about the English NHS, in practical terms, despite the fact that not a single item of commentary that I saw referred to England.

No, what’s going on – in addition to deliberate deception – is this process of psychological identification of England with Britain, predominantly by English people. If the politicians and media in question don’t properly make the distinction between England and Britain, it’s because they actually don’t see it (in) themselves: they’ve bought into, and completed in their own subjective minds, the state’s assimilation of England to ‘Britain’. They’re rather like the women in the film The Stepford Wives, who get replaced by identical, obedient automatons that are mechanical apart from one detail: the eyes are taken from the real women. In other words, these politicians and citizens have completed the process of national transformation and now answer only to the name ‘Britain’; except that this Britain is a re-working of an English ‘eye’ / I: a traditional English subjective perspective on the Union.

On this level, it actually doesn’t matter if the politician concerned knows that his portfolio extends only to England, and that when he’s referring to ‘Britain’ or ‘the country’ he actually means England. This is not only or always deceit, which involves passing one thing (England) off as another (Britain), because, in the politician’s mind, they’re not actually two different things: for them, there is only Britain; it’s just that in their particular case (e.g. education or health), their ‘British’ responsibilities stop at the borders with Scotland and Wales. So, in their minds, they’re actually ‘correct’ in referring to the country affected by their policies as ‘Britain’, because that’s how they genuinely see it. But then, of course, if the Britain involved in such cases does not extend to the ‘other’ UK nations, this is another way in which the ‘real’ name for ‘Britain’ is in fact England.

And this is why I believe that a self-governing England, with a distinct national identity, will emerge only when English people – including the English people who by and large still run the British state – are able to disentangle their English subjectivity from the objective reality that is known as Britain. After all, self-government implies that one knows who and what one’s ’self’ actually is; and until English people can accept themselves as English, they will continue to be suppressed ’subjects’ of the British state. Freeing ourselves politically as English citizens, therefore, will follow from freeing our minds to be English.

“Britain – the four home nations – each is unique, each with its own great contribution and we will never allow separatists or narrow nationalists in Scotland or in Wales to sever the common bonds that bring our country together as one. And let me say to the people of Northern Ireland we will give you every support to complete the last and yet unfinished stage of the peace process which Tony Blair to his great credit started and which I want to see complete – the devolution of policing and justice to the people of Northern Ireland, which we want to see happen in the next few months.

“I want a Britain that is even more open to new ideas, even more creative, even more dynamic and leading the world and let me talk today about how we will do more to support the great British institutions that best define this country.”

Gordon Brown, Labour Party conference, 29 September 2009.

Gordon Brown hates England. Or should that be ‘England’, expressing the peculiar aversion our PM has towards the very idea of England – to the extent that he wishes it into non-existence? I defy anybody reading the above passage from Brown’s keynote speech to the Labour Party conference earlier this week not to acknowledge that it reveals an insulting contempt towards England at the very least. The PM refers to the “four home nations” and then mentions three of them by name, although the references towards Scotland and Wales are not especially affirming. But what about England? What indeed – our PM won’t commit the indecency of mentioning the unmentionable!

The Prime Minister is not so shy about referring to Britain; no, he loves ‘Britain’. I counted 61 instances of either ‘Britain’, ‘British’ or ‘Briton(s)’ in his speech compared with none – no, not a single one – to England. This is despite the fact that, as we know, most of the policy announcements in the speech related to England only, or to England and Wales with respect to crime and policing.

