One of the most depressing experiences in politics is to listen to a focus group discuss Labour and the NHS. Time after time, the voters’ attitude is simple: unconditional praise. No matter how bad the health service’s performance, there is a feeling that it is safest in the hands of the party that created it. Apart from a short period in the run-up to the 2010 election, Labour has comfortably outstripped other parties on the issue in the polls, to the extent that it currently enjoys a 30-point lead. The NHS is such an electoral asset that Ed Miliband is expected to make it a central part of his campaign to be Prime Minister – not least because he lags so badly on so many other issues, such as economic competence and personal credibility.
But does Labour really have cause to be proud of its record on the NHS? Today, the results of an investigation into suspicious death rates at 14 hospitals – carried out in the wake of the scandals at Mid Staffordshire – are revealed. The facts are appalling: their performance was so poor that up to 13,000 people may have died needlessly. So severe are the problems that Prof Sir Bruce Keogh, the medical director of NHS England, is expected to place many in special measures, or replace management teams entirely.
This comes on the back of a number of revelations about abuse and neglect in the NHS, stretching back over many years. Yet while the agencies set up by Labour to monitor patient safety have been shown to be either negligent – with many of the 14 trusts on the “death list” receiving clean bills of health from the Care Quality Commission – or actively complicit in covering up hospitals’ errors, no politician has had to carry the can. In fact, the polls show that in the wake of revelations about Labour-era scandals such as at Mid Staffs, it is actually the Tories who are blamed.
That, however, could be about to change. A parliamentary question tabled by the Tory MP Priti Patel shows that Labour ministers – including Andy Burnham, the party’s current health spokesman and former health secretary – received more than 1,500 warnings over the safety of care at the 14 hospitals on this “death list”, many from concerned staff, patients or members of the public. This includes more than 400 letters about the United Lincolnshire trust, and more than 300 about Blackpool.
In addition, people around the last government are starting to speak out. Prof Sir Brian Jarman – the expert who uncovered the original problems at Mid Staffs, Morecambe Bay and Basildon hospitals – has claimed that his work was “suppressed” by Labour ministers, describing the Department of Health as “a denial machine”, focused on producing good news stories rather than getting to the bottom of the death-rate data. Two former NHS regulators who worked under Labour, Dr Bill Moyes and Baroness Young, have also described the “pressure” exerted on the system by ministers to keep quiet about unsafe care.
The problem with establishing who knew what, and when, is that the public-sector machine will close ranks against any attempt to shine a light into its murky world. The recent Francis Report on the deaths at Stafford Hospital is a prime example. This was a whitewash, blaming generalities such as the health service’s “culture”, rather than ministers and their policies. I have worked in government, and know how the information channels work, including those that reach Downing Street, and I find it inconceivable that ministers did not know what was going on. It is, of course, perfectly possible that Andy Burnham and his predecessors were kept in the dark, or actively lied to, but we need a rigorous inquiry to establish that – one covering not just Mid Staffs, but going into the advice ministers received about other hospitals on today’s shameful list.
It is not just in Westminster where there was, and still is, a problem. One central reason why Labour has been allowed to get away with the idea that it is the “party of the NHS”, while presiding over such a shameful record, is that it benefits from the axis within the public services that tirelessly attacks those who dare to suggest that the health service might need to change. Most notorious is the treatment of Julie Bailey, the ex-nurse whose mother was killed by neglect at Mid Staffs, who has been the targeted of venomous abuse for speaking out about it. In 2011, union activists posted an internet video which stated they hoped she would die; she has since been subjected to a campaign of nuisance calls, threats and online vitriol; has been hounded from her business and her home and even seen her mother’s grave desecrated.
While there is no suggestion that the Labour Party in Westminster put anyone up to this, it must recognise that there are elements in its movement so determined to maintain state control of public services that they resort to smears and abuse. One party activist, Diane Smith, even claimed that Bailey was campaigning to close Stafford Hospital and sack local staff; allegations which she then had to withdraw. When I wrote in this newspaper about the need to bring transparency and competition into public services, a trade union activist used official Barnet council resources to send me a profanity- and abuse-laden tirade.
The easy option for Andy Burnham and Ed Miliband would be to continue to deny all culpability for the NHS’s failings, and to turn a blind eye to the local zealots who speak in their name. Or – as over party funding and candidate selection – they could unequivocally distance themselves from the union extremists, and show that they recognise where they have gone wrong.
In doing so, their best approach would be to drop the ideological baggage and agree to some simple, tough decisions about how to prevent a repetition of the scandals that occurred on their watch. For instance, while they may never agree with the Government on allowing competition in the NHS, there is a clear case for urgent action over our worst hospitals. Of today’s 14, there are at least six that cannot be turned around with their current management in place. So why not support an open competition for new providers, including private-sector ones if necessary, to take them over and turn them around on a payment-by-results basis?
Next, there should be more transparency in the NHS – and we need to go much further than the present Government’s introduction of an online rating system of hospitals. The Care Quality Commission, which Labour established, has recently been exposed for covering up abuse. It should not only be overhauled, but forced to produce simple, trusted league tables advising people about hospital safety and standards, much like Ofsted does for schools.
Such ideas, however, are vehemently opposed by the trade unions – meaning there is little hope of Miliband being able to change Labour’s current policy of taking the NHS back to a state-only system of “preferred providers” to deliver hospital care. But the voters are wising up: not only to Labour’s past mistakes, but its lack of new ideas on how to fix things. For that reason, today may well be the beginning of the end for Labour’s comfortable monopoly on being trusted to run our most valued public service.