I am subject to a chronic embarrassment. It is assumed that because I write about politics, I must be able to forecast the future. But I always decline. If people insist, I will have a crack at predicting the recent past, but that is difficult enough.
Consider the position last December. The Labour Government had endured a lousy start, and this was entirely its own fault. It had done nothing to prepare for government, concentrating on prettifying ministers with the help of Lord Alli plus some imaginative CV drafting, and finally some mean-spirited indulgence in class warfare. Almost in the aftermath of the huge Labour victory, people were asking how long this could last, to which there was an inevitable and regretful answer. Given the brute force of such a parliamentary majority, four years is doable.
Three months later, politics, if not transformed, is certainly very different. The Government has been galvanised – particularly by Donald Trump. The Donald had various expectations for his presidency: Sir Stumbler, for his Premiership too. Neither man would have seen the other as a political partner.
That said, ‘partnership’ is still a premature assessment. But this American administration is discovering, as its predecessors almost always did, that out of all the European nations, the Britons are more likely to see the world through the same eyes as the Yanks do. The Starmer Government may yet make a crucial contribution to stabilising Nato. After all, Ernest Bevin was there at the beginning. Certainly, the special relationship seems likely to survive.
It of course is a much more complex matter than some simple-minded Tories assume. As Churchill himself discovered vis-a-vis Roosevelt, Americans are not necessarily natural allies. They are too strong and too big. Suez was a spectacular example of everything going wrong, but even the Thatcher-Reagan years saw the president’s early vacillations over the Falklands and the landing on Grenada – without telling Her Majesty’s Government that one of the Queen’s territories was about to be invaded: the Monarch was not pleased – and finally Reykjavik, when the president seemed ready to compromise on the UK’s independent deterrent. There are two conclusions from such a complicated history. First, that the Americans eventually do the right thing, but only after exploring the alternatives. Second, that although the special relationship may have had a mythic dimension, it is as strong as ever.
Our current Prime Minister seems to have a bold strategic ambition. He would like to act as a bridge across the Atlantic, helping to establish a modus vivendi between the Europeans and the President Trump. Will this work or will it end in mistrust all round? It will be fascinating to watch.
This has not exhausted Starmer’s boldness. Since Clement Attlee established the NHS, successive administrations have tried to decide how to run it. Enoch Powell identified one unique feature. Normally, if an organisation is failing, it will come under an uncharitable scrutiny and its top management will be fired. In the case of the NHS, those in charge merely demand more money.
Back in 1980, I ran into John Hoskyns, then head of the No.10 Policy Unit. He gave his verdict. The NHS was like a primitive dinosaur. It had no central nervous system and did not know what it was doing and why. In area health authority A, a given course of treatment would cost X. Area health authority B next door: 3X, with no apparent difference in outcomes or patients’ satisfaction. So he was going to speed up evolution and enable the NHS to think through its activities. That sounded like common sense, but alas, the revolutionaries gave the contract to Dr Frankenstein’s laboratory. It produced a bureaucratic monster which gobbled up resources, demoralised doctors and pleased no one except its own employees.
Fast forward 30 years. The Tories’ 2010 Manifesto declared that there would be no more top-down reorganisations. But that didn’t consider Andrew Lansley, the incoming health minister. He was determined to leave his mark on history. Hence a giant bill and the establishment of NHS England. The aim was to free the NHS from political interference. But that never worked. Lansley set out to be Nye Bevan II. Instead, he became Dr Frankenstein II.
Step forward Wes Streeting, one incoming Labour minister who had taken some trouble to master his new brief. When in opposition, he uttered a defining statement, which few if any Tories would have had the courage to echo: that the NHS should be a service, not a shrine. He has now taken a scythe to the bureaucrats to create more resources for the front-line while reasserting political control. This of course does mean that ministers will be in the line of fire if anything goes wrong. As Bevan put it, if a nurse drops a bed-pan, the sound will reverberate through Whitehall.
Streeting proposes to scrap about 10,000 posts, most of which are occupied by Labour voters: bold indeed. There are some grounds for doubt. The Streeting reforms will focus attention on hospitals but the NHS’s real weaknesses are in GP care, not to mention social care. Another problem is the shortage of doctors and nurses. At present, large numbers of British youngsters are being turned away by medical schools. Many of them would do a good job. Though that may take years to correct, it ought to be put right.
As it is, the Tories are trying to work out how to deal with Starmer Mk 2. In the short run, statesmanlike caution is advisable. As far the slightly longer run, the problem of prediction remains unsolved.
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