Are the Lib Dems the “party of NHS and social care”?
Could I please start with a mini-rant?
I promise I’ll get onto the main topic in a minute!
I’ve spent the last few days digging into analysis around “costings” that have been put out by the main political parties ahead of the General Election; and now I’m sitting down to write to you, I was hoping to air my frustrations!
Whenever politicians suggest that investment is needed to improve public services, there is a response from columnists, think tanks and talk-show hosts that is as predictable as clockwork. “Well if these politicians want to spend money, then someone will have to pay”, they say with disapproving tones, wagging fingers and a general air of superiority. When I see this, I’m bemused. Of course someone has to pay. That’s fine, because lots of extremely wealthy people and corporations do not pay nearly enough!
But do you know what I find most frustrating of all? Most of the people trotting out these lines, telling ordinary people that investment can’t be magicked out of thin air are, themselves, ordinary people. Most journalists are not wealthy. Most columnists do not own a yacht. Why are they bending over backwards to act appalled at the notion of taxing the wealthy properly? The mind boggles...
OK... rant over!
Let’s talk about the Lib Dems and what they’re saying about the NHS…
The Liberal Democrats are riding high on the back of a very successful General Election at the moment; they now have 72 MPs in Parliament, making them the third largest political party. There’s been some confusing coverage about this in the press, with journalists appearing to think that they have achieved this as a result of the stunts Ed Davey performed during the campaign. He certainly attracted a great deal of press attention for his bungee jumping and general high jinks, but I’m not convinced this is what won the Lib Dems all of those seats. I think it’s more likely that people were utterly fed up with the Conservatives, and in many constituencies the Lib Dem candidate was the natural pick to replace a Tory MP. Their policies will have had an impact too of course, and from what I could see this summer, the policy area which achieved the most “cut-through” in terms of press attention and public awareness were their plans for social care and the NHS.
I scrutinised the manifestos of each major political party ahead of the General Election (it might be worth clicking here for a reminder of what they were all promising before they secured our votes!), and the Lib Dems had clearly given their plans for the NHS and social care a lot of thought. There’s a great deal of detail in the manifesto, suggesting they took the time to really understand the issues in key areas like dentistry, mental health, and General Practice. It looked like they’d actually listened to people affected by the issues, and their priorities were clear. But while their plans were bold and well-structured - setting out practical solutions they hoped to implement - they completely ignored the four decades of political decisions that have decimated of the NHS’s inherent architecture. The NHS is in a mess because of underfunding, understaffing, and poor leadership, all of this is true. But if any group of politicians actually wants to fix it, they also need to look at the structure of the overall system.
The NHS should operate as a cohesive system, with equal care across the UK, equal access to services, continuity of care for patients, and sustainable relationships between the NHS services themselves with sharing of knowledge and innovation. This cohesion is how a public healthcare system delivers excellent care, and this is how we would achieve progress in our outcomes too. Over time however, politicians have fragmented the NHS through their “reforms”, breaking it down into component parts, and allowing many of those parts to be infiltrated by profit-making companies who sign up to short-term contracts. A postcode lottery and a lottery of care has been created where patients in one part of the country can’t access the same things as those in another. Any party claiming that they’ll fix things needs to address this issue, because the disintegration of the system as a whole has allowed privatisation to wreak havoc on the infrastructure of our healthcare system, and this is bad for patients and for staff.
The reason I’m talking about this today is that the Lib Dems have just held their annual party conference in Brighton, and they’ve been making some very bold statements indeed about the NHS. They have spoken up about the role they hope to play now that they have won a much louder voice in the public conversation, and more influence in the House of Commons.
A press statement released on Friday 13th September said this:
“Liberal Democrat Chief Whip Wendy Chamberlain MP is to set out plans for Liberal Democrats now they're the third largest party in Parliament, including being a ‘constructive opposition’. Chamberlain will declare that the ‘Liberal Democrats are the party of the NHS and care in every part of Britain’ and criticise the ‘out of touch Conservative party who allowed hospitals to crumble and waiting lists to soar’
and...