Brown’s presentation of English policies as if they were British exemplified all the familiar dishonest and self-serving motivations:

• ‘Create the impression your policy “innovations” affect the whole of Britain to avoid comparisons with Scotland and / or Wales where these policies are more comprehensive and have been effective for some time already’: announcement of a ‘National Care Service’ [for England only] that will provide free personal care for the elderly, but only for “those with the highest needs” – as opposed to the universal free social care provided for Gordon Brown’s constituents. The same applies to Andy Burnham’s pusillanimous announcement of free parking for hospital inpatients and their families “over the next three years, as we can afford it” – as opposed to the free parking for both inpatients and outpatients that already applies in Scotland and Wales. Burnham also conveniently forgot to mention that his announcement related to England only.
• ‘Avoid awkward questions about why a Scottish-elected prime minister is putting forward legislation that does not affect his constituents’: “I can tell the British people that between now and Christmas, neighbourhood policing [in England and Wales only] will focus in a more direct and intensive way on anti-social behaviour.  Action squads will crackdown in problem estates”. Whatever your views on how best to deal with anti-social behaviour, the truth of the matter is that this is a Scottish PM sending in the cops to crackdown on the English (and Welsh) populace.
• ‘Avoid proper scrutiny of the nature and effect of taxation and spending commitments across the different countries of the UK’: “I am proud to announce today that by reforming tax relief [affecting people throughout the UK] we will by the end of the next Parliament be able to give the parents of a quarter of a million two year olds [in England only] free childcare for the first time”. The same goes for more or less any spending commitment: once you mention that a pledge relates to England only, awkward questions could be raised about why England appears to be being given preferential treatment by benefiting from increases in general taxation. Another example: “So we will raise tax at the very top [for all UK citizens], cut costs, have realistic public sector pay settlements [for all UK public-sector workers], make savings we know we can and in 2011 raise National Insurance [across the UK] by half a percent and that will ensure that each and every year we protect and improve Britain’s [i.e. England's] frontline services”.

  Of course, it would be farcical to argue that only English public services will benefit from increases in UK taxation, as any rise in English expenditure gets passed on with interest to the devolved administrations via the Barnett Formula. However, in terms of policy presentation, it is just plain awkward if you have to explicitly acknowledge that commitments to maintain or increase spending on the NHS, education, policing and other ‘frontline services’ relate to England only: it looks as if England is being favoured, even if it isn’t. And if you then have to explain that rises in English expenditure will trigger even greater proportionate rises in the other nations – or, conversely, that if English spending falls, spending in the other countries will fall to an even greater degree – then you can get yourself into real deep waters with voters in England or the devolved nations respectively. Better to just pretend there is one undivided pot of taxation and spending – which there isn’t.

  This is of course going to be a, if not the, major battle ground at the general election; so you can expect all the parties to attempt to gloss over these inconvenient ‘complications’, and the media to ignore them as comprehensively as they did in the coverage of Brown’s speech – none of the commentary I’ve come across, including an extended analysis on the BBC News website, pointing out that much of it related to England only.

All of these reasons for making England out to be Britain were present in spades in Brown’s speech. But the aspect of it I’m interested in highlighting here is the moral character of Brown’s repugnance towards England. The speech sets up an implicit opposition between the ‘British values’ of fairness, responsibility and hard work, on the one hand, and what Brown perceives as the ‘English’ social and individual characteristics of unfairness, irresponsibility and work-shyness / the benefits culture. This view of England forms a subtext to Brown’s paean of praise to the above-mentioned ‘British values’, which are constantly reiterated throughout the speech:

“Bankers had lost sight of basic British values, acting responsibly and acting fairly.  The values that we, the hard working majority, live by every day”

“It’s the Britain that works best not by reckless risk-taking but by effort, by merit and by hard work. It’s the Britain that works not just by self-interest but by self-discipline, self-improvement and self-reliance. It’s the Britain where we don’t just care for ourselves, we also care for each other. And these are the values of fairness and responsibility that we teach our children, celebrate in our families, observe in our faiths, and honour in our communities. Call them middle class values, call them traditional working class values, call them family values, call them all of these; these are the values of the mainstream majority; the anchor of Britain’s families, the best instincts of the British people, the soul of our party and the mission of our government.”

In Brown’s vision, these Scottish-Presbyterian ‘British’ / (new) Labour values must be exercised in reforming and responding to the effectively English crisis of moral values that has led to the economic and social mess we are in. This perspective is evident even in relation to the reserved policy area of macro-economics, in that the near collapse of the UK’s banking sector is linked by Brown to the dominance of an essentially ‘English’ philosophical commitment to self-regulating free markets, and to socially irresponsible behaviour and greed on the part of English bankers.

