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Commentary from Westminster
Labour’s Campaign on Behalf of the National HealthService
THE Labour Party is now committed to a loud and
unremitting campaign-inside and outside Parliament-against the Government’s rundown of NHS resources.Many apolitical friends of the NHS will be pleased aboutthat, out perhaps they should reserve their judgment for awhite. The projected campaign carries some risks for theNHS. The Party’s new leader, Mr Neil Kinnock, has shownsome political astuteness in identifying the plight of the NHSas an issue which has united, for the first time, a very widespectrum of people and interests against Government policy.Not only are the BMA and health workers from consultantsto porters apparently as one in their fears about the financialfuture, but also many people, patients and non-patients,are to all appearances deeply worried. This discontent offersan obvious opportunity for the Labour Party, an opportunitywrrich it is not at all improper for them to seize.They have seized it, launching a campaign which includes a
publicity-attracting ambulance; and urging people to lobbytheir MPs, health authorities, local newspapers, and com-munity health councils, to raise petitions, and to involve theirtrade unions as much as possible. Mr Kinnock insists that heeoes not see this campaign as merely a useful rung for theLabour Party on the long ladder back to Parliamentarypower. In the recent Commons debate on the NHS he
promised that Labour would welcome any reversal of presentGovernment policies, even if it meant that the wind was takenout of Labour’s political sails. Mr Kinnock’s newlyappointed shadow Health Minister, Mr Frank Dobson(Holborn and St Pancras South), says: "If the Governmentresponded to the national desire for a properly funded healthservice then I would be glad about that, even if it made it moredifficult for us to criticise them". Labour’s campaign, whichpromises to be a strident one, could possibly alienate many ofthe people now committed against the Government’s policyunless Labour politicians can give convincing answers to twoquestions.The first doubt that must occur, at least To those directly
involved in providing health care, is whether inviting thepress to take photographs of an ambulance outside Labour’sLondon headquarters is really the most effective way of
getting more trained nurses ino neonatal intensive care unitsor providing funds for mere dialysis machines. Mr Dobson,for one, has a lot of faith in such publicity. "In a democracy,"he argues, "all you can do is tell the truth and try to generate a
big enough head of steam among the public to get theirpressure to divert the Government from its present course ofaction". He is quite sure that public disquiet over thedirection of Conservative thinking has already saved theNHS from having its pockets picked by the Treasury evenmore thoroughly than has already happened. Politicians’efforts at Westminster can be effective only when they reflectthe concerns of the public, he maintains; and Westminster isonly one part of the battlefield in what he calls "the war tosave the NHS". Although more and more people are
becoming aware of the crisis in NHS funding, most of thepopulation are neither patients nor relatives of patients, andthus do not see the issue as directly affecting themselves,which is why Labour’s campaign must be strident.The second doubt must be about the ability of Mr Dobson
and Mr Michael Meacher, Labour’s new shadow SocialServices Secretary, to sustain the united front into which the
Conservatives have so clumsily and fortunately forged theGovernment’s opponents inside and outside the NHS.
Opposition to the funding reductions is now a very broadchurch, but Mr Meacher and Mr Dobson could prove to bepriests far too sectarian to hold it together. Mr Meacher is adevoted acolyte of Mr Tony Benn, who is said to see hisprotege as another Clement Atlee in the making. During thecontest for the party’s deputy leadership Mr Meacher drewhis support principally from the uncompromising "hard"left, and received enough votes to give him some authority asthe left’s standard-bearer. He is sponsored by the healthunion COHSE. At least one Labour health aficionado has
already expressed a fear that Mr Meacher will not be able toavoid discharging his duties with rather too strong a biastowards the health unions for many people’s taste.Mr Dobson is not so closely identified with the far left. He
makes no bones, however