Britology Watch: Deconstructing \’British Values\’

9 January 2013

Coalition Mid-Term Review: Sidelining England in the British-national interest

The UK coalition government published its mid-term review on Monday of this week. It is not the intention of this article to carry out a detailed analysis: I am interested mainly in the way England is treated, or rather is not, in the document.

At first sight, for a document produced by the UK government, it is remarkable how many times the words ‘England’ and ‘English’ actually appear: 15 and six respectively. However, most of the references to ‘England’ are of two related types: 1) where it is necessary to spell out that certain facts or policy proposals relate to England only in order to avoid misunderstanding, and to prevent people living in Scotland, Wales or Northern Ireland from thinking they are affected by them; and 2) to make sure that credit can be claimed for England-specific achievements for which the coalition parties hope to be rewarded by English voters at the next election.

Examples of the first type of reference occur on page 26, where the document refers to a number of policy proposals in the area of personal care as being specific to England, such as rules regarding eligibility for care and the introduction of a Deferred Payment Scheme designed to prevent people from having to sell their homes in order to pay for care. Clearly, these are important statutory and financial matters, and it is necessary to make it clear to non-English readers that they affect only people living in England.

Examples of the second type of reference are:

  • “We have provided the resources to help local authorities in England freeze their council tax for three years in a row” (page 14): Tory policy – please vote for us, England. (What are these ‘resources’, though? I thought local-authority funding in England was being cut, and the council-tax freeze was just a statutory, central government-imposed diktat. Do they mean local-authority funding is being cut by less than it would otherwise have been if authorities had been allowed to increase council tax willy nilly?)
  • “We have brought in the Protection of Freedoms Act to limit the retention of DNA samples in England and Wales in line with practice in Scotland” (page 37): Lib Dem policy – look, we actually do care about you, England, at least in the lofty area of British civil liberties if nothing else.

The first type of reference to England described above has the character of a legal declaration of ‘territorial extent’, along the lines of when cereal packets make it clear that a competition is limited to Great Britain and does not include Northern Ireland. And indeed, the whole document is circumscribed by a legal disclaimer of this sort covering territorial extent, which appears right at the end:

“As a result of devolution, many decisions made by UK Ministers or in the Westminster Parliament now apply to England only. The Northern Ireland Executive, the Scottish Government and the Welsh Government make their own policy on these devolved issues. This document therefore sets out the agreed priorities for the Coalition Government in Westminster.”

No clarification as to which policies “now apply to England only”, of course! Is the general public just supposed to know what they are, as the document certainly doesn’t make this clear to the reader as it goes through the different policy areas, apart from the few exceptions I have already mentioned? But throwing in a disclaimer like this means the government can essentially cop out of providing a detailed break-down and say: ‘look, we’ve acknowledged that some policies are England-only, and anyone interested in those particular policies will know whether they’re England-specific or not’.

This is simply not good enough, although it is par for the course. We’ve come to expect from Westminster politicians and the UK government that they will avoid referring explicitly to ‘England’ as much as they possibly can, and will do so only when it is necessary to avoid factual misunderstanding and harmful political consequences, in the ways outlined above. But their unwillingness to acknowledge a country called ‘England’ to which so many of their policies relate means that Westminster politicians cannot and do not hold themselves properly accountable to the ‘nation’ and people affected by those policies.

This fact is evident in the evasive manner in which many of the policy ‘achievements’ and remaining objectives of the coalition are described; and in many instances, the evasiveness relates directly to the suppression of references to ‘England’. For example, the document never makes it explicitly clear that when it discusses ‘the NHS’, it means only the NHS in England. This helps it gloss over the fact that the coalition has legislated for a massive reform to the NHS that will alter it – in England only – quite radically from the institution created by the post-war Labour government. And yet, the government still has the gall to refer to it as “one of our great national institutions”, as if the NHS it presides over is still fundamentally the same old British NHS, which it no longer is (at least not in England).

So suppression of the England-specific nature of the NHS reforms goes hand in hand with evasiveness about the scope and nature of those reforms. For example, the document says: “We have improved the NHS by . . . starting to devolve commissioning of most health services to GP-led clinical commissioning groups”. But what it doesn’t say is that these changes are limited to England and that the said commissioning groups are statutorily obliged to consider bids from private health-care providers even if the services they provide are initially more expensive than those of existing, public-sector NHS providers.

A more honest account of the government’s measures would be explicit about both their England-specific character and their ultimate guiding principles, and would be expressed something like this: “We have reformed the NHS in England in such a way as to create a competitive health-care market in which private companies will increasingly take over the provision of publicly funded services”. This is actually intended to be an ideologically neutral statement of what the government has done: it has marketised the health-care sector in England, whether you believe that’s the most effective way to deliver health care or not. So why should a Tory-led government not trumpet that achievement? Well, because it suspects, probably correctly, that if English people knew what had been done to ‘their NHS’ (but not to the NHS’s in Scotland, Wales and Northern Ireland), involving changes that were not set out in any manifesto or in the Coalition Agreement, they’d probably violently object. So instead, the coalition pretends that ‘the NHS’ remains fundamentally the same – a primarily public-sector and ‘British’ institution – neither of which is true any more: in England, that is.

The same analysis could be made of many, many other parts of the document that discuss England-specific policies and legislation while avoiding clarifying either that they relate to England only or that they are driven by an ideological bias in favour of private enterprise and markets at the expense of the public sector and, arguably, the public interest – in England. Another brief example – one among many – is where the document says: “We have introduced a presumption of sustainable development in the National Planning Policy Framework, which includes protection of the Green Belt, Areas of Outstanding Natural Beauty and Sites of Special Scientific Interest”. How disingenuous can they be? What this really means is: “We have prepared legislation to make it easier to obtain planning permission for major developments in England’s countryside, with only Green Belt, Areas of Outstanding Natural Beauty and Sites of Special Scientific Interest retaining the previous level of protection”. So England’s green and pleasant land can be concreted over under the pretext of driving economic growth, in the British national interest, regardless of the very passionate interest the English public has in protecting its countryside and natural heritage.