The Liberal Democrats put NHS and care at the heart of their manifesto and their General Election campaign.”
Ed Davey backed up this stance in his leader’s speech at conference on 17th September, when he said:
“I urge Labour: do not make the same mistakes the Conservative Party did. Be more positive. Act now. Show the ambition and urgency this moment demands – and save our NHS for good.”
...and Daisy Cooper, the Liberal Democrat Deputy Leader who has spoken to the press about her personal experience of Crohn’s disease and her NHS treatment, said:
"Wes [Streeting], if you are listening - take up our ideas or put your own forward … If we don't see the right level of ambition or urgency, we will hold your feet to the fire.”
These are bold statements, fighting talk, and the Liberal Democrats are already making specific demands of the new government. The BBC published an article earlier this week, explaining their calls for additional investment:
“Sir Ed is calling for a ‘budget for the NHS’ in October, with more investment in hospitals and training doctors, nurses and dentists. The party says the NHS needs £3.7bn a year extra in day-to-day spending, and a further £1.1bn a year for investment.”
And the Evening Standard wrote about their demands for the NHS to be better prepared for winter pressures too:
“Sir Ed’s party also announced it would campaign for a new Winterproof NHS Taskforce, which would manage a £1.5 billion budget to build resilience across hospital wards, accident and emergency departments, ambulance services and patient discharging.”
Both of these important policy items, crying out for attention and resourcing from the Labour government, and this action from the Lib Dems should be commended and supported. It’s also worth noting that for a while now, they have also been doing excellent research into many problems within the NHS, strengthening public understanding and putting pressure on leaders to step up. Last year, for example, they called attention to the hundreds of sewage leaks in England’s hospitals. Several months ago they released information about the thousands of vermin infestations in NHS hospitals, and less than a week ago they did it again, sharing information about the staggering number of patients waiting for 4 weeks for a GP appointment.
But the recent Lib Dem press statement I shared carried the headline “Lib Dems vow to be ‘party of the NHS and care’ as Chief Whip sets out top priority of new Parliament”, and here’s where we need to be careful and push back where necessary. All political parties like to associate themselves with the NHS, because it is deeply beloved by the public, and is consistently an important issue that wins votes and support for politicians. But a political party can only be considered “the party of the NHS”, if they are willing to acknowledge the systematic destruction of the NHS that has been caused by corporatisation and privatisation, and put together plans to reverse this degradation of our public healthcare system.
If they truly want to fix the NHS and create a system which creates world-class, excellent, sustainable care for all, the Lib Dems need to be brave enough to call for profit creation to be removed from the direct delivery of public healthcare in the UK.
The Green Party and the NHS.
Political commentators and journalists tend to get excited about these weeks in the early autumn. As the major political parties host their conferences, it presents an opportunity for the media to get close to the politicians, to witness the atmosphere of a political party at close quarters and to socialise.
As an outsider, a campaigner, this has always made me feel slightly queasy. Some of the conferences host events sponsored by private companies. There’s a lot of jollity, and often some scandal. I’m sure that the political party members find these events interesting and valuable, but there’s something slightly “off” about the relationship between journalists and politicians at these conferences. It feels a bit cliquey and strange, like they’re on a month-long jolly - the Westminster-bubble-on-tour. A microcosm of many of the things that are going wrong in UK politics.
That said, the political coverage itself is fascinating and important. Articles, podcasts and discussion pieces come thick and fast during conference season, and so it’s important that campaigners pay attention to developments. This is the time when splits in opinion come to the fore, often between the body of members and the central party. There are attempts from senior politicians to give a sense of calm when the mood from the wider group is chaotic or strained. A snapshot of what is happening at a party conference can help predict what will happen in the months to come - the ruptures, collapses in support, reshuffles, and fall-outs. It can be seen as a barometer of the true state of a political party and what is going on at the top.
