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The Labour Party Worries about Health
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Commentary from Westminster The Labour Party Worries about Health
A GLOOMY and enveloping shadow fell over last week’s Labour Party conference debate on the health service. Observers who scrutinised it closely swiftly recognised its shape as that of the new social services secretary, Mr John Moore. His speech on the future of the welfare state, on’ which I reported last week, was specific enough on social security issues to enable Labour delegates to attack it in some detail in an earlier debate. But his intentions on health, having been held back for his appearance before the Conservative conference at Blackpool, remained tantalisingly unclear. Labour’s response to this difficulty was to assume the worst. This is a familiar political tactic. It lends itself well to the making of fulminating speeches, which is more fun than delivering sober analytical ones; and if the minister’s subsequent proposals turn out to be rather less lurid than you predicted, you can always tell yourselfand possibly even other people-that it must have been the compelling power of your own eloquence which caused him to repent of his original intentions. It was accordingly assumed by successive speakers in the health debate that Mr Moore was now set on nothing less than the abandonment of the commitment to equal and universal care free at the point of delivery on which the NH S was founded. And the debate plainly demonstrated the fear which now haunts the Labour Party that the now constant and general headlines about a service groaning horribly under stress, especially in the hospital sector, may be exactly what the Conservative Party wants. In the parliamentary report to conference published by the party’s National Executive, grateful thanks were given to those NHS professionals who had appeared on Labour platforms during the election to testify to the privations of the service. "A year ago", it said, "it was difficult to persuade professionals to go public on their experience of the NHS, but in the months running up to and during the election campaign we were able to mobilise administrators, doctors, nurses, patients, and academics to stand on Labour platforms throughout the country". But now that the Conservatives have got their feet under the table for a further four years, the imperatives may be different. The predicament was put most brutally by Mr Hector MacKenzie of the Confederation of Health Service Employees (COHSE). In recent months, he claimed, the health service picture had changed dramatically. The views of the ultra-right and those of the political establishment had converged at frightening speed. Yesterday’s heresies had become today’s quite serious proposals. The Government was anxious to create the impression of a service in trouble, bogged down by bureaucratic efficiency, with a new emphasis on private provision as the only hope of bailing it out-with tax relief for those paying into private health insurance as an increasingly favoured sweetener. Mrs Gwyneth Dunwoody, Labour MP for Crewe, who spoke for the Executive, nursed the same suspicions. A myth was being deliberately created that only new and different ways of funding could save the NHS. She was particularly apprehensive about the inquiry by the King’s Fund into the present system and its possible alternatives. "It is not an
accident", she told the conference, "that those in the King’s Fund who are looking at possible methods of funding the finances in future are themselves in some cases responsible for setting up private GP centres". It was not, I fear, a very distinguished debate. Most of the resolutions debated at Labour conferences are what is known as "composites", stitched together from the individual and disparate motions originally tabled by local parties and others. The main health motion this year, which COHSE put forward, was a ragbag affair combining several different themes, some of which could have made an hour’s debate by themselves. It began with an attack on people in general and Prof Bryan Thwaites of Southampton University in particular who had argued that the NHS, with inadequate resources to meet ever-expanding demand, had to devise some form of rationing. Professor Thwaites was bitterly lambasted for allegedly favouring a system which gave priority to breadwinners, thus reducing the unemployed, the pensioners, and others to second-class status. The Government, COHSE demanded, must publicly wash its hands of such thinking. Next came a section regretting the growth of private medicine and asking for an investigation of the "back door privatisation" being practised by some doctors who used NHS facilities for routine tests and then charged patients for them. After that there was a reference to the huge inequalities revealed in the Health Education Council document, The Health Divide; a call for a bridging fund to ease the transition of mentally ill people from the hospital to the community; and finally the traditional Labour demand for the democratisation of NHS management. To make matters worse, two further resolutions were down for discussion in this brief debate. One, moved by the delegate from Neath, was on women’s health, one of Labour’s principal themes of the past 12 months. It called for women to have cervical and breast cancer tests at work, or to have paid time off to have them done. One woman who spoke in the debate said she had asked for such testing to be carried out at the House of Commons, where she worked, and had been backed by the parliamentary Labour Party; but the authorities had told her to get a test at St Thomas’s Hospital just across the river. This she found unacceptable. The second, moved by the Acton party, condemned health authorities which no longer provided free pregnancy testing, leaving women at the mercy of the private sector. Speakers linked this motion with the plans of the Liberal MP, Mr David Alton, to bring in a Bill to prevent late-term abortions. Some anti-abortion doctors, it was claimed, were causing these late abortions by deliberately delaying their processing of tests in the hope that results would be too late. If Mr Alton was so concerned, let him drop his Bill and deal with this scandal instead. All this was dispatched in a mere half hour, with some of the main provisions going unmentioned. At the end, with little dissent, they carried all three resolutions-which means, among other things, that the Labour National Executive, which ignored the demands made last year for a defined commitment on managerial democratisation, now finds itself under orders to come up with something specific within the next 12 months. The NEC will not fret too much about that. Any further backsliding on its part, its members may well have calculated, should be safely drowned by the debate which Mr Moore was expected to start at Blackpool this week. DAVID MCKIE