“What let the world down last autumn was not just bankrupt institutions but a bankrupt ideology. What failed was the Conservative idea that markets always self-correct but never self-destruct. What failed was the right wing fundamentalism that says you just leave everything to the market and says that free markets should not just be free but values free. One day last October the executive of a major bank told us that his bank needed only overnight finance but no long term support from the government. The next day I found that this bank was going under with debts that were among the biggest of any bank, anywhere, at any time in history. Bankers had lost sight of basic British values, acting responsibly and acting fairly.  The values that we, the hard working majority, live by every day.”

Of course, it’s quite preposterous that Brown should now disown the market economics and belief in self-correcting markets that have characterised Labour’s economic policy in government and informed Brown’s own actions as Chancellor. But what I’m interested in here is the ‘national’ subtext: although the above passage does not explicitly say so (but then, Brown never explicitly refers to England if he can help it), the right-wing, Conservative market fundamentalism he describes is associated with English ideology and the English City of London, which would be a familiar association for someone like Brown who cut his political teeth in the battle against the ‘English’ Thatcherism of the 1980s, which was so deeply unpopular in Scotland. Never mind that the bank Brown alludes here to is almost certainly the Royal Bank of Scotland.

For Brown, what is needed to ‘fight’ against this unfair [English] Conservatism and the reckless irresponsibility of unchecked markets is a good dose of ‘British’ morals, and the British values of fairness, responsibility and honest hard work:

“Markets need what they cannot generate themselves; they need what the British people alone can bring to them, I say to you today; markets need morals.
So we will pass a new law to intervene on bankers’ bonuses whenever they put the economy at risk. And any director of any of our banks who is negligent will be disqualified from holding any such post. . . . I tell you this about our aims for the rescue of the banks: the British people will not pay for the banks.  No, the banks will pay back the British people.”

It is this same set of moral / British values that is brought to bear in Brown’s social policies affecting England (plus occasionally Wales) only. The implication is that it’s English moral irresponsibility, lack of fairness and idleness that has brought its society to the pass where it needs a stern application of correct British values to set things right. Take the example of the proposed measures to ‘help’ young unmarried mothers:

“It cannot be right, for a girl of sixteen, to get pregnant, be given the keys to a council flat and be left on her own. From now on all 16 and 17 year old parents [in England only] who get support from the taxpayer will be placed in a network of supervised homes. These shared homes will offer not just a roof over their heads, but a new start in life where they learn responsibility and how to raise their children properly. That’s better for them, better for their babies and better for us all in the long run.”

The opening words here, “it cannot be right”, are ambiguous: they imply that it’s morally wrong for 16- and 17-year-old [English] girls to get themselves pregnant, alongside the explicit meaning, which is that it’s ‘unfair’ and ‘irresponsible’ for [English] councils to give such girls a council flat without any other support. There we go again: reckless English teenagers causing social problems and unnecessary expense to the taxpayer through their immoral behaviour; and English councils compounding the problem by throwing money at them without really dealing with the underlying social and behavioural issues. So Brown’s solution: if English girls in such a situation, who are not cared for by their own irresponsible, dysfunctional families, want the support of the British taxpayer, then they’ll be effectively placed in a form of incarceration where they can jolly well learn how to behave and look after their babies ‘properly’.