Unfortunately, political party conferences do not all attract equal attention by the media. The 3 big ones - Labour, Conservative, Lib Dem - are covered vociferously and offer a valuable glimpse into the dynamics and power shifts within each party. The smaller conferences like that of the Green Party are relatively neglected, adding to the skew we see in UK politics between where the power is situated, and what the public actually wants. We know that our voting system leads to disproportionate allocation of power within our democratic system, and at the moment there are many advocates for moving to a “proportional representation” model instead. I’ve stumbled across a fascinating document from the House of Commons library illustrating the situation really neatly. It explains the performance of each political party in the General Election this Summer and the corresponding number of seats they have won in Parliament.
If you have a few minutes spare, I’d really recommend taking a look because it is very revealing. Here’s a quote:
“The Green Party of England and Wales, Scottish Green Party and Green Party in Northern Ireland are separate entities. Considered together, they had 629 candidates and 6.7% of the vote share, with the Green Party of England and Wales winning four seats.”
So despite winning 6.7% of the vote share, the Green Party won just 4 seats in Parliament, which amounts to 0.6% of the total. Perhaps media outlets follow the principles of the voting system, and seek to provide coverage in line with the power distribution in Parliament. Perhaps the disproportionality in media coverage between the parties is more complicated - perhaps it’s based on which politicians attract more attention from the readership, or the views of a publication’s owner. Regardless of the reasoning, the recent Green Party conference has had very little media coverage at all. In fact, unless you’ve taken a specific interest in the party, I would be surprised if you had known it was going on. But their influence politically is growing, and with a large group of voters I think it’s important to consider what they’re currently up to, particularly with the NHS in a state of emergency and the new government taking no proper action to tackle things.
The Green Party conference happened in Manchester between 6-8th September, and as the FT (who are one of the few outlets who seem to have covered the event), said:
“The Green party, which went from one to four MPs in July’s general election and now has more than 800 councillors across the UK, has grown significantly in recent years and the mood at the Manchester conference was optimistic. Membership has increased from 53,000 at the end of 2023 to 59,000 and about 1,000 members — half of them new — attended the conference.”
As a campaigner it has been interesting to watch this swell of attention for the Green Party. They have been a stalwart, and often lonely voice, pushing against NHS privatisation for some time. There’s sometimes a worry that once a political party gains any degree of influence, they will move away from their more progressive policies, but that doesn’t seem to be the case with the Greens. In fact, before the General Election, during their campaign and beyond, they have been resolute on their stance regarding the NHS.
As well as their staunch opposition to privatisation, they also made bold policy pledges within their General Election manifesto about NHS funding, saying:
“… we estimate that the NHS in England will require additional annual expenditure of £8bn in the first full year of the next Parliament, rising to £28bn in total by 2030. Additional capital spending of at least £20bn is needed over the next five years for hospital building and repair.”
Before the General Election, many pieces were written about whether these pledges were achievable or desirable, because of the amount of money that would need to be found. Whenever I read pieces telling us that adequate investment in the NHS is “impossible”, “unachievable”, or “not sensible”, I always think about what happened in 1948. We had just come out of the Second World War, the country was completely broke, and yet we invested in the health service because of the short and long-term benefits it would confer on our entire society.
There aren’t many people who would now regret the investment which enabled the development of the welfare state. It enriched the lives of millions of people and strengthened our economy too, because a healthier society is a more productive society. I often wonder what people will think in 76 years’ time, looking back at how we are enabling rich people to get richer while our public healthcare system collapses.
Anyway, I digress. The speeches and statements from The Green Party recently have been really refreshing. The FT piece mentioned above contains this quote:
“Newly elected MP for North Herefordshire Ellie Chowns criticised the short-termism of Westminster politics and said there needed to be ‘a ten, twenty, thirty-year plan” on issues from the environment to housing and social care. The political system, she said, “does not reward consensus building’, resulting in small conflicts over policy rather than fostering a culture in which politics makes real change.”
I cannot agree with this more. Particularly when it comes to infrastructure investment, politicians think in 5-yearly, electoral cycles, dissuading themselves from making the necessary investments that building hospitals, roads, schools require. If these situations were less politicised and more long-term, the public would benefit greatly.
