There has been a touch of the ‘I had that David Cameron in the back of my cab’ to the Prime Minister this week.
Street parties for the Royal Wedding … all them Labour councils (allegedly) stopping people having fun, elf’n’safety blahdiblah … then he takes on the issue of the lack of black students at his alma mater, Bullingon College, Oxford … ‘ok, I got my facts all wrong, but you know what I’m saying’ was the post-rant defence … and now immigration, where he is in the unfortunate position of the BNP claiming he has lifted whole sections of their manifesto.
The similarities between cabbies and Prime Ministers include the fact that they are expected to have opinions on everything from Fernando Torres to Colonel Gaddafi (both under pressure at the moment). The difference is that the Prime Minister can devise policies to address the problems and talking points that consume so many words in taxis (he didn’t go for a cap on footballers’ pay when we took the Dream School kids to meet him by the way, so Torres’ money is secure even if his form is not).
It is hard to discern what the policy proposals are in Cameron’s immigration speech, and that does lead one to the view that this is all a bit of pre May 5 dog whistle politics, playing back to the public what they have said in focus groups, rather than taking a difficult policy area and really thinking it through.
… Which brings me to health. I had an interesting ringside seat to the Royal College of Nursing’s battle with health secretary Andrew Lansley yesterday. I was there to talk about mental health, and the Time to Change campaign, but was asked about how I thought they should handle the government’s NHS reforms.
It is inevitable a lot of the focus will be on Lansley, but I warned them not to personalise it too much. Cameron and Nick Clegg are every bit as signed up to these plans, and there is a danger Lansley becomes the fall guy but (post reshuffle) the basic thrust for the NHS will be the same – smaller state, bigger free market role in the NHS.
Sincere thanks to those of you who sent in examples of frontline cuts already happening. I used plenty of them in my speech, which I believe you can see on the RCN website. I also used the brilliant description by Mark Brown, editor of One in Four, on why the frontline in mental health services is a different, and more complicated concept that it is for other aspects of health care.
I also pointed out that it is important not just to allow the debate to be dominated by the reforms. Because cuts are happening to the frontline now. They promised no cuts, and no top down reorganisation. They are now embarked on a programme of both.
On the reforms, I quoted nurse Karen Chown … ‘the NHS is not failing by any objective standards. We have a lower neonatal death rate than the USA and our life expectancy is longer. It is also – contrary to misinformation by the Tories – one of the most cost-effective health care models in the world.’
And I concluded with this … ‘You have Mr Lansley visiting some of you later today. He is on his pause tour. He is listening. Well I hope he listens to those people (who responded to Monday’s blog).
I hope he listens to people surveyed recently who gave the NHS the highest satisfaction ratings in its history.
He should listen to the voters at the last election who denied his party a majority precisely because they were worried about what they would do for the NHS. It was barely an issue. It barely figured in the TV debates. Why? Because people were largely happy with the service you gave.
So now along they come – no mandate, not in the Tory manifesto, not in the Lib Dem manifesto, not in the coalition agreement – with the biggest shake up since the creation of the NHS.
I know a bit about politics. I know a bit about strategy and tactics. Understand that the pause is a tactic. The strategy is still the same – to drive through the cuts and to drive through the reforms even though they promised they wouldn’t do the cuts and even though they promised there would be no top down reorganisation.
The Tories are using the political cover of a coalition government and the economic cover of the fall-out from the global crash to do things they always wanted to, and that includes shrinking the state and that includes in relation to the NHS. And he hasn’t got the bottle to face all of you because he knows that you know exactly what’s going on.
Again it is mental health I worry about … I have yet to meet one GP who wants to take on MH services in the way set out in the reform plans, or who thinks they can run those services adequately with all the other pressures on them.
David Cameron constantly espouses the virtues of community and social wellbeing in his ‘Big Society’. Yet at the same time as attempting to sell some idea of a ‘political utopia’ they are seeking to starve the very sector that is best placed in helping them achieve their goal. It is simply not good enough to suggest that any shortfall in assistance can be met through the voluntary sector alone, because as we have heard, they are facing cuts and financial pressures too.
Let me state the obvious – a decline in the nation’s mental health budget will lead to a decline in the nation’s mental health. At a time of austerity and savage cuts the state of the nation’s mental health and general wellbeing will be essential components in overcoming the challenges our country faces in the years to come.