The same attitude informs Brown’s announcements on things like tackling the effects of [English] binge drinking, [English and Welsh] anti-social behaviour, and dysfunctional [English] families:

• “We thought that extended hours would make our city centres easier to police and in many areas it has. But it’s not working in some places and so we will give local authorities [in England] the power to ban 24 hour drinking throughout a community in the interests of local people”: clearly, we English drunkards can’t be trusted with ‘24-hour drinking’, in contrast to the Scots with their Presbyterian, responsible behaviour around drink.
• “There is also a way of intervening earlier to stop anti-social behaviour, slash welfare dependency and cut crime. Family intervention projects are a tough love, no nonsense approach with help for those who want to change and proper penalties for those who don’t or won’t. . . . Starting now and right across the next Parliament every one of the 50,000 most chaotic families [in England only] will be part of a family intervention project – with clear rules, and clear punishments if they don’t stick to them”: the British state is now going to take it upon itself to single out the most unfairly behaving, irresponsible and work-shy English families, and will make sure they learn how to stick to the British rules or else get the British stick!

Well, clearly, action is needed to deal with social problems such as these. The point I’m making is that Brown’s prescriptions are pervaded by a deep moral repugnance towards what are in effect characteristics of English society and culture. And that repugnance is not merely incidental, in the sense that they just happen to be English social problems because it’s only English society that the government that Brown heads up can act upon through legislation and policy. On the contrary, Brown has a personal, moral dislike and prejudice towards the English seen in the contrasting figures of the anti-social, indeed ‘anti-societal’, underclass, on the one hand, and the selfish, arrogant upper classes and mega-rich capitalists represented by the likes of David Cameron, George Osborne and the out-of-control bankers, who seek only to protect their own wealth and privileges.

To these images of Englishness, Brown opposes British values personified in what he repeatedly terms the ‘mainstream majority’ of hard-working, responsible working-class and middle-class communities, families and individuals. Brown articulates his and Labour’s ‘mission’ as being that of raising the [English] underclass and humbling the [English] upper classes, so that the whole of society meets in that mainstream middle ground and middle class of fairness, responsibility, the work ethic and meritocracy. Or bourgeois mediocrity and social conformity.

But one thing for sure is that Brown’s mission to reform ‘the country’ involves taking the England out of England, and transforming it into a ‘Britain’ made in Brown’s Scottish-Presbyterian image. And that’s why Brown can never say England: not just out of political expediency but because ‘England’ is the name for a moral decadence that he sees it as his duty to change – in the name of ‘British values’.

The Patients Association – a lobby group that looks after NHS patients’ concerns and rights in England and Wales – yesterday published a shocking report containing 16 case studies of the mistreatment and neglect of elderly and vulnerable patients in NHS hospitals.

It probably won’t surprise my readers to learn that all the case studies in question related to English hospitals. However, this fact appeared to elude the media yesterday. At one point, on BBC Radio 4’s Today programme, it was stated that the case studies were drawn from “across the UK”, wording that was reiterated on the BBC website. Later in the programme, in the news headlines, they did indicate that all 16 case studies involved the experiences of English patients only, while clarifying that people from throughout the UK had contacted the Patients Association with similar examples of neglect. Another article on the BBC website does make this explicit while failing to make clear that not only the examples of abuses but the whole objective and scope of the report are to highlight instances of malpractice in England, and to call on the Department of Health (England) and the Care Quality Commission (the quango that looks after the quality of health- and social care in England) to take action.

Sky News are no better. The report on their website equally makes no mention of the England-only content and purpose of the Patients Association report. The Sky News web page contains a video in which agony aunt Claire Rayner, the president of the Association, asserts that many of the problems derive from the government’s obsession with targets, which force NHS staff to regard patients as mere units and as boxes to tick off rather than real people needing time, care and attention. Of course, this government-driven target culture, and the innumerable targets themselves, affect the English NHS only. They do things differently in the devolved NHS’s.

(Incidentally, I drew the failure of the Sky News report to mention the England-only nature of the story to the attention of their person in charge of dealing with viewer concerns, with whom I’ve been having an email dialogue following on from an open letter to the BBC that I posted on English Parliament Online and drew to Sky News’ attention. I received an initial response from the Sky News executive in question, in which he maintained that Sky does always take care to indicate when a political story relates to England only. I’ve since drawn to his attention two instances relating to the English NHS – including the present one – where this has manifestly not been the case; but I have yet to hear back from him.)