A press statement put out by The Green Party at the start of their conference includes this quote from their co-leader Carla Denyer:
“The Budget at the end of October will set the course for the rest of this parliament. Green MPs do not accept the need for public spending cuts. On 4th July people didn’t vote for things to get worse. They voted for change”
…which feels both timely and necessary, given how many people are feeling about the winter fuel payment situation, among other decisions Labour is currently making. And on that note, specifically regarding the NHS, they have put out a statement concerning the recent Darzi report and Labour’s response to it, saying:
“Starmer says there can be no money without reform. We say there can be no improvement to waiting times, cancer death rates, treatment for mental health – and many other struggling areas – without more money … ‘reform’ has in the past been used as a stalking-horse for privatisation. The Green Party completely rejects privatisation and fragmentation of the NHS. Private companies are focused on creaming off profits which can result in degraded services and more people not getting the treatment they need from the NHS.”
These are bold words, containing messages that many of us wish our new government was promoting. Indeed, I’m sure that there are Labour MPs who wish that the leadership was taking a more progressive stance at present and investing in what is necessary to improve things for the public.
How much change can the Green Party and their 4 new MPs create? That remains to be seen. But their messaging on the NHS and in other areas at their conference feels coherent, relevant, and robust. I really hope that they see their political influence in Parliament grow, along with the number of column inches that they attract. We desperately need strong voices in Parliament advocating for the welfare of the public, the investment in public services, and the rejection of corporate interests within the NHS, and at the moment, the mood in the Green Party feels buoyant.
Why is nobody talking about Streeting’s plans to privatise the NHS?
Whenever a minister makes a major speech - a budget announcement, a keynote address or a party conference address - there are many people watching and listening. Commentators and think tanks wait, poised and ready to offer their view on what’s shared. Experts read between the lines and try to predict what was meant by opaque phrases or unusual turns of phrase. Did they include that line as a dig towards another politician? Have they used that particular case study because they intend to focus on policy in one particular area? Have they hinted at a budgetary announcement to come? In the hours that follow, we see statements crop up on the websites of organisations, from CEOs offering their thoughts: “We were disappointed by this...” “We welcome the minister’s thoughts on this...”, “We need more detail”, or “clarity”, or “investment” or “urgency”. And we see the radio waves come alive and news websites peppered with new articles latching on to an inflammatory remark or controversial new suggestion.
Everyone’s desperate for information, and with a new government we’re more desperate than ever to understand what the plan is, and what it’ll mean for us all. But this week I’ve been less worried about media buzz and reactionary statements, and more by lack of scrutiny; the lack of proper detailed analysis from these think tanks and commentators. In fact, I find it downright alarming.
The Labour Party conference has been happening this week in Liverpool, and the mood has felt slightly “off” altogether. With Labour commanding an enormous majority in the House of Commons, many expected this conference to be a celebration; the triumphant gathering of a newly-elected governing party. But as the conference began, many media outlets were printing critical articles of donations and gifts that had been received by Keir Starmer and other senior Labour leaders, and this seems to have thrown cold water on proceedings. A general sense of unease has been growing in many quarters about Labour politicians in recent weeks, and for some, those concerns have been heightened even further when they learned some details about events happening at the conference.
The Guardian printed an article several days ago containing this quote:
“Big banks, oil companies and tech firms were among the more than 500 lobbyists and executives who flocked to Labour’s biggest ever business event at its conference, paying £3,000 a ticket for the chance to gain access to ministers.”
...and the Labour MP Zarah Sultana shared a post on social media on Wednesday saying this:
“Google provided £10,000 of hospitality to senior Labour figures and the party ditched plans to raise the digital services tax.”
These examples and others have led to a sense of distrust around the behaviour and intentions of Labour politicians, and this feels particularly cloying because of the actions of the previous Conservative government. A lot of people voted for this Labour government because they wanted change of course, and they’re starting to feel let down already, only a few months in. But there’s another situation happening in UK politics and the media receiving scant attention; a situation that deserves a lot more focus, and that’s the lack of proper scrutiny being applied to ministerial speeches at party conferences.