The identity of the ‘nation’ on which this concept of the ‘national interest’ is predicated is quite nebulous in the Mid-Term Review, as indeed it was in the original Coalition Agreement. This is quite simply because, in so many instances, the nation concerned is in reality England, but the government will not and cannot acknowledge this fact. This is rather damaging, as the very raison d’être of the coalition, then as now, is to govern in the ‘national interest’, as the title of the Mid-Term Review makes clear: “The Coalition: together in the national interest”. But whereas the phrase ‘national interest’ is adduced as justification for the coalition’s existence or for certain key decisions on five occasions in the document, the word ‘nation’ is used only once: “In 2012, the nation came together to celebrate the success of the London Olympic and Paralympic Games and the Diamond Jubilee”.

Three of the references to ‘national interest’ relate to the formation and continuance of the coalition, based on pulling the UK round from a dangerous financial and economic crisis; one to supporting the work of the Airports Commission, which could lead to controversial approval for, say, a new terminal at Heathrow or a new runway at Stansted (i.e. more environmental degradation in England “in the national interest”); and the other reference deals with the decision to opt out of, or in to, various EU police and criminal-justice measures. In other words, ‘national interest’ is very narrowly defined in terms of a small number of strategically important reserved policy areas – the economy, air transport, foreign policy and security – whereas large parts of the document deal with devolved policy areas, i.e. with those affecting England only or mainly.

Are these English measures also being introduced in the ‘national interest’? It’s hard to believe they are given the unwillingness of the government to connect the phrase ‘national interest’ with the specific nation, England, concerned? And if they’re not being carried out in the English-national interest, in whose interest are they being done? The interest of the government’s ideological, commercial and financial bedfellows (its corporate sponsors and partners, and its financial creditors)? The interests of the UK state and establishment, and their preservation from an economic meltdown that could have accelerated the centrifugal, nationalist forces challenging their  continuing existence? Or the interests of the coalition parties themselves, who want to come out of the five-year relationship claiming they have fought their corner and followed through on their manifesto pledges – irrespective of the fact that many of the measures they’ve introduced were never outlined in detail and in some instances were flatly contradicted by their manifestos and by the Coalition Agreement, such as the [English] NHS reforms or the Higher Education policies (especially the massive hike in tuition fees for English students)?

But these questions, as indeed the English Question itself, are completely sidelined by the Mid-Term Review. After all, the Coalition can hardly be expected to hold itself accountable to an entity such as ‘the English people’, can it, if its remit is to govern in the British national interest?

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4 April 2012

England Uncut: From words to action?

In some respects, I quite admire UK Uncut: the protest movement that has put tax evasion and avoidance by wealthy corporations and individuals back on the UK political agenda, and has suggested there is an alternative to the coalition government’s remorseless cuts agenda.

But there’s one big problem about UK Uncut: they can’t bring themselves to say ‘England’ and engage with the England-specific aspects of the cuts. Many, but not all, of the cuts in public spending and services they’ve protested about relate exclusively to England; e.g. the effective abolition of the [English] NHS, the withdrawal of funding for arts degrees at [English] universities, and the closure of public libraries in towns and cities up and down the country [England].

For the use of ‘[England]‘ – in red font and square brackets – please see my previous post. Essentially, this could be read as meaning ‘England-cut’, or ‘England-denied’: cut off not only from public spending, and increasingly privatised, but cut out and denied from language, consciousness and the political conversation. The two processes are closely connected. If you don’t believe, to begin with, that there is such a thing as an English nation that has a right to determine for itself what sort of health service or higher-education system it wants, and how the money it raises through taxation is spent for the good of its people, then it makes it a lot easier for the UK government to simply impose these measures without consulting the [English] people they affect.

None of the above actions of the coalition government were spelled out in any of the main parties’ manifestos in the 2010 election. In fact, no policies at all were spelled out as being ‘English policies’, as the main parties steadfastly avoided referring to ‘England’ in the sections of their manifestos that dealt with England-only or England-mainly policy areas. If you don’t say the name of the country affected by your policies, then it’s easier to make out, to yourself and to the [English] public, that those policies are just ‘necessary reforms’ and ways to allocate scarce resources as effectively as possible, rather than an act of taking major public services out of national [English] ownership and control, and of stripping away vital elements of our national patrimony.

These measures become just ‘cuts’, not the ‘cutting of England’. And the more that cultural institutions and public services that make up England’s national civic life are removed or privatised, the more the unreality of England that was your starting point becomes the new reality: England-cut. It’s easy to deny England her rights as an economic, social and institutional entity – a nation – when you were denying her existence and validity as a nation to begin with. And the best way to fool the [English] public that its nation is being robbed from under its feet is to systematically avoid all reference to [England]: to censor it from discourse as a condition of abolishing it in reality.

UK Uncut’s silence on the England-specific dimension of the cuts effectively conspires with them: it’s part of the ‘conspiracy of silence’ the UK government relies on to pursue its programme of de-nationalising and ‘de-nationing’ England. And if that sounds over the top and paranoid, think of what UK Uncut could have achieved if they’d chosen to foreground the English dimension to these issues. They could have tapped into a much more powerful vein of anger and resentment at the raw deal England is getting from UK plc, which is pursuing, in [England], a far deeper and more radical programme, not just of cuts, but of public asset stripping than in the other parts of the UK – for the very good reason that it is not responsible for most public services in the other UK nations. So by not explicitly standing up in defence of English people’s services and rights, which are being denied in ways not faced by other British citizens, UK Uncut has indeed conspired in letting the UK government get away with it.

