This week’s TUC conference signals the start of the political season, when the rhetorical volume gets turned up.
So before we get stuck into our own slanging match over those public spending cuts and tax rises which some people want for other people, listen to this for a bit of perspective.
The US debate over President Obama’s healthcare reforms has unleashed such deep and irrational anger that it could end in violence.
Who says? Three friends, just back from separate trips Stateside, with whom I talked.
“You don’t know what it’s like now, Mike, you haven’t lived there for years,” said one, himself a Yank. “A lawyer, an educated man, said to me ‘Tell me about these death panels you have in Britain.’”
“Why is this National Institute for Clinical Excellence called NICE if it kills people?” added another.
Scary stuff, and more so if you can spare the time on YouTube to watch the president’s speech to Congress last week, as lucid and rational a case for regulated medicine and shared risk as you could hope to hear, though one congressman shouted: “You lie.”
What is more, I suspect Gordon Brown, David Cameron, Nick Clegg and their health barons could all sign up for most of what Obama said. That is why I make the point. Our current political differences on health are significant, but not fundamental as the US’s are.
Andrew Lansley made a big pre-election health speech last week.
At a King’s Fund breakfast this week Andy Burnham was due to make his own. Mr Lansley’s speech wasn’t actually billed as covering new ground, but it led The Telegraph: “Tories to cut rate of spending on NHS.”
What he said was blindingly obvious.
The rate of spending under a Cameron government will slow down compared with Labour’s boom years. The NHS will have to “tighten its belt,” there will be “no blank cheque”. Ageing, obesity, higher expectations, they all cost money. I don’t think the shadow health secretary will mind much if I say he left no cliché unturned.
What struck me talking about the speech to Tory officials was that they believe their message to staff and patients is clear: we will fulfil our promise to protect the health service and not to privatise it, but it faces challenges.
It is Labour which is sending out mixed signals, they say.
Cross the street and Labour complaints are almost a mirror image.
“They must come clean. We need to know where the Tory cuts will fall,” says one.
The overall 18 week wait, the official suggested. Creeping privatisation too.
Andy Burnham has been in Liverpool this week assuring wary health workers in Unison and elsewhere at the TUC that Labour will protect frontline jobs and services which the Tories can’t wait to cut.
Lord Mandelson’s “wise spenders, not big spenders” speech silkily conveyed the same message. Are you much the wiser? No, I thought not.
Pre-publicity for the health secretary’s speech stressed his warning that up to 4 per cent of tariff payments after 2011 will depend on patient satisfaction levels (staff satisfaction too, he told the TUC), and the need for nurses to smile and remember that post-op cuppa. That is an important point (could it work in real life, I wonder?), but not a fundamental point in the Obama sense.
This week the TUC has raged against bankers’ bonuses. It wants the rich to pay for the crisis. Trouble is there are never enough rich. Higher taxes, tighter services, we will all pay, whoever wins.