Wes Streeting made a speech yesterday at the Labour Party conference about the NHS, and it was the sort of speech we’re now familiar with from Streeting. He likes to tell us he “won’t back down”, often from imagined enemies, or people who in fact support the NHS or keep the service going. He is certainly not afraid of a fight; and has attacked trade unions, GPs, NHS workers striking for fair pay, and “middle-class lefties” as he put it. Most recently, he told the BMA to stop “sabre-rattling”.
I routinely feel incredibly frustrated by his tone, but we could perhaps forgive Streeting for his inflammatory language - he is a politician, after all, and is behaving in a manner he believes will win political favour and achieve his goals. I don’t, however, extend that same attitude to the individuals and organisations who are meant to be apolitical and scrutinising what he’s doing. Following his speech yesterday, various statements came out from high profile think tanks and other organisations, and none of them touched on the privatisation which he spoke about in his speech.
“where there’s capacity in the private sector, patients should be able to choose to go there too, free at the point of use, paid for by the NHS.”
Within hours of Streeting’s speech, a statement was published by the NHS Confederation which covered several important aspects of the NHS’s current crisis, and included this strong quote...
“With a challenging winter period on the horizon, the government will need to use its Autumn Budget to address the NHS’s short-term deficit of at least £2.2bn as this is leading to local organisations either cutting or freezing posts, and to services halting or scaling back their transformation projects in order to respond to their immediate pressures.”
…but they completely failed to mention anything about Labour’s plans for further NHS privatisation.
The Kings Fund also published a statement, covering various important areas, including the need for investment in illness prevention, and community services...
“So alongside initiatives to accelerate elective activity, we need concrete plans to prevent ill health, intervene early and support people to manage their health in their homes and communities. This will require a significant shift in resources and political focus towards primary and community services.”
...and yet they also failed to cover privatisation.
The same is true of the statement from The Nuffield Trust which, among other things, discussed the need to reform social care funding, and the Health Foundation who mention the need for increased capital funding. None of these organisations felt the need to draw attention to the elephant in the room; Wes’s words about the private sector, and Labour’s poorly thought-through plans to use yet more privatisation within the NHS.
This matters. It doesn’t only matter because the majority of people oppose the involvement of private companies within the NHS. It doesn’t only matter because there is mounting evidence that increasing privatisation does not help within public healthcare systems. It matters because there is no evidence to suggest that the private sector has meaningful capacity to assist the NHS in the manner that Labour politicians are claiming. There isn’t an enormous, secret army of healthcare professionals in the UK. If the private sector is given yet more NHS work, they will simply poach more NHS staff to do that work (and the NHS is already missing over 100,000 staff in England alone). Justin Ash, the CEO of one of the biggest private healthcare companies in the UK even went to The Times a few months ago, to explain that this plan from Labour wouldn’t work. The headline says it all:
“Private hospitals boss says they’re not the answer to NHS crisis.”
So why aren’t the think tanks and other organisations holding Labour to account about these plans, when they’re happy to talk about underinvestment, or staffing problems, or crumbling buildings in the NHS? Is it ignorance, or is it something worse; the politicisation of the organisations who should be impartial, and should be scrutinising all aspects of the political policy put forward by this government and every other? What do you think?
The Reform Party is like a carnival hall of mirrors.
Some people might say that the Reform Party should be ignored at the moment; that it’s best not to give oxygen to their divisive ideas. But from what I’m seeing when I speak to people about the NHS, their ideas are already out there gathering pace, and so I think it’s important that we pay attention. In fact, I think we need to do more than pay attention, I think we need to scrutinise their ideas just as we would with any other political party. After all, if they want to be taken seriously, then they should be bringing some serious ideas to the table.
In the run-up to the General Election, they were definitely not bringing serious ideas to the table for the NHS. Here are three of their manifesto pledges, although they didn’t call it a manifesto, they called it “Our Contract with You”:
“Despite record extra funding in recent years, NHS healthcare outcomes have declined. While still free at the point of delivery, our healthcare needs major reforms to improve results and enjoy zero waiting lists.”