Well, that’s UK Uncut’s loss, and perhaps ours. I’m now setting up ‘England Uncut’ as a vehicle to tap into some of the creativity and power of social networking that UK Uncut has successfully used to organise its protests to see if we can’t do a bit of the same for England, as England. So far, it’s just a Twitter account, which I invite you to follow: https://twitter.com/#!/EnglandUncut. Maybe that’s all it will ever be. But it’s up to its followers to decide what it should become and whether it can indeed become a vehicle for protesting against England’s raw deal.

We think the first action that’s required is some sort of demo against the BBC, and its systemic failure to adequately represent English affairs as English, which can be redressed only by establishing a BBC England. An England Politics page on the BBC News website would be a start, rather than the derisory regionalisation of English politics we have to put up with now. More on this theme anon: watch this space.

So, England Uncut it is then. Enough talking (well, perhaps I’ll continue with that as well . . .). Time for action!

1 April 2012

[Un]rule Brit-Anglia: Speaking the Eng-closed

Have we been wrong in the way we’ve configured devolution? Specifically, have we [English] been wrong in the way we’ve understood devolution as, to an extent, setting Scotland, Wales and Northern Ireland free to govern their own affairs and forge their own identities; while we [English] have been denied the choice of self-determination and self-identity: subjected to the imposition both of British rule and British identity?

Could we [English] perhaps not reverse this paradigm? Could it not be argued, on the contrary, that in being allowed to run many of their own affairs, the Scots, Welsh and Northern Irish have been allowed to affirm and own their very Britishness; while it is we [English] that have set out in a different direction: a distinctive, [English] direction, albeit under the direction of the British polity and in a way that is predicated on the absence of a distinct Englishness?

That’s why I’m choosing to call it [English] – in red font and square brackets – rather than just ‘English’. The post-devolution [England] has been a virtual, shadowy ‘Anti-England’: the unacknowledged Real that is the actual ground of meaning (and also ‘ground’ in the sense of ‘territory’) and the referent of the symbols of Britishness and of the imagined country that is ‘Britain’. In other words, the UK government – particularly in relation to devolved matters – has become in one sense ‘really’ an English government. That is to say, its actions and laws relate in reality – on the ground and in terms of their impact on real people’s lives – primarily to England. But those actions and laws are symbolised as ‘British’ not ‘English’: they are not spoken of as the actions of an English government that affect a land called England and people who are English. Though the government itself is comprised mainly of English people, elected from English constituencies for which they are, at least in theory, elected to provide national government, the members of the UK government and parliament speak of themselves as a British government of a country called Britain.

In short, we [English] have had, since devolution, ‘government of the [English] people by British (but in fact mainly [English]) people for the British state (though ostensibly for the [English] people). It’s been a sort of ‘not-the-English government’: both really English, in the sense outlined above, but not-English / anti-English / British at the same time. Of England, by English people but not in England’s name, which would mean it was democratically accountable to a nation that knows itself as ‘England’, and acknowledges that government and those MPs as its representatives: which would, in other words, be real English (not [English]) government.

So I’m suggesting a new typographical convention – [England] and [English] in red and square brackets – as a way to refer to the ‘really’ English character of what tends to be referred to and imagined as ‘British’ even though it primarily relates to England in terms of its material import, and reflects an English perspective – political and cultural – on ‘the country’. For the avoidance of doubt, I’m not suggesting that ‘British’ and [English] are in some sense equivalent terms: that if we all know that what is spoken of as ‘British’ is in fact really [English], but that we’re all just being inclusive and politically correct by referring to it as ‘British’, it doesn’t really matter whether you call it [English] or British.

For example, I’m not saying, as some Scottish nationalists do, that the British government and establishment are ‘really’ an English government and establishment. Well, yes, it is an English establishment, but one that is best evoked as an [English] establishment. The establishment, and particularly our present government, is comprised of privileged, largely public school- and Oxbridge-educated English people, with a typically English cultural and political perspective on the nation they like to imagine as ‘Britain’ and the polity they refer to as the UK. But it cannot really be referred to as an ‘English establishment’ when the people involved present themselves primarily as ‘British’, and see themselves as governing a country called ‘Britain’. They are English-as-British people that view themselves as governing England-as-the-UK; and it seems somewhat unfair, but understandable, for Scots nats to feed that back as ‘British-but-really-English’ people governing in the interests of a Britain-that-is-really-England. The whole point is that, whereas it might in fact be ‘really’ an English government, it’s not a government in England’s name that holds itself accountable to the English nation: it’s an English-but-not-English government, a ‘not-the-English’ government – an [English] government.

The more ‘British’, the more not-English, in fact – by which I’m trying to suggest a paradox that the more post-devolution British governments have tried to affirm their ‘British’ character and deny their [English] reality, the more distinct from the rest of Britain / residual Britain have their [English] policies been. In other words, the more they’ve led [England] in a distinct direction, different from the devolved nations, the more indistinct from ‘Britain’ has been their way of talking about [England] – as if the way to deny the separating of [England] away from the other nations of Britain that has been driven as much by their distinct policies for [England] as by devolution is to talk more and more as if that [England] and those [English] policies were all there is of Britain: to retreat into a solipsism, as much as a solecism, which denies the splitting up of Britain by re-imagining [England] as ‘Britain as a whole’ and, indeed, as ‘Britain as whole‘. So in fact, the more ‘British’ England’s governance and self-representation has become, the more [English] it has in fact been: distinct from the rest of Britain, which has a justifiable claim to represent the ‘true Britain’ and the true (at least, post-war) traditions and consensus of British government and political values.

