The right Labour attack on Lansley’s health bill

by Jonathan Todd

“The trick is to keep doing outrageous things. There’s no point passing some scandalous piece of legislation and then giving everyone time to get worked up about it. You have to get right in there and top it off with something worse, before the public have had the chance to work out what’s hit them. The thing about the British conscience, you see, is that it really has no more capacity than … a primitive home computer, if you like. It can only hold two or three things in its memory at a time.”

Thus spoke Henry Wilshire, cut-out evil 1980s Tory of Jonathan Coe’s What a Carve Up. And Wilshire was half right. But only when certain conditions hold.

The conditions are that the central principle of the reform enjoys both popular mandate and sympathy.

This brings to mind, not for the first time, the contrasting fortunes of Iain Duncan Smith and Andrew Lansley. The first is at the peak of his career, the second fights for his.

The latter is taking forward legislation that voters did not vote for, while the former is doing broadly what the last Conservative manifesto promised. If we wish the next Labour government to be transformative, our manifesto must, to borrow a supposed Cameroon maxim, seemingly forgotten by Lansley, roll its pitch.

Pitch rolling should connect proposed policy programmes with popular values. Duncan Smith’s core argument is that work should pay more than welfare. This resonates so strongly with popular values that he has reduced much of the public to Wilshire’s 1980s’ home computers.

The contentious details of his proposals elude their hard drive, which has already filed them under: “Thank goodness someone is doing something about this travesty that Labour left us with.”

We can only get back into this debate by neutralising Duncan Smith’s core argument, which Liam Byrne has begun to do.

Lansley, in contrast, with the 1000 amendments to his Bill, barely has a core argument to speak of.

Andy Burnham’s task of opposing him is like shooting fish in a barrel compared to Byrne’s of opposing Duncan Smith. In the absence of a coherent argument, let alone one chiming with popular values, the public and the health professions won’t give Lansley the benefit of the doubt.

When war is waged against a treasured national institution, without a popular mandate or justification, the public transform into a computer that just says “no”. And a public put through such an experience does not forget it quickly. It was fear of the force of popular memory that motivated Conservative Home’s call for the NHS Bill to be dropped:

“By ‘succeeding’ in enacting a contentious Bill every inevitable problem that arises in the NHS in the years ahead will be blamed on it.”

An enacted NHS bill, like the poll tax, which one of the ministers grumbling to Conservative Home about the NHS bill compared it to, will be a source of discontent for years.

This invites the question: Would abandoning the NHS Bill be the biggest u-turn since the poll tax?

Perhaps. But surely falling out of the Exchange Rate Mechanism (ERM) after insisting this would not happen was a bigger u-turn? And wouldn’t the public be less angry with the government when problems emerge in the NHS if this u-turn is now made?

There’s political logic to u-turning now and this would be a less spectacular about turn than that which the prime minister participated in as a special adviser at the treasury.

The poll tax had more ideological motivation, as far as Thatcherites were concerned, than membership of the ERM. But the Conservatives won again after the ideological assault of the poll tax but not after the calamity of ERM exit.

The public can stomach some ideology so long as the appearance of competence remains, especially if the opposition are mistrusted by voters.

But incompetence is highly damaging and fatal when combined with an opposition demonstrating that it can provide a viable alternative. This is what happened when the memory of ERM incompetence combined with the never-ending homily to competence of shadow chancellor Gordon Brown’s infatuation with prudence.

It is, so to speak, the fishes with a flavour of incompetence, not immorality, which Burnham should be shooting in Lansley’s barrel. Especially on as an emotive a subject as the NHS, it’s tempting to major on his undoubted moral failings. But governmental incompetence is harder to erase from the hard drive of public memory than moral laxity, particularly in a “politicians are all as bad as each other” era, and highly destructive to a government’s hopes of re-election.

It took the incompetence of Ted Heath’s “who runs the country?” for Harold Wilson to defeat a government in one term in 1974 and the incompetence of James Callaghan’s winter of discontent for Margaret Thatcher to do likewise in 1979. Perceptions of incompetence always damage governments and may be a precondition of them being, as Labour is now attempting to ensure, evicted after only one term.

They can u-turn if they want to but it’s Cameron’s incompetence that must be seared on the hard drive of popular memory.

Jonathan Todd is Labour Uncut’s economic columnist

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