Firstly, all public healthcare systems become more expensive over time; that’s because of medical advances, increasing expectations and inflation. These things are to be expected, and as far as the first two are concerned, welcomed - this is progressin society. The percentage increase in the NHS’s investment actually fell far below what was required during the 2010s, which is one of the reasons why the service is in such a state. Click on this BBC article and scroll down - there’s a really good chart that illustrates this.
Shall we even discuss Reform’s “zero waiting list” pledge? The NHS has never had zero waiting lists, and it shouldn’t either. If we had such an extraordinary level of healthcare provision that not a single person was waiting for anything, we would have devoted the most astronomical proportion of our country’s money, and there wouldn’t be many other things working.
OK, onto the second point from their manifesto:
“Tax Relief of 20% on all Private Healthcare and Insurance. This will improve care for all by relieving pressure on the NHS. Those who rely on the NHS will enjoy faster, better care. Independent healthcare capacity will grow rapidly, providing competition and reducing costs.”
This would, in fact, accelerate the creation of a two-tier healthcare system within the UK, which is not what we need!
And thirdly, this absolute corker of a pledge:
“NHS Patients will receive a voucher for private treatment if they can’t see a GP within 3 days. For a consultant it would be 3 weeks. For an operation, 9 weeks. Services will always be free at the point of use.”
One imagines that a lot of patients would be left holding a voucher, and waiting a very long time for treatment. These policies from the Reform Party are so ludicrous that many people have laughed at them in recent months, but I don’t think laughing at them is going to make them go away.
I spend a lot of time online speaking to people about what’s happening to the NHS; the actions of politicians, the state of the service, and what people think needs to be done to change things. Recently, I have noticed a growing trend. There is unrest in many quarters at what the Labour Party have planned for the NHS, and a growing number of people commenting under my posts “Labour are just like the Tories, vote Reform!”. I have to admit, this makes me feel deeply uncomfortable. I don’t want to be responsible for pushing people to the far-right because I’m drawing attention to the failings of other politicians.
It puts us in a difficult position; should we ignore the failings of the “mainstream” political parties in order to avoid the far-right growing in popularity? Surely that isn’t the right answer either? Either way, the Reform Party is growing in influence, scooping up disillusioned voters and offering them something different, and the party is changing too.
As The Independent reported last week:
“Nigel Farage has announced he is ‘relinquishing’ control of Reform UK and giving up his majority shareholder position, just one day before the party begins its annual conference. The conference, taking place in Birmingham, ‘marks the coming of age’ of the party, Mr Farage said … Reform UK Ltd is a registered company, unlike most other political parties, and was previously registered as the Brexit Party from 2018-2021.”
He’s changing the structure of the organisation so that it’s owned by the members instead, and says that Reform now has more than 70,000 of these. Many of them attended their party conference last week which was held in Birmingham, and the party seems to be riding high on their General Election success (where they won 5 seats in the House of Commons). I haven’t been able to find the transcripts of any of the conference speeches online, and most of the articles written about the conference haven’t contained much detail either. Instead, we’re told about the music, or the fireworks, or the merchandise.
An article from Politico contains this quote:
“In Birmingham’s National Exhibition Centre, legions of fans sporting merchandise backing either Farage’s Reform UK outfit or U.S. Republican Donald Trump filed towards the main stage — many clutching pints of beer before noon as the fun began.”
...and it doesn’t stand alone. The Independent led with the headline “Eminem, fireworks, and the cult of Nigel Farage: Inside Reform UK’s party conference”. John Crace’s column for The Guardian is entitled “Reform’s conference is all blame, grumpiness – and no idea how to fix things”.
There’s the sense that the Reform Party has no soul of its own, it’s just a set of regressive ideas which has formed in reaction to other things. And yet they somehow project that attitude onto those trying to examine the party too. It feels like a hall of mirrors, with light bouncing back and forth, creating twisted shapes, never settling in a way that can reveal its true shape.