The Labour governments of Blair and Brown neatly illustrate this paradigm and paradox. As I’ve argued elsewhere, one of the purposes behind devolution to Scotland and Wales was to allow Labour to maintain its hegemony over those countries in perpetuity, and to pursue Old Labour social-democratic policies there that Labour had given up on for [England]. New Labour, ostensibly a project for a ‘New Britain’, was in fact a programme for [England] only. New Labour’s Big Lie and act of treachery towards England was that, at the very moment that it plotted a neo-Thatcherite course for [England] only (on the assumption that Old Labour was unelectable in England), it had the gall to make out that this was a programme for Britain (as a whole). Old Labour was true British Labour – a party that thought that, by definition, socialist principles should be applied across Britain as a whole. New Labour, on the other hand, is really [English] Labour: charting a distinct (neo-liberal, market-capitalist) direction for [England] while at the same time presenting this as if it were a project for a New Britain and consistent with, but modernising, British Labour’s values – whereas, in fact, those British Labour principles had been abandoned for [England] but remained alive, well and funded by the British state in the devolved nations.

So, contrary to the language and our [English] conception of devolution, it was the devolved countries that remained more truly British, whereas it was the land that could be referred to only as ‘Britain’ (i.e. [England]) that set off in a different direction. This is not so much ‘England is Britain is England’, as the Scots-nats would have it, but ‘Scotland / Wales / N. Ireland is Britain and “Britain” is [England]‘.

But I don’t think one should impute deliberate treachery and deceit to the whole Labour movement in this matter; although I’m positive the Labour leadership knew what it was doing by spinning [England] as Britain. For the mass of [English] Labour members and New Labour apologists, [England] could be referred to only as ‘Britain’ because Labour was in massive denial that its distinct policy agenda for [England] was separating [England] from the old socialist Britain for which Labour was supposed to stand just as firmly as devolution was doing. Devolution and a distinct agenda for [England] in fact went hand in hand for New Labour: devolving Scotland and Wales to pursue separate policy agendas for the devolved countries and for [England]; but denying it was pursuing divide and rule, and abandoning its socialist principles for [England] only, by making out that [England]
was Britain – ultimately not divided from ‘the rest of Britain’ because it had been re-imagined as the ‘whole of Britain’ and no longer actually included the ‘rest of Britain’ within its New Labour horizons. The New Britain was in fact [England].

But what of the oh-so [English] present government and the not-PM-for-England, David Cameron, himself? Laughably, David Cameron’s Canute-like refusal to endorse a new EU fiscal-consolidation treaty back in December of last year was portrayed by some as an example of a new Conservative ‘English nationalism‘, something which I refute in turn here. But there are some senior Tories who would explicitly like to champion this sort of ‘go-it-alone-England’ – free from the two Unions: European and British – as the new English nationalism. Tories such as John Redwood, who described this anti-EU English nationalism recently, and paradoxically, as “the new force in UK politics”. (Paradoxically, because he still refers to “UK politics”; and English nationalism as such can be talked of as a reality only when it starts to become possible to use the phrase ‘English politics’.)

John Redwood is perhaps something of an exception, in that, unlike many of his parliamentary colleagues, he has never been ashamed of talking about England as a nation in her own right, with her own claims to self-determination. But for most Conservative MPs, it would be more appropriate to talk of [English] nationalism rather than English nationalism. Yes, they are, mostly, English MPs, elected from English constituencies, with a typically ‘English’ cultural outlook, conception of the UK and antipathy towards EU interference in [English] affairs. But the ‘nation’ they wish to safeguard from absorption into continental Europe is ‘Britain’. And if it’s necessary to accept the secession of Scotland as the price for being able to preserve, govern and shape that Britain in accordance with their ideological precepts, then so be it. Their Britain will just keep calm and carry on – with or without Scotland, and preferably without the EU – except that, without Scotland, it would be, err, mainly at least, England. But why let reality stand in the way of a good political fiction?

So the [English] nationalism of the New Tories is far from being a positive political programme for a new, self-governing England (which is true English nationalism). In fact, it represents a radical continuation of the distinct, Blairite policy agenda and vision for [England] originally set by New Labour, and which is so resolute to resist anything that might stand in its way that it’s prepared to go even further than New Labour in splitting [England] off from (the rest of) Britain. Whereas, for New Labour, it was sufficient to hive Scotland and Wales into devolved Old Labour enclaves in order to continue the Thatcherite agenda in [England], for the New Tories, it may be necessary to ditch Scotland altogether – if not, perhaps, Wales; at least, not yet – in order to continue the work of Blair.

But don’t let’s fool ourselves that this will involve building a New England as the continuation of Blair’s New Britain, because, just like New Labour, the New Tory project involves a radical denial of England as a nation in her own right, and with rights of her own. In fact, just as Cameron’s Conservatives are prepared to risk separating off ‘Old Britain’ (Scotland, Wales and Northern Ireland) from [England] even further than devolution by happily tolerating Scottish secession, they are also pushing the England-denying project to its radical limits by privatising the last vestiges of the post-war British-national settlement in [England], which ultimately means privatising [England] itself.