One of the reasons why the lazy media got it wrong – again – is that the Patients Association report does not make it explicit at any point that its observations and recommendations relate to England only. But they do affect only England: as I said, all the case studies concern events that took place in England; and the report’s call to action is addressed only to the authorities that deal with the English NHS. This absence of explicit references to England is in fact a characteristic of all the Patient Association’s communications and campaigns. Indeed, looking at its website, you’d be hard put to work out that the Association’s active campaigning is limited to England and Wales, and then in the latter country only in instances relating to common English and Welsh law. However, reading between the lines, all of the Association’s campaigns dealing with issues of health-care delivery, and the way in which they’re described on the website (with references to ‘the government’ and the Department of Health (England)), emerge as England-specific: GP services, care of older people, health-care-associated infections, dentistry and mixed-sex wards. I then discovered that there is a separate Scotland Patients Association – not affiliated to the (England and Wales) Patient Association – that deals with the corresponding issues for the Scottish NHS.

Why does the Patients Association (England and Wales) appear to go out of its way to conceal the in fact mostly England-specific nature of its activities? This seems in part to be an issue of funding. The PA reported that, after its report was publicised in the media yesterday, it had been “inundated by hundreds of emails and calls from patients across the country contacting us to offer their support and relate their own experiences of poor care”. This will in effect have served as a massive membership drive, and the Patients Association welcomes members (and corresponding financial contributions) from across the UK. It was therefore important for the Association to emphasise that their report deals with issues of concern to people across the UK, which the rush of offers of support and information on further abuses yesterday confirmed. Also, to be fair, the PA does provide information on how to complain about, and seek legal redress for, poor NHS treatment in each of the UK’s nations. But in terms of campaigning for action and change, the Patients Association’s activities are largely limited to England. The Association is in effect soliciting financial support from Scottish and Northern Irish citizens that would probably be more effectively directed to their own patients’ associations, which can actually do something about issues in those countries.

A similar situation applies to corporate sponsorship. The Patients Association’s list of corporate sponsors contains some impressive names; e.g. AstraZeneca, Denplan, GlaxoSmithKline, Johnson & Johnson, 3M, Napp Pharmaceuticals, Pfizer and Virgin Healthcare. Compare these with the sponsors of the Scottish Association: Arnold Clark, Barrhead Travel, It’s so Easy! Travel Insurance, Lloyds Pharmacy, Mobility Scotland, ScotWest Credit Union, Ross Harper Solicitors and Vision Call – Eye Care Home Services. Hardly as prestigious nor, one suspects, as remunerative! The Patients Association is clearly passing itself off as the ‘British’ association in order to secure the backing of such global blue-chip enterprises. Does it fear that if it more accurately designated itself as the Patients Association for England and Wales, it would lose some of these sponsors and the revenue they bring, and would have to rely on more ‘parochial’ English names?

On one level, I am reluctant to criticise the Association for this, as it is clearly important that it maximises its income in order to act as an effective advocate for English and Welsh NHS patients. However, is this advocacy not itself severely impaired and limited by the Association’s almost total avoidance of references to England, or to England and Wales, in the campaign material it puts out? Referring to issues relating to health-care delivery in England without any reference to England itself, as if they were issues of relevance to the whole of the UK, insulates the Association’s critiques and prevents them from becoming a truly powerful cross-UK analysis involving comparisons between practices, patient satisfaction and funding in each of the UK’s health services. It is as if the Association does not want in any way to connect its criticisms of bad practice in England with the politics of devolution, and of health-care funding and provision in the rest of the UK. But isn’t it vitally important to compare the experience of patients in England with that in Scotland or Wales; and if they’re doing things better in those countries, what can we in England learn from them – and do we need to direct more funding into improving the situation in England, given that per-capita expenditure on health care in England lags that in the other UK nations?