This is the true horror really. The loud music and the jolly pints and the bonhomie and the wide smiles conceal something sinister; something that should be examined, something which deserves proper attention and scrutiny and banishment from UK politics. With all of the problems in UK politics, we definitely need something different, but we do not need this. Not the ludicrous policies. Not the division, and not the hate.
No sign of reflection from the political party that ruined a nation.
There’s been a lot of coverage in the media this week about the Conservative Party conference. As curious onlookers wonder what the next steps are for a party that was voted out of government and into oblivion just a few months ago, I’ve been watching the commentary closely, and there’s been a general sense of deflation from journalists. They’d perhaps been looking forward to looking on triumphantly as the politicians tried to pick themselves off the floor and reassemble into something vote-worthy, respectable, and robust. They’d perhaps been looking forward to witnessing the soul-searching of a group of people who took the helm and, through callous decision-making and the raucous and reckless decisions of people who were giddy on power, crashed us all into the rocks.
If that’s what they’d been expecting and hoping for, then they'd have been disappointed this week, because the 2024 Conservative Party conference has been far from an exercise in self-reflection. Instead, the mood at events seems to have been buoyant, and the politicians don’t seem repentant about any of the problems that they, or their colleagues, have caused in recent years.
I’ve been watching all of this unfold with incredulity. I went to medical school straight after leaving school, spent the long years necessary to become a doctor, and then worked clinically for a decade. It was impressed upon us immediately and continually that we held deep responsibility for the decisions we made, for the way we presented ourselves, explained things and navigated difficult medical problems and emergencies for, and with, our patients. This was crucial in setting a philosophy of work in service - it was the grounding of everything we did and everything we learned. While my non-medical friends were carefree in their late teens and early twenties, I and my medical school friends were put through our paces in patient-communication sessions, learning how to break bad news and explain procedures clearly. Those who didn’t take it seriously enough, made jokes, or seemed disinterested were forced to repeat the sessions. On one occasion a colleague of mine was outright dismissed from a session. In fact, he was later dismissed from medical school altogether, as many medical students are. Despite our youth, we had to take things extremely seriously, right from the off. There was no other option.
From my very first medical job, I was part of morbidity and mortality meetings; witnessing discussions about people who had become very sick and died, and analysing a series of events with a fine-toothed comb. I took part in debriefs after resuscitating patients or particularly traumatic encounters and attended meetings with supervisors. We discussed individual cases, what I’d done, what I could have done better. When we slipped down, which we did, we would think deeply about this, and our supervisors would too. There was no room to hide from bad decisions, and no room for bluffing, and it’s one of the things I love most about medicine. It’s a deeply honest profession because it has to be. It has to be because people’s care matters too much to allow any mistakes to hide in the grey areas. Facts are facts. Learning has to be done. You have to keep trying to do better, be better, deliver more for your patients.
Medicine is frequently sad, and doctors support each other through the darker days too. I can still remember the first patient I delivered CPR to and who died. He’d arrived too late in the A&E department, and we couldn’t do enough to save him. My consultant could see that I was on the verge of tears and sent me off to have a cup of tea, which felt like an act of extreme kindness. There’s something excruciating about standing in a resuscitation room with a stethoscope around your neck, close to tears. But even then, the discussions had to be had. He talked me through the case, and we spoke about what I could learn. Facts and understanding can never be lost amid the emotion, or the trauma, or the drama of human suffering.
I think because I was cocooned in this world for many years, most of my adult years, I came to political campaigning expecting that the same attitude would exist within politics too, or some version of it. After all, politicians also carry the weight of responsibility for others. Politicians also have to weigh up facts and make the decisions they consider to be best. Politicians slip up too, often, and require that level of accountability to scrutinise themselves and do better. I was shocked to find out that many politicians don’t have this attitude at all; this sense of deep responsibility to others. Some do, some care extremely deeply, are enormously well-versed in policy and listen deeply to experts. Others are callous and unconcerned with the fate of others.