This is the profound meaning of the [English] government’s Big Society agenda and programme of privatisation of things like the [English] NHS (which I now like to call the ‘English Public Health-care System’ (EPHS), as it is no longer British, nor nationalised, nor a single ‘service’ as such but is definitely English), [English] education, [English] policing and even [English] local government and public administration. Are you getting the point now? Thatcherism was about privatising British nationalised industries. But Thatcher’s New Labour and New Tory continuators have extended this programme of privatisation and marketisation beyond industry to the institutions and organisations that symbolised and embodied a shared British nation – but only within [England]. And once you’ve torn down – brick by brick, as Cameron put it last week – the edifice of the British state in [England] that was once publicly owned and run in the public interest, you’re left not with a new England but an atomised landscape in which health care, education, planning, policing and all the rest are no longer seen as being ultimately the responsibility of a national (e.g. English) government but are all in the hands of the private domain and the market: private enterprise, private individuals, social enterprises and co-operatives, competitive health-care providers, public-private partnerships, local GP consortia, local development plans concocted by democratically unaccountable local cliques in place of proper local democracy, etc.

In short, abolishing the national in [England] (nationalised industries, and nationally owned and accountable public services) ultimately means abolishing the English nation. The ultimate logic of Thatcherite privatisation and marketisation is the asset-stripping of nationhood, so that all you’re left with is the private sphere (and its extension, the micro-local) and the market. But for [England] only: they’ve made sure of that.

But the left – or the post-Blairite wasteland that passes for one in [England] – have got no answer to this, because any sort of answer would have to be national, and the nation to which the answer would apply could only be ‘England’. That’s why I have absolutely no confidence in the claims made this week that Labour, if re-elected into [English] government, would ‘repeal’ the present government’s privatisation of the [English] NHS, or the EPHS, if you’ve followed me to this point. And that’s not just because the [English] Health and Social Care Bill was in fact no more than a continuation to its logical limit of many of the marketisation measures New Labour introduced into the [English] NHS, but because Labour has no language in which to articulate a vision for the / an English nation as such, let alone for a new NHS that would be per force an English NHS now, because all possibility of maintaining the pretence that the now abolished [English] NHS was the NHS (i.e. the original, British one, founded by the post-war Labour government) has vanished. Just as Scotland, Wales and Northern Ireland have remained true to the post-war British settlement, they still have their British NHS: state-run, -owned and -funded. So a new Labour (not New Labour?) [English] government couldn’t ‘reintroduce’ or ‘re-nationalise’ the NHS (the British one) because it still exists, except not in England. No, they’d have to create something new: an English health service.

Is the left in [England] at all capable of articulating a vision of and for England? Well, that is the 64,000-dollar (donation) question. And it’s a question, ultimately, that applies to all of our [English] political class, not just to Labour. Politicians will not be able to ‘reconnect’ with the [English] public, as the saying goes, until they reconnect with their own Englishness: until they liberate themselves from the mental chains, repression and ‘enclosures’ that prevent them from seeing and accepting themselves as English, and as having a primary purpose, as English politicians, to serve the English people and nation.

I use the expression ‘enclosure’ to refer to a confinement of the English and of England to the private realm, both in the context of the wholesale privatisation of England I’ve just described and in the context of a process whereby persons engaged in public life in [England] close off their ‘inner Englishness’ into their private life: not to be spoken of in politically correct, British (i.e. [English]) society. Of course, the two processes are linked. I was struck by this recently when reading an article entitled, ‘Britain is not just “undergoing privatisation”, this is a modern enclosure movement’. This described the process of privatisation of [English] public services, essentially as I have described it, as a latter-day version of the enclosure of common land in England from the 16th century onwards, but without mentioning that either the modern or original enclosures were largely limited to England – something that I wasted no time in pointing out in the comments!

What sort of mental enclosure, intellectual barrier or self-censorship prevents the author and many like him from acknowledging that public assets and services are being closed off into the private realm in [England] only or primarily, not ‘Britain’? Is it because they themselves – in the wake of Thatcher and Blair – fundamentally do not believe in an English public realm, out of some sort of internalised hatred and contempt for England, the common English people and themselves as English? It is as if, in their minds, England and the English – and themselves as English – deserve no better: deserve, that is, to be just cut-off, isolated, private individuals striving and competing against one another for the services and goods they need from private suppliers and employers, rather than expecting as of right the dignity of a nation that takes care of its own.

Politicians, left or right, will not be able to make an effective stand against the privatisation of England until they are prepared to resist the privatisation of their own Englishness. They’re going to have to ‘out’ themselves from their own British enclosures – ‘come out’ publicly as English – before they can pretend to speak in the name of an English public: an idea that they have thus far repudiated just as they have repudiated their own Englishness. English ownership of public assets means English people owning their Englishness. But until such time as those who would represent [England] can think of themselves as English, and identify with the English people, England will remain in the British enclosure.

In short, New Labour brought us an England re-imagined and marketed as ‘Cool Britannia’. The New Tories have brought us ‘Rule Brit-Anglia’: an England privatised and branded by the market as ‘Britain’. But for England to come into its own, to ‘unrule Brit-Anglia’, English people must first break open the mental ‘Eng-closure’ that prevents them from saying ‘England’ and choosing to speak in her name – which is, after all, what a real English parliament would be for. Then, perhaps, we’ll at last be able to talk of a self-governing England, not a Brit-ruled [England].

10 June 2011

The head of the Anglican Communion criticises the government’s English policies without saying ‘England’

“A democracy going beyond populism or majoritarianism but also beyond a Balkanised focus on the local that fixed in stone a variety of postcode lotteries; a democracy capable of real argument about shared needs and hopes and real generosity: any takers?”

These are the words with which the Archbishop of Canterbury, Dr Rowan Williams, concluded his article in the New Statesman yesterday criticising key coalition government policies on social services and welfare as being without a proper mandate.