But clearly, the Patients Association has decided to avoid getting enmeshed in such political controversies. It would rather carry on working away in its own little bubble: drawing its concerns to the Department of Health (England) and the (English) Care Quality Commission without embarrassing either of these bodies by pointing out to the public that they’re letting England down compared with the corresponding bodies in the other UK countries that are more focused on the needs of their countrymen and -women. After all, rock the boat too much, and you could put off the corporate sponsors; and go on about England too much, and you could put off the individual members from Scotland and Northern Ireland.

But is it possible for the Patients Association to help bring about real improvements to the care provided to English NHS patients if the Association itself doesn’t care enough about England to mention her by name?

Hard to say which is the greater victory: England beating the Aussies to regain the Ashes or the fact that this victory forced Gorden the Ashen One to at least write – if not speak – the word ‘England’ no fewer than three times! In a report on yesterday’s somewhat more subdued celebrations of England’s triumph at No. 10 than in the days of Tony Blair’s premiership, the Guardian quoted from a letter Brown had written to the England captain Andrew Strauss. It’s worth repeating in full here for its sheer rarity value:

“I wanted to write to congratulate you and the entire England squad on regaining the Ashes. The series has been yet another wonderful showcase for cricket and for all that is great about sport. It has provided high sporting drama throughout the summer that has yet again gripped the entire nation, and to win the Ashes with your magnificent display at the Oval – and coming back from the defeat at Headingley in the fourth test – shows great determination and commitment.

“There have been many outstanding performances this summer on both sides, but throughout the series you have led England from the front, with patience, resolution and courage. The country is extremely proud of what you have achieved this summer. I would like to invite the England squad in to Downing Street for a reception to celebrate your victory [my emphases].”

Yes, your eyes do not deceive you: Brown said England three times! Note, however, that despite the fact that the Ashes win wrung these words out of him, Brown couldn’t resist making mendacious mention of ‘the entire nation’ being gripped by the series (which nation, you liar? Britain or England? Say ’English nation’ when you mean it!) and invoking the pride of ’the country’: again, England or Britain? And also note the telling reference to ‘your victory’ at the end: not ‘our victory’, which would evoke true emotional engagement and national identification.

Well, if the whole ‘country’ of Britain is so proud of the English players, you wouldn’t mind them having a victory parade through the English and British capital city, would you - just as, last year, there was no apparent incongruity in your mind in allowing only a victory parade for the whole British Olympic team – not the English medallists only – for the English people to express their pride in ‘their’ athletes? Oh yes, how silly of me: it’s OK for the English to take pride in British achievements, but your talk of the whole of Britain taking pride in English successes is mere rhetoric. So much for your uttering the dreaded ‘E’ word: it’s all just empty talk.

Actually, I’m not really that upset about there not being a victory parade for the England cricket team like the one in 2005; nor that very few if any of the team members will be recommended for inclusion in the New Year’s Honours list, like the flurry of honours that were granted to the whole team last time we won the coveted relics. All of that was a bit OTT and something of a carrot to the English people: like the ancient Roman practice of organising games to appease the people and make them forget they don’t have any real power over their lives. But if it had been a British cricket team, then what a different story it would have been!

Anyway, just as he’s not really an England man, Brown isn’t a cricket man, either; and after his six-week break, he’s far too busy and got far too many important concerns to attend to than the celebration of a national (English) triumph.

On top of which, I’m not sure that, as a true Scot, his sympathies weren’t really with the Aussies. But he’s got plenty of opportunity to pay England back (not monetarily, you understand) through his political actions. England may have got back the Ashes of English cricket; but Brown will make sure she doesn’t rise from the ashes of her abolished nationhood. Now that’s a British victory Brown would drink a dram to, I feel sure.

I’ve been particularly struck in the past few days by the extent to which the debate on the two main parties’ commitment to the principles and funding of the NHS has been completely blind to its English dimension. I suppose this should not come as any surprise, as it’s totally normal for Labour and the Tories to discuss England-specific matters as if they related to the whole of the UK. But this time, the blanket ignoring of the fact that the debate is relevant to England alone has been total, not only on the part of the politicians involved but also the media and bloggers. What is it about the National Health Service that makes us blind to its national specificities?