I should probably know better, after operating in this world for the past ten years, but I think I’ll always find it shocking to recognise the lack of personal accountability that many politicians take for their actions. This week was a reminder of all of that is lacking in so many of our leaders as we watched Tories at their conference; we observed the things on which they chose to focus, and the things that we needed to hear as a nation, but which remained unsaid.
As the conference opened on Sunday, many media outlets were busy covering some remarks from the Conservative Party leadership hopeful Kemi Badenoch, which she had made about maternity pay. As the BBC reported:
“Tory leadership candidate Kemi Badenoch has suggested maternity pay has ‘gone too far’ and the government needed to interfere less in people's lives.”
It’s inspired a lot of debate and plenty of outrage, which presumably was her intention. Not to be outdone, Robert Jenrick has been making a lot of noise about the European Court of Human Rights:
“Tory leadership contender Robert Jenrick has said the UK must leave the European Convention on Human Rights because trying to reform it would take decades and be ‘doomed to failure’”.
...which has led to much eye-rolling as to whether he is simply seeking another Brexit-style issue - something to drive a wedge between groups of voters and stir up support for the party again. It wouldn’t be a ludicrous idea if he did, because it worked pretty well for Boris Johnson, propelling him into Number 10 in 2019. It would be terrible for the nation to be put through something similar all over again, however.
I’ve been scouring the information about the actual goings-on at the conference, because I was keen to see what was being said and report back to you on important policy topics, particularly the NHS. There were a handful of events on offer, mostly fringe events, discussing problems in the NHS and potential solutions. Some of these involved think tanks or health charities, and one, rather alarmingly, was sponsored by the pharmaceutical company Roche. One wonders, cynically, why they were interested in doing this.
There had been much talk from journalists about the absence of key senior Conservative figures at the events, and how strange this had felt, and yet attendees don’t seem to have escaped Jacob Rees-Mogg, who was listed as attending a private drinks reception despite losing his seat as an MP. Various think tanks whose names we’ve all become familiar with in recent years were in attendance at the conference too, including the Institute of Economic Affairs, who held their own fringe event entitled “Going for growth: the abundance agenda” which seems a little optimistic given the current state of things.
There have also been several statements from Conservative leadership hopefuls about the NHS recently too. As covered by The Independent:
“Kemi Badenoch has suggested the public may one day change its mind on whether people should have to pay for access to healthcare … The Conservative leadership contender was pressed about her views on the free use of the NHS in a broadcast interview as the Conservatives gather in Birmingham for their conference … Tory former minister Ms Badenoch signalled on the BBC’s Sunday With Laura Kuenssberg there is currently a ‘consensus’ that the NHS should remain free at the point of use, but said she cannot say whether she might change her own mind on the matter in future.”
...which was slightly depressing to observe, but perhaps not unsurprising. Jenrick also took to Twitter several weeks ago, saying: “We should treat the NHS as a public service to be reformed, not a religion to be worshipped” … among other things. This is a line repeatedly trotted out by think tanks and media outlets who are looking for ways to attack the NHS or anyone supportive of it. And that, really, is the theme of the Conservative Party conference this year.
There was a buoyancy, and a camaraderie to the proceedings as they dismissed the failings of the past and attempted to look to the future. But that future feels hollow because they are serving up a jumble of old ideas, rehashed themes, and an invigoration of “culture wars” (which despite their inflammatory nature, feel a bit tired, somehow). After all, these are no longer the powerful and threatening statements of those in power, but instead the rants and musings of those on the opposite team, looking for attention.
4 candidates; Tom Tugendhat, James Cleverly, Kemi Badenoch and Robert Jenrick remain in the race for Conservative leader, and they are making a lot of noise. But if you take a look at page 194 of the Conservative Conference handbook, even their campaign logos look a bit boring, care-worn and thin on promise or pizazz. If the Conservatives want to build back their place in UK politics, they need to reflect a lot more on what went wrong, because it’s going to take an awful lot to convince voters to back them again.
Thank you JGP, plenty of Info there, take the rest of the day off
Thank you so much for providing that summary. You’re an absolute star!!