My answer to this question would be, ‘how about an English democracy?’

The Archbishop rightly and powerfully articulates some of the central problems about the government’s social agenda with respect to the lack of any real democratic debate, scrutiny and consensus they may have received. Elsewhere in the article, Dr Williams writes: “With remarkable speed, we are being committed to radical, long-term policies for which no one voted”.

It is indeed true that the government’s policies in areas such as education, health, localism and the Big Society were not set out clearly and in detail in either the Conservative or Liberal Democrat manifestos at the last election, nor were they explained or debated openly and vigorously throughout the election campaign. And there was one very good reason for that: these policies are English policies.

At the election, none of the three major parties openly acknowledged and explained that their policies for education, health, communities and social services – all of which are devolved matters – related to England alone; indeed, their manifestos contained barely any mention of England (as I analysed at the time here, here and here). And as we know, almost the very raison d’être of the British government and establishment is to suppress the existence of any sort of English-national polity in which policies and laws intended for England are openly and honestly discussed as relating to England.

Accordingly, there’s a very good reason, Dr Williams, why neither the government nor the opposition are adequately explaining the thinking and priorities behind their radical policies, nor explaining what their likely impact will be on the ‘nation’ as a whole. That’s because they can’t even acknowledge the very name of the nation for which those policies are intended. Indeed, the policies themselves – in their actual content – express the drive to abolish any form of English civic nationhood in that they pass on the responsibility for the civic life of, and public services for, the English nation to the private realm: to individuals, small groups, communities, and not-for-profit or for-profit organisations that are now meant to take responsibility for education, health care, local services and amenities, and social services without any overarching national plan and vision.

There’s no national plan or vision because the nation that is being privatised and, as it were, ‘de-nationised’ is completely invisible: England.

And yes, these policies have not been voted for. And that’s not just because they weren’t adequately explained at the election but, more fundamentally, because they were not presented either to or for the nation in which they were to be implemented: no English-national electorate was either addressed or invoked during the election; nor was any English nation acknowledged for which these policies might represent any sort of blueprint for the future. No one voted for these policies, and they weren’t adequately explained, because to do so implies the existence of some sort of national political life in which those policies are a part of the public debate, and a nation for which those policies are intended. But none of that applies to these policies, because they’re English, and England was absent from the election, and is absent from government and the political process in the present.

So the answer to the Archbishop’s question at the end of his article is that these policies will be subjected to the scrutiny they demand, and a more participative democracy holding politicians to account will be brought about, and a positive vision for society and the common good will be developed, only when the nation for which those policies are intended is brought into the process and a vigorous, healthy English polity comes into being.

Why, therefore, did the Archbishop himself not mention the name of the country – England – where these policies are being implemented? Why is even the spiritual head of the Church of England not standing up for ‘England’ as such even where he makes such an impassioned plea for the creation of a more genuinely participative, democratic life in which English policies can be subjected to the scrutiny of the nation as a whole?

England is the great lack and absence at or from the centre of it all. And while politicians, media and archbishops cannot bring themselves to say ‘England’, none of them by definition can ever articulate a shared vision for England.

19 May 2010

Geographical extent of Cameron’s Big Society

If you were hoping that in the era of ‘change’ ushered in by the Conservative-Liberal Democrat coalition government, official statements would be more honest and transparent about the UK countries they refer to, think again. Below is a transposition of yesterday’s statement on the coalition’s plans to implement the Conservatives’ Big Society manifesto policy for England, with the countries the proposals relate to being indicated in the left-hand column:

Country / -ies Policy proposal
Aspirational: Britain; in reality, England, as communities, local government and families are devolved Our Conservative – Liberal Democrat Government has come together with a driving ambition: to put more power and opportunity into people’s hands.

We want to give citizens, communities and local government the power and information they need to come together, solve the problems they face and build the Britain they want. We want society – the families, networks, neighbourhoods and communities that form the fabric of so much of our everyday lives – to be bigger and stronger than ever before. Only when people and communities are given more power and take more responsibility can we achieve fairness and opportunity for all.

The Union play: denying the Big Society relates only to devolved functions of government but is the expression of a social transformation for the whole of Britain Building this Big Society isn’t just the responsibility of just one or two departments. It is the responsibility of every department of Government, and the responsibility of every citizen too. Government on its own cannot fix every problem. We are all in this together. We need to draw on the skills and expertise of people across the country as we respond to the social, political and economic challenges Britain faces.

This document outlines the already agreed policies that we believe will help make that possible. It is the first strand of a comprehensive Programme for Government to be published in the coming days, which will deliver the reform, renewal, fairness and change Britain needs.

England only 1. Give communities more powers

  • We will radically reform the planning system to give neighbourhoods far more ability to determine the shape of the places in which their inhabitants live.
  • We will introduce new powers to help communities save local facilities and services threatened with closure, and give communities the right to bid to take over local state-run services.
The first part relates to England only; the second part implies that government will also provide funding and other support for the devolved administrations to promote neighbourhood groups.
  • We will train a new generation of community organisers and support the creation of neighbourhood groups across the UK, especially in the most deprived areas.
UK 2. Encourage people to take an active role in their communities

  • We will take a range of measures to encourage volunteering and involvement in social action, including launching a national ‘Big Society Day’ and making regular community involvement a key element of civil service staff appraisals. ƒ
  • We will take a range of measures to encourage charitable giving and philanthropy.
England only
  • We will introduce a National Citizen Service. The initial flagship project will provide a programme for 16 year olds to give them a chance to develop the skills needed to be active and responsible citizens, mix with people from different backgrounds, and start getting involved in their communities.
England only 3. Transfer power from central to local government