I suppose part of it is that the NHS is one of those national British institutions we like to think of as being present and valued to an equal degree in all parts of the UK, like the BBC, the Royal Family (for some, at least) and Parliament itself. But like Parliament and, to some extent, even the BBC, the national character of the NHS has been fundamentally changed by devolution. There are now four NHS’s (one in each of the UK’s constituent countries), with four government departments looking after them, four separate organisational structures, and separate funding arrangements. As with all legislation and social policy for England, the NHS in England is looked after by the UK government and the UK Department of Health. So although the government and Westminster politicians discuss policy for the NHS in the British terms relating to the level at which policy is made for it (at the UK level), the NHS in question is the English one, not a British one as such, which does not exist any more after devolution.

Given the apparent total unwillingness of the parties and the media to engage with the fact that the NHS whose future is being discussed is the English one, it is necessary to ask what they have to gain in ignoring this fact. In essence, the parties are trying to avoid framing an ideological polarity in national terms: ‘English’ political philosophy and social policy = support for privatisation, market principles and a reduced-size public sector; ‘British’ ideology and policy = support for nationalisation, state control of essential services and a generously funded public sector.

The truth of the matter is that, in England, the New Labour government has carried out major reforms to the NHS that have introduced more elements of privatisation than the previous Conservative governments were ever able to get away with; e.g. Foundation Trusts; autonomous GP surgeries competing for funding based on ‘performance’; public-private partnerships to build and run hospitals; outsourcing essential and ‘inessential’ services to private contractors; the introduction of patient ‘choice’, causing treatment centres to compete against each other to deliver the most lucrative and ‘popular’ treatments; more ‘consumer-friendly’ polyclinics being forced through despite the objections of practitioners fearing it would result in the break-down of individual doctor-patient relationships; etc. etc.

Not to put too fine a point on it, the Tories’ actual policies as outlined in policy documents such as their Plan for NHS Improvement are pretty much more of the same: advocating a flexible blend of public-sector and private-provider approaches to deliver the desired health benefits supposedly more cost-effectively and efficiently. This document, by the way, is an absolute master class in the art of dodging the issue of which National Health Service, or rather which nation’s health service, is being discussed, as it studiously avoids referring to England in all but some statistical examples that strangely relate to England alone (strangely, that is, if you thought the policy document was referring to Britain when in fact it was dealing with the English NHS only).

So for all the hullabaloo over the past few days, it turns out that there are in practice no ideological differences between Labour and the Conservatives over the NHS (in England, that is); just minor differences in the methods to be adopted to deliver the same type of ‘reforms’ – by which is meant the introduction of market mechanisms that supposedly lead to greater efficiency, and improved patient choice and outcomes. But to listen to the politicians from both parties as they traded blows over this you could be mistaken for thinking that what they are really falling over backwards to agree about is their commitment to the principles of a generously funded, public sector-based ‘British’ NHS that lives up to its founding mission to provide health care free at the point of delivery.

Two aspects are key here: 1) a general ideological shift has occurred, prompted by the recession, whereby people’s faith that markets could go on delivering ever greater prosperity, and hence the mechanisms and means to continually improve the NHS, has been shaken; and they are worried that talk of increasing private-sector involvement in the health-care system is simply an excuse to make expenditure cuts. Labour are clearly playing on these concerns; and the Tories are having to emphasise the fact that they plan to increase expenditure on the NHS (in England) in real terms, and underplay the fact that they are still intending to introduce more private-sector mechanisms for allocating those resources and delivering care; 2) both parties have a strong vested interest in suppressing the fact that the marketisation of the NHS they have been carrying out and intend to extend even further is limited to England, whereas the separately administered and funded NHS’s in the other countries of the UK have continued on more traditional public-sector lines.