Commentary from Westminster The Labour Party Worries about Health
A GLOOMY and enveloping shadow fell over last week’s Labour Party conference debate on the health service. Observers who scrutinised it closely swiftly recognised its shape as that of the new social services secretary, Mr John Moore. His speech on the future of the welfare state, on’ which I reported last week, was specific enough on social security issues to enable Labour delegates to attack it in some detail in an earlier debate. But his intentions on health, having been held back for his appearance before the Conservative conference at Blackpool, remained tantalisingly unclear. Labour’s response to this difficulty was to assume the worst. This is a familiar political tactic. It lends itself well to the making of fulminating speeches, which is more fun than delivering sober analytical ones; and if the minister’s subsequent proposals turn out to be rather less lurid than you predicted, you can always tell yourselfand possibly even other people-that it must have been the compelling power of your own eloquence which caused him to repent of his original intentions. It was accordingly assumed by successive speakers in the health debate that Mr Moore was now set on nothing less than the abandonment of the commitment to equal and universal care free at the point of delivery on which the NH S was founded. And the debate plainly demonstrated the fear which now haunts the Labour Party that the now constant and general headlines about a service groaning horribly under stress, especially in the hospital sector, may be exactly what the Conservative Party wants. In the parliamentary report to conference published by the party’s National Executive, grateful thanks were given to those NHS professionals who had appeared on Labour platforms during the election to testify to the privations of the service. "A year ago", it said, "it was difficult to persuade professionals to go public on their experience of the NHS, but in the months running up to and during the election campaign we were able to mobilise administrators, doctors, nurses, patients, and academics to stand on Labour platforms throughout the country". But now that the Conservatives have got their feet under the table for a further four years, the imperatives may be different. The predicament was put most brutally by Mr Hector MacKenzie of the Confederation of Health Service Employees (COHSE). In recent months, he claimed, the health service picture had changed dramatically. The views of the ultra-right and those of the political establishment had converged at frightening speed. Yesterday’s heresies had become today’s quite serious proposals. The Government was anxious to create the impression of a service in trouble, bogged down by bureaucratic efficiency, with a new emphasis on private provision as the only hope of bailing it out-with tax relief for those paying into private health insurance as an increasingly favoured sweetener. Mrs Gwyneth Dunwoody, Labour MP for Crewe, who spoke for the Executive, nursed the same suspicions. A myth was being deliberately created that only new and different ways of funding could save the NHS. She was particularly apprehensive about the inquiry by the King’s Fund into the present system and its possible alternatives. "It is not an
accident", she told the conference, "that those in the King’s Fund who are looking at possible methods of funding the finances in future are themselves in some cases responsible for setting up private GP centres". It was not, I fear, a very distinguished debate. Most of the resolutions debated at Labour conferences are what is known as "composites", stitched together from the individual and disparate motions originally tabled by local parties and others. The main health motion this year, which COHSE put forward, was a ragbag affair combining several different themes, some of which could have made an hour’s debate by themselves. It began with an attack on people in general and Prof Bryan Thwaites of Southampton University in particular who had argued that the NHS, with inadequate resources to meet ever-expanding demand, had to devise some form of rationing. Professor Thwaites was bitterly lambasted for allegedly favouring a system which gave priority to breadwinners, thus reducing the unemployed, the pensioners, and others to second-class status. The Government, COHSE demanded, must publicly wash its hands of such thinking. Next came a section regretting the growth of private medicine and asking for an investigation of the "back door privatisation" being practised by some doctors who used NHS facilities for routine tests and then charged patients for them. After that there was a reference to the huge inequalities revealed in the Health Education Council document, The Health Divide; a call for a bridging fund to ease the transition of mentally ill people from the hospital to the community; and finally the traditional Labour demand for the democratisation of NHS management. To make matters worse, two further resolutions were down for discussion in this brief debate. One, moved by the delegate from Neath, was on women’s health, one of Labour’s principal themes of the past 12 months. It called for women to have cervical and breast cancer tests at work, or to have paid time off to have them done. One woman who spoke in the debate said she had asked for such testing to be carried out at the House of Commons, where she worked, and had been backed by the parliamentary Labour Party; but the authorities had told her to get a test at St Thomas’s Hospital just across the river. This she found unacceptable. The second, moved by the Acton party, condemned health authorities which no longer provided free pregnancy testing, leaving women at the mercy of the private sector. Speakers linked this motion with the plans of the Liberal MP, Mr David Alton, to bring in a Bill to prevent late-term abortions. Some anti-abortion doctors, it was claimed, were causing these late abortions by deliberately delaying their processing of tests in the hope that results would be too late. If Mr Alton was so concerned, let him drop his Bill and deal with this scandal instead. All this was dispatched in a mere half hour, with some of the main provisions going unmentioned. At the end, with little dissent, they carried all three resolutions-which means, among other things, that the Labour National Executive, which ignored the demands made last year for a defined commitment on managerial democratisation, now finds itself under orders to come up with something specific within the next 12 months. The NEC will not fret too much about that. Any further backsliding on its part, its members may well have calculated, should be safely drowned by the debate which Mr Moore was expected to start at Blackpool this week. DAVID MCKIE