So what can you do? Well first of all, understand that though this is a government that wants to change the world, the prime minister is not averse to changing his mind when the political heat is on … forestry, school sports, housing benefit, school milk, Bookstart, knife crime, and of course now the Lansley pause. Margaret Thatcher may not have been one for turning. But David Cameron is. They respond to pressure, they turn when the heat is on … so let them feel the heat. Let them know what you think. Let them know that you’re telling your patients what you think, because people will believe you more than the media or the politicians. Above all please, stand up for the protection of mental health services. Persuade them that they are cutting off their nose to spite their face… that cuts today will mean not just more human suffering tomorrow, but more money needed to deal with the health, social, the criminal justice consequences.
They say the frontline is protected. You know the frontline has already been cut. And we all know the frontline faces further cuts in the future. You know that if the cuts go through and the reforms go through we no longer have an NHS as we know it and as we have built it up over the years. So fight the good fight, keep on caring, keep on nursing, keep on in the knowledge you are popular, respected and cherished by the British people whatever plans the government may have, and you have more support than it might feel like when the government are whacking you about the head.’
I was a nurse when Thatcher the Hatchet fell. I now find myself as a long-term patient under the boy blunder & already my referral times have substantially increased, staff are noticeably under more pressure & afraid for their patients, forced to run guerilla clinics under radar of their bosses & terrified for the future of the NHS.
I have been going to Congress for a long time and I cannot remember anyone getting two standing ovations before, so well done and thanks for all you said and all you do for mental health issues. I am a mental health nurse and I know the cuts are hitting the service to the patient. You talked about salami slicing. it is happening
I heard his immigration minister on the radio and he sounded embarrassed. He could not really explain why Cameron was making this speech now. By the way am I alone in feeling a bit sorry for Lansley?
Loved Dream School last night. I thought the kids did ok with Cameron and he did ok with them, though without giving any sense he understood what they were about. Your exchange with Osborne was priceless but at least he looked like he might have a sense of humour about himself
The spats between Cable and Cameron over immigration and between Alexander and Osborne over AV/FPPP reinforce my fears that the Coalition won’t ride out the May elections, resulting in a General Election sooner than expected – one which the Tories might scrape through with more seats than last May. Someone persuade me I’m a pessimist!
The Lib Dems can’t afford an election as they would probably disappear! So, no matter how bad the May results they’ll still be there having their metaphorical 15 minutes of fame.
Cameron’s immigration speech has served its purpose even before he delivered it: to push Lansley and the NHS disaster off the media. Downing Street will probably be pleased that Cable has now weighed in and criticised Cameron because that will give the story even more mileage and both the Tory core vote and the right-wing press will side with Cameron anyway.
Dream School was great entertainment, which is the primary purpose of all TV programmes, including the News programmes. It was by turns infuriating and very moving and I think gave some genuine and worthwhile insights into education, the most important being that most kids are capable of being inspired and discovering their talents and aptitudes, be those academic, artistic or practical. The problem is that doing this is extremely expensive in both time and money and politicians’ pieties about education will never be matched by the kind of resources that could really make a difference to those who currently fail. Giving teachers more freedom, as Jamie suggested, would be fairly cost-free. But can you imagine the reaction of the Daily Mail if a teacher emulated Robert Winston’s brilliant idea of getting boys to provide a semen sample for a science lesson? Maybe there are great swathes of adult society that need to ‘grow up’ before we can expect better behaviour from kids.
May I add that one of the main criticisms of the kids in Dream School was their rowdiness in class and inability to shut up and listen. But such rowdiness and shouting people down is normal behaviour in the House of Commons, especially at PMQs or occasions like Budget Statements. Over the years MPs have been guilty of sexist abuse, homophobic abuse, being drunk in the Chamber and even mocking MPs with disabilities.
We’re always told this is part of our grand old Parliamentary tradition but I suspect that the Dream School teenagers would just see it as double standards and I tend to agree with them.
I also think that allowing MPs to use iPads during debates is a bit silly when trying to crack down on school students using mobile phones. If MPs really want to modernise, switch to electronic voting instead of wasting hundreds of hours a year trooping through the lobbies.
Michael White liked your speech too – have a look at the Guardian.
You know health is a devolved issue?
The UK government can only batter the English NHS not the mythical “British NHS”.
most cab drivers these days can’t speak English anyway, so you’d have a job getting any opinions out of them, unless you spoke Urdu or Punjabi
The Tory-led government has a small-state agenda.
Like Thatcher, it claims that there is no alternative. But its plans are not working.
Slashing public spending has not produced recovery.