  • We will promote the radical devolution of power and greater financial autonomy to local government, including a full review of local government finance.
  • We will give councils a general power of competence.
  • We will abolish Regional Spatial Strategies and return decision-making powers on housing and planning to local councils.
UK 4. Support co-ops, mutuals, charities and social enterprises

  • We will support the creation and expansion of mutuals, co-operatives, charities and social enterprises, and support these groups to have much greater involvement in the running of public services.
England only
  • We will give public sector workers a new right to form employee-owned co-operatives and bid to take over the services they deliver. This will empower millions of public sector workers to become their own boss and help them to deliver better services.
UK
  • We will use funds from dormant bank accounts to establish a Big Society Bank, which will provide new finance for neighbourhood groups, charities, social enterprises and other nongovernmental bodies.
UK 5. Publish government data

  • We will create a new ‘right to data’ so that government-held datasets can be requested and used by the public, and then published on a regular basis.
England and Wales
  • We will oblige the police to publish detailed local crime data statistics every month, so the public can get proper information about crime in their neighbourhoods and hold the police to account for their performance.

Opinions will vary on the Big Society proposals themselves. Some of them sound quite laudable. Few people could object, for instance, to the aims of encouraging volunteering, fostering community groups, and giving people more control over planning decisions and services in their local area. It would just be nice if the government could bring itself to mention that many of the key proposals here relate to England only, which would suggest that the government has aspirations and affection for England as such, and that it is concerned to improve the strength and mutuality of English communities.

It is hard to trust in the sincerity and benevolence of these proposals for England, and not to see in them merely a hidden agenda for spending cuts and privatisation, if the government is unwilling to acknowledge the name and identity of the country for which its plans are intended. Instead, the coalition government seems intent on devolving its responsibility for England away from any national tier of governance – whether at the British level or that of any prospective English government – down to the sub-national and even sub-local level: to the level, in fact, of Little England.

Cameron’s Big Society is therefore a vision of Little England, involving the dispersion of any aspirations the English as a whole might have towards self-government to the level of small-community empowerment and social enterprise. But can a Big Society England – an England where individuals are mindful of their social responsibilities, and communities become more caring and resourceful – really be fashioned in the absence of any big vision for England as a whole, and without English people feeling truly empowered to effect democratic change at the national level as well as the merely local?

For the Big Society vision to work in the benign way David Cameron appears to wish, it has to be a vision for which English people as a whole can take ownership and responsibility, to use Cameron’s favourite word. But if even David Cameron can’t articulate his vision for England in a holistic and transparent way, how can English people be expected to realise it?

5 May 2010

Cameron’s Big Society is the next phase of the Thatcher revolution: privatising government and England itself

One of the things Margaret Thatcher was famous for saying was that there was “no such thing as society”. David Cameron’s Conservatives’ manifesto for the May 2010 election – entitled ‘Invitation To Join the Government Of Britain’ – has now self-consciously reversed this dictum, prefacing its section on changing society with the graphically illustrated words, “There is such a thing as society – it’s just not the same thing as the state”.

Margaret Thatcher recognised only the core building blocks of ‘society’ as such: the individual and the family. In his turn, David Cameron is big on the family but downplays the individual, as he wishes to dissociate his ‘modern compassionate Conservatives’ from the selfish individualism that was fostered by Thatcher’s ideological obsession with private enterprise and the profit motive. However, those of us with long memories still attribute much of the break-down of communities up and down the land – particularly, working-class communities that had built up around particular industries – with the ideological, social and economic changes that Thatcher introduced, often with callous indifference to the misery and hopelessness they caused.

Cameron’s ‘Big Society’ is on one level an attempt to redress the social injustices and deprivations the Thatcher revolution left in its wake by placing communities back at the centre of his model for society. But at the same time, this is opening up communities and society (communities as society) as the new front for privatisation and the unfolding of market principles: what Thatcher did for the individual, Cameron would like to do for society – privatise it and turn it into a market society.

A full-scale critique of the Conservatives’ Big Society concept is beyond the scope of the present article. However, in essence, I would like to urge those who are tempted to vote for the Conservatives and potentially give them an overall majority in the new parliament to think carefully about what the Big Society means in social, economic and political terms. The core idea, in my view, is that small groups of interested persons should be empowered to take over the ownership and / or management control of public-sector bodies responsible for providing public services and amenities as diverse as schools, hospitals, community facilities, social care and social services.

In theory, this form of ‘social enterprise’ (community enterprise as opposed to Thatcher’s private enterprise) is supposed to be carried out by groups forming themselves into, or already belonging to, co-operatives, mutual societies, charities, voluntary organisations and non-profit-making / socially responsible enterprises. This is doing for ownership of public services what Thatcher did for ownership of publicly owned assets such as council houses and nationalised industries: privatising them. The only difference is that the ‘private’ sphere is extended beyond the individual – as in Thatcherism – to the level of the community. This is, then, a form of privatising the public sector itself: moving from government ownership and responsibility for public services to ownership and responsibility on the part of private groups of individuals (communities), as opposed to private individuals alone under Thatcher.

This all sounds great in theory. In practice, however, these private- / community-owned public services will be competing against each other in an aggressive, competitive market place. In economic terms, these reforms are intended to make the ‘public’ sector run on private-enterprise principles as a means, in theory, to provide services much more cost-effectively in the way that commercial businesses are generally run in a more cost-conscious, efficient way than the public sector.

