Common Honesty
David Aaronovitch writing in The Times has a well-deserved blast at the ongoing level of debate in the Westminster general election in which all of the parties tend to treat the voters as complete idiots who are unable to hold two different thoughts in their heads at the same time.
For the moment it's all a bit of fun as the various political rivals all seek to outbid each other over NHS funding, for example, or the length of time UK immigrants will have to work before becoming eligible for state benefits.
But once the election is over there will come a day of reckoning and that's the point at which everyone will agree the sums simply don't add up and the whole process will start all over again.
So while I'm all in favour of a bit of honesty in the NHS and other political debates the truth is that the political culture in the UK has developed into one where the favourite tactic is to 'monster' the opposition.
Let’s have a bit of honesty in the NHS debate
By David Aaronovitch - The Times
The election is awash with wild funding promises. Trouble is, we prefer trivia and bluster to serious, informed discussion
I have been abroad for two weeks, but even so I find it hard to believe that while I was away the voters of Pudsey and Paddington became suddenly more concerned about Nicola Sturgeon than about the health service. And if one in five Tory voters could pick out Grant Shapps from a line-up of failed Apprentice contestants I would be astonished.
Yet that seems to be half the election we’re fighting. The other half was well expressed in the odd debate held without the coalition parties while I was away. Reports suggested that it took the form of an auction: I see your bid of 1,000 extra nurses and raise it by 500 midwives and an army of extra border protection officers. Funding details to be found in our fully costed manifesto or else in our first budget, when we’ve seen the books.
Me, I am scarred still by 2010. All the major parties went into that election promising not to cut frontline services and all knowing that the promise was impossible to keep. Despite having the leaders’ debates the formats made it impossible to interrogate the would-be prime ministers on the true nature of the problems and challenges of the new decade.
The absence of the proper leaders’ debates hasn’t improved things. Let’s take the health service, mentioned by nearly half of all voters as among their top concerns. As things stand not one of the main parties has explained how they will meet the stand-still cash needs of NHS England up to 2015, let alone their party aspirations for improvement.
As revealed yesterday the budgets for hospitals and other health providers were overspent by more than £800 million in the financial year that ended three weeks ago. This is on top of the £900 million extra switched into their accounts from various sources, and the savings resulting from lower than anticipated inflation.
So the new government faces an immediate NHS cash crisis in a situation where already there are deteriorating outcomes in waiting times and in A&E. That shortfall is the short-term part of the now-magical £8 billion per year figure, conjured up by NHS England last year and required by 2015. That figure itself was predicated on productivity gains that look unlikely to be achieved.
So you would have thought that, at the absolute minimum and before anyone did anything else, the main parties would account for the £8 billion (or whatever sum they wished to substitute) and how they intended to fund it.
None of them has. Labour has promised an immediate fund of £2.6 billion “in the first 100 days”, supposedly partly funded by a not-to-be-disclosed-before-the-election level of taxation on houses worth more than £2 million. But this fund has already been loaded with extra commitments. Attempts by BBC interviewers this week to get the health spokesman Andy Burnham and his colleague Jamie Reed to answer questions about the £8 billion per year shortfall deserve close scrutiny by lovers of political farce.
Would they commit to the £8 billion? Reed wouldn’t say, but “We’ve been absolutely consistent that we’ll give the NHS what it needs”. But Burnham’s reply was that (a) he wouldn’t write cheques that might bounce and (b) Labour had founded the NHS. In other interviews Burnham appeared to insist that integration of health and care services would create huge savings and therefore make such large NHS spending increases unnecessary. Yet he must know that such savings were already built into NHS England’s productivity assumptions. And this week both he and the Liberal Democrats in effect committed themselves to end the limitations on pay increases in the NHS.
This may well be the right thing to do, since NHS recruitment could become a huge problem (and if the “control immigration” parties get their way, an insuperable one), but it adds to the £8 billion.
What about the Tories and the Lib Dems? They will both guarantee the £8 billion but have loaded their offer with extra promises and, in the case of the Conservatives, made no coherent suggestion of where the money would come from and how it would be staged.
Remember, the £8 billion was the imaginary amount needed to stand still and, probably, deteriorate a little. Once we begin to try to pay for essential improvements then we are in different territory. The Barker Commission into social care estimated that future needs would amount to an extra £14 billion by 2025. They recommended looking at funding options such as the reintroduction of prescription charges for most current exemptees, limiting free TV licences and winter fuel payments, as well as increasing national insurance for the over-40s and the wealthier.
In the absence of honesty in the funding debate it is easy to fall back into pessimism. It’s a black hole, we can never afford it, let’s ditch the NHS and start again etc. But the NHS is not popular in Britain because the British are mad but because it is readily understood and represents a social solidarity and pooled risk that citizens actively endorse. Whichever system you chose you’d still have to pay more for it. But you really ought to say how.
My point here goes beyond just the NHS. A panic over immigration has led to a series of auctions over measures supposedly to control the numbers of people coming here. For example, who can suggest the longest qualification period before new migrants are eligible for benefit? Who can bash the anti-Brit gangmasters hardest? Yet none of these measures can or will curb immigration, even if that were desirable.
So where is the accountability in this election? And do we even want it? I would recommend to readers the heroic work put in by analytical and data journalists, trying to indicate to voters what the facts are and what the promises amount to. But they must often feel that the voters are in soft cahoots with the parties in not wanting to be distracted from trivia and bluster by the hard work of comparing pledges with realities.