The government thinks that the smaller the state, the better the economy will thrive.
The government believes that the only way to restore private sector spending is to cut the Budget deficit as quickly as possible by reducing public spending.
People will then know that there will be no need to raise taxes, and they could spend their extra savings now.
The Tory-led government wants to reduce the deficit from 10% of GDP to zero.
But it should understand that fall in PRIVATE spending causes the deficit to rise. Fall in demand is the real problem, not rising interest rates.
It is a basic rule that you do not cut government spending unless recovery is firmly established.
Growth is higher in countries with higher public investment in social and physical assets.
There should be no cuts in capital investment now.
Expansionary fiscal contraction works only if there is relaxation of monetary policy and devaluation of the exchange rate.
But there is no rapid growth in Britain at the moment!
Britain is facing higher taxes, depressed wages and rising unemployment. Interest rates will also start rising.
The economy is not strong enough for the cuts of £81bn.
The ideologically-driven incompetent Tory-led government is only creating chaos. It is wrong on cuts, deficit and growth!
I feel sorrier for the UK electorate. We lap up these people at face value (Lansley and his “sorry…sorry” being a good example) and we keep letting them get back into government and they never change their spots, always the same old Tories, same old nasty party, same old bunch of elitist retros harking back to the ‘Glorious Revolution’ of 1688 and Edmund Buke’s 1790 diatribe against ‘the swinish multitude’. So here we are in 2011, granted a day off work to celebrate the recrudescence of feudalism and simultaneously letting this Toffocracy try to abolish our own day off when we celebrate organised and international labour.
I need a therapeutic walk in the countryside – but what are these signs juxtaposed ahead? ‘PRIVATE: KEEP OUT’. ‘TRESPASSERS WILL BE PROSECUTED’. ‘VOTE CONSERVATIVE’. Sometimes I despair.
You are right! These brats get their role models by watching BBC Parliament, and develop their foul mouthed agression via PMQs and Budget Statements. How shrewd of you to have been the first to spot the connection.
I made no such causal connection so your sarcasm is misplaced. I simply drew attention to the similarity between the two sets of behaviour.
Worth noting though that the privately-educated are vastly over-represented in the Commons especially on the Conservative benches, so these particular ‘brats’ can’t blame their bad behaviour on failing State schools.
‘Again it is mental health I worry about … ‘
You do not appear to be alone check out the 40th Maudsely Debate….
This House Believes That The NHS Mental Health Services Should Not Fear The Private Sector
One could conclude that on this night, the final vote and all that was said by those present, indicates that Institute of Psychiatry’s Maudsley Debate audience dammed any further opening up of mental health services to the private sector and stated unequivocally that capitalism does not care enough.
you do know about politics, but what i can’t get is why the very best at central govt just dont connect with the front line. The Time for Change compagne or See Me For What I Am is not the battle ground. The problem, from the perspective of of senior working within housing in local governent, is not identifing with those with mental health iissues, but addressng those peopple’s need when most of the time they are marginalised from society and have no agency taking the lead (often for budgetry reasons ). My believe is that mental health is a class issue – prisons full and cemeteries follow !
If the Tories allow them, Jose. There have been recent indications amongst the Tory ranks that it may soon be time to ditch the encumbrance of the LibDems. If FPTP wins in the Referendum and the Tories make gains in the local elections at the expense of the LibDems, then it’s possible they may go for the big one, especially if Cameron smiles photogenically at the Royal Wedding and manages to come out of the Libya crisis smelling of roses.
@ Skristmanns – “my believe that mental health is a class issue”
You could well be correct about that. Many homeless people clearly have mental health problems. I often wonder which came first, being homeless or their mental health problems. Personally, and maybe rather controversialy, I think it was a mistake to close down the asylums. Some people with MH problems can manage fairly well in the community, with a bit of help and medication. Others simply can’t manage and never will be able to cope with “normal” life. The asylums gave them a safe sanctuary where they may have got just a little enjoyment from life. Surely thats a better option for them than living rough (very rough) on the streets?
“… Dream School teenagers would just see it as double standards and I tend to agree with them.” By “tending to agree with them” you not only confirm that this is an opinion held by such Dream Schoolers, you are supplying them with an excuse for their loutish behaviour.
The brat, excluded from the Downing St visit, was ready to give AC hell in the last Politics class as a result, but was rewarded for a half hearted apology.
So the non privately educated MPs blame their own bad behaviour on failing State schools do they? Chips on shoulders lead to bad deportment and mental obesity.