In short, the flip side to the privatisation of the public sector that the Big Society represents is public-spending cuts. The two go hand in hand: in order to provide public services more economically while minimising the social impact of cuts, the Conservatives believe it is necessary for those services to be run both on market principles and by those who are dedicated to that particular public service, such as the teachers, doctors, social workers, volunteers and communities themselves. These people will then have both an economic interest, indeed imperative, to run those services on as small a budget as possible while at the same time focusing on maximising the quality and positive social impact of the services they deliver.

All this is predicated on the assumption that it is possible to combine the virtues and driving forces of private enterprise and public service. There are indeed many examples of social enterprises, charities and mutual societies that already do superb work in the community on a self-financing, voluntary or partially publicly funded basis. So the model can work as part of the mix of public services. But Cameron’s sights seem set on re-modelling the whole of the public sector along these lines. Hence the ‘Big Society’: a concept that implies that the ‘little people’, or what Cameron referred to at the start of the election campaign as the ‘great ignored’, take on the functions and powers of ‘big government’, with the huge apparatus of the state replaced by tens of thousands of community enterprises and initiatives across the country – England, that is.

Before I elaborate on the England point, I just want to reiterate: this sounds great in principle, but in practice all of these little companies and mutual societies founded to run schools, hospitals and social services are going to be competing for government funding in an environment of brutal public-spending cuts; and they’ll also be set in competition against each other and against other businesses – private businesses from outside the communities concerned – that will be able to bid more price-competitively for contracts and licences to take over failing schools or improve hospital facilities. In order to compete for funding and deliver the statutory level of service they are required to provide, the co-operatives and social enterprises are going to have to make use of management expertise and operating techniques from commercial businesses, and it’s easy to imagine how all the little community groups will eventually get swallowed up into larger enterprises that can pool talent and costs, and provide services at a lower cost for the real customer: government.

What we could easily end up with is not the little people empowered to form the Big Society, but big business effectively doing the government’s job (or community enterprises joining together to form big businesses) at a fraction of the cost that the former public sector would have been either capable or willing to achieve. And this will inevitably involve reinforcing social inequalities and disadvantage, in that commercially minded businesses – albeit ones with an ostensibly socially responsible remit – will clearly be less willing to take over failing schools filled with problem children from dysfunctional homes, or under-performing hospitals requiring substantial investments to turn them around.

The money will be attracted to where the money is: wealthier, middle-class areas with parents who are willing to invest time and money in their children’s education, enabling ‘education providers’ to attract more funding because of the good academic results they have achieved. Or hospitals that have succeeded in delivering a greater ‘through-put’ of patients in particular areas of specialisation – resulting in a concentration of the best health-care facilities and personnel around specialist centres of excellence, and more ‘cost-effective’ health conditions and therapies. A less commercially orientated health system, on the other hand, might seek to provide an excellent level of medical care for the full range of health problems available in the areas where people actually live, including the ‘unglamorous’ conditions such as smoking-related illnesses and obesity, associated with the lifestyles of poorer people who, in addition, are less able to travel to the specialist centres where treatment might still be available on the NHS.

The English NHS, that is. Because let’s not forget that the tough medicine of the Tories’ Big Society is a prescription for England alone. Though they don’t say so in their manifesto, we should hardly need reminding that education, health care, social services, local government and communities, and policing are all devolved areas of government; and therefore, the UK government’s policies in these areas relate almost exclusively to England only. So it’s not really or mainly the British state that would be superseded by the Big Society but the public-sector assets and services of the English nation.

There’s another word for ‘privatisation’ that is particularly apt in this context: ‘de-nationalisation’. It’s the English nation whose systems and organisations for delivering public services would effectively be asset-stripped by the Tories: in theory made over to community-based co-operatives and social enterprises but in fact transformed into a free market in which the involvement of more ruthless profit-minded enterprises would increasingly become unavoidable.

This could potentially be another example of what happens in the absence of an authentic social vision for England on the part of the British political class: a vision based on the idea that the government and people of England can and should work together to improve the lives and opportunities of the English people; one that does see the government and public sector as having a real role in serving the people alongside a vibrant, enterprising private sector.

The British political establishment has, however, disowned the view that it has an authentic, valuable role to play in the life of the English people. This is precisely because it refuses to be a government for England (just as Cameron once famously indicated he did not want to be a prime minister for England) and refuses to allow the English people to have a government of its own. Instead, the establishment – whether New Labour or Cameron Conservative – have attempted to re-model English society along purely market-economy lines, and will continue to do so if we let them: the Big Society being one where English civic society is transformed into just another competitive market place, with the inevitable winners and losers.

Ultimately, then, it’s not the government of Britain that English people are being invited to participate in; but it’s a case that any idea and possibility that the British government is capable or willing to act as a government for England is being abandoned. Instead, the government, public sector and indeed nation of England will be privatised under the Tories: sold off to the most cost-effective bidder and dismembered perhaps even more effectively than through Gordon Brown’s unaccountable, regionally planned (English) economy.

Well, I for one won’t buy it. And I won’t vote for a party that seeks to absolve itself from the governance of England and wishes to permanently abandon any idea of an English government. And I urge all my readers not to vote Conservative for that reason, too. Even, if it is necessary (and only if it’s necessary) to do so in order to defeat your Tory candidate, vote Labour!
And believe you me, it really hurts and runs against the grain for me to say that.

At least, if there is a Labour-LibDem coalition of some sort, there’ll be a chance of some fundamental constitutional reforms, including consideration of the English Question, as stated in the Lib Dem manifesto. Under the Tories, there’s no chance – and England risks being for ever Little England, not a big nation, as it is privatised through the Big Society.

17 August 2009

The debate on the National Health Service is a proxy for a debate on nation-specific ideologies and policies

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.

15 August 2009

The Conservatives are the “party of the NHS”: but which one?

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.

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