Instead they are beguiled by a nice woman in a supermarket in, I don’t know, Bromsgrove, being asked whether she’d like to be given six months’ extra paid childcare. And yes, she would!
In my ideal world all the terrestrial channels plus Sky News would be required by law to screen peak-time election debates between the main spokespeople on health, education, foreign policy, the economy and so on, in which the questions would be asked by experts and unsatisfactory answers would be challenged. In my ideal world, of course, everyone would want to watch.
The election is awash with wild funding promises. Trouble is, we prefer trivia and bluster to serious, informed discussion
I have been abroad for two weeks, but even so I find it hard to believe that while I was away the voters of Pudsey and Paddington became suddenly more concerned about Nicola Sturgeon than about the health service. And if one in five Tory voters could pick out Grant Shapps from a line-up of failed Apprentice contestants I would be astonished.
Yet that seems to be half the election we’re fighting. The other half was well expressed in the odd debate held without the coalition parties while I was away. Reports suggested that it took the form of an auction: I see your bid of 1,000 extra nurses and raise it by 500 midwives and an army of extra border protection officers. Funding details to be found in our fully costed manifesto or else in our first budget, when we’ve seen the books.
Me, I am scarred still by 2010. All the major parties went into that election promising not to cut frontline services and all knowing that the promise was impossible to keep. Despite having the leaders’ debates the formats made it impossible to interrogate the would-be prime ministers on the true nature of the problems and challenges of the new decade.
The absence of the proper leaders’ debates hasn’t improved things. Let’s take the health service, mentioned by nearly half of all voters as among their top concerns. As things stand not one of the main parties has explained how they will meet the stand-still cash needs of NHS England up to 2015, let alone their party aspirations for improvement.
As revealed yesterday the budgets for hospitals and other health providers were overspent by more than £800 million in the financial year that ended three weeks ago. This is on top of the £900 million extra switched into their accounts from various sources, and the savings resulting from lower than anticipated inflation.
So the new government faces an immediate NHS cash crisis in a situation where already there are deteriorating outcomes in waiting times and in A&E. That shortfall is the short-term part of the now-magical £8 billion per year figure, conjured up by NHS England last year and required by 2015. That figure itself was predicated on productivity gains that look unlikely to be achieved.
So you would have thought that, at the absolute minimum and before anyone did anything else, the main parties would account for the £8 billion (or whatever sum they wished to substitute) and how they intended to fund it.
None of them has. Labour has promised an immediate fund of £2.6 billion “in the first 100 days”, supposedly partly funded by a not-to-be-disclosed-before-the-election level of taxation on houses worth more than £2 million. But this fund has already been loaded with extra commitments. Attempts by BBC interviewers this week to get the health spokesman Andy Burnham and his colleague Jamie Reed to answer questions about the £8 billion per year shortfall deserve close scrutiny by lovers of political farce.
Would they commit to the £8 billion? Reed wouldn’t say, but “We’ve been absolutely consistent that we’ll give the NHS what it needs”. But Burnham’s reply was that (a) he wouldn’t write cheques that might bounce and (b) Labour had founded the NHS. In other interviews Burnham appeared to insist that integration of health and care services would create huge savings and therefore make such large NHS spending increases unnecessary. Yet he must know that such savings were already built into NHS England’s productivity assumptions. And this week both he and the Liberal Democrats in effect committed themselves to end the limitations on pay increases in the NHS.
This may well be the right thing to do, since NHS recruitment could become a huge problem (and if the “control immigration” parties get their way, an insuperable one), but it adds to the £8 billion.
What about the Tories and the Lib Dems? They will both guarantee the £8 billion but have loaded their offer with extra promises and, in the case of the Conservatives, made no coherent suggestion of where the money would come from and how it would be staged.
Remember, the £8 billion was the imaginary amount needed to stand still and, probably, deteriorate a little. Once we begin to try to pay for essential improvements then we are in different territory. The Barker Commission into social care estimated that future needs would amount to an extra £14 billion by 2025. They recommended looking at funding options such as the reintroduction of prescription charges for most current exemptees, limiting free TV licences and winter fuel payments, as well as increasing national insurance for the over-40s and the wealthier.
In the absence of honesty in the funding debate it is easy to fall back into pessimism. It’s a black hole, we can never afford it, let’s ditch the NHS and start again etc. But the NHS is not popular in Britain because the British are mad but because it is readily understood and represents a social solidarity and pooled risk that citizens actively endorse. Whichever system you chose you’d still have to pay more for it. But you really ought to say how.
My point here goes beyond just the NHS. A panic over immigration has led to a series of auctions over measures supposedly to control the numbers of people coming here. For example, who can suggest the longest qualification period before new migrants are eligible for benefit? Who can bash the anti-Brit gangmasters hardest? Yet none of these measures can or will curb immigration, even if that were desirable.
So where is the accountability in this election? And do we even want it? I would recommend to readers the heroic work put in by analytical and data journalists, trying to indicate to voters what the facts are and what the promises amount to. But they must often feel that the voters are in soft cahoots with the parties in not wanting to be distracted from trivia and bluster by the hard work of comparing pledges with realities.
Instead they are beguiled by a nice woman in a supermarket in, I don’t know, Bromsgrove, being asked whether she’d like to be given six months’ extra paid childcare. And yes, she would!
In my ideal world all the terrestrial channels plus Sky News would be required by law to screen peak-time election debates between the main spokespeople on health, education, foreign policy, the economy and so on, in which the questions would be asked by experts and unsatisfactory answers would be challenged. In my ideal world, of course, everyone would want to watch.