In other words, the parties’ concern to underplay their commitment to market principles in the NHS is of one piece with their need to suppress the England-specific character of those market reforms – by which I do not mean that those reforms are supported by the English people and reflect the English ‘character’ as such; but rather the mere fact that those reforms have been and would be driven through in England only. Why is this? Because both parties, for their separate reasons, want to be seen as parties for Britain, not England. Labour is appealing to its core support, particularly in Scotland and Wales where it has supported and provided funding (via the Barnett Formula) for traditional public-sector NHS’s. Ignoring the rather different market-orientated policies that have been specific to its management of the English NHS helps Labour to invoke the folk memory of the nationalised health service when it was indeed a uniform public-sector service for the whole of Britain.

The Tories, for their part, are desperate not to be seen as a party associated with the Thatcherite market economics and wholesale privatisations that always enjoyed far more popular support (though never that of a majority of English voters) in England than in Scotland or Wales. For the Tories, openly supporting private-sector initiatives to improve public health-care outcomes, even though (and in part because) such measures would be limited to England, would be electoral suicide in Scotland and Wales. The Conservatives would then be portrayed as the party for the wealthy south of England, intent on cutting public expenditure in England, leading to reduced budgets in Scotland and Wales via the workings of the Barnett Formula. And, in fact, this is true. As I stated in my previous post on this subject, although the Tories are actually pledging to increase expenditure on health in England, they’re planning overall cuts in spending, which will result in lower budgets for the Scottish, Welsh and Northern Irish administrations, and possibly the need to cut spending on their NHS’s. So in fact, the Tories may end up spending more on the English NHS resulting in less spending on the NHS’s in the other UK countries.

So, by referring to the English NHS as the British NHS, the Labour Party are trying to gloss over their record in government, which has involved a substantial degree of privatisation of the service in England that the party has not supported in Scotland or Wales. And the Tories are also trying to downplay their actual support for market reforms of the NHS in England, which risks conjuring up the ghost of Margaret Thatcher and the idea that the Conservatives are the party for the wealthy and privileged of England (particularly, the south), not a progressive party for the whole of Britain.

But the consequence is that neither of the parties can be honest about their plans for the English NHS as such. Can we really be sure that if, by some freak, Labour got re-elected, they would not deepen their marketisation of the NHS – in England, only? And can we be confident that when the Tories set about extending the role of the private sector in the NHS (in England only), this will not become an excuse for delivering ‘efficiency savings’ that can then be passed on to the less efficient NHS’s in the other UK nations via the superior state funding they are guaranteed by the Barnett Formula? We don’t know, because the parties won’t tell us. They merely talk in misty-eyed terms of the British institution that is the NHS and how they stand firmly by its principles – even if those principles are put into practice in very different ways in England from the rest of the UK.

On one level, that’s fine: why shouldn’t the different nations of Britain develop the NHS along divergent lines in accordance with popular and national priorities? Why not, indeed? Except, in England, our actual priorities are not taken into consideration at all: the parties appeal to our affections for a fully state-funded and -run ‘British’ NHS and then they deliver an NHS in England that suits their own ideological and economic agendas, and is not what most English people are expecting, I would think. If the politicians actually engaged in dialogue with the English people and debated with them what sort of NHS we think we can afford, and the mix of public- and private-sector approaches that might best deliver the desired result, they might be surprised at the response they got. I don’t actually know what that would be: it might be more traditional public-sector, or more innovative, commercial and hybrid public-private. Genuine public consultation across the nation could deliver surprising results.

But the point is we’re not consulted, because a politics of dialogue between the English people and their political representatives would actually create a national English political community: one which might in turn design an English NHS that was worthy of the name. Instead, under the guise of a supposedly uniform British NHS that no longer exists, the parties canvass our support and that of those living in the other UK nations in order to deliver their own unspoken agendas for England. Unspoken, that is, because if they can’t even say the name of the country whose NHS they are supposedly standing up for, then such a health service is not a National Health Service that is truly designed with the best health outcomes in mind for the English nation.

And then they have the gall to talk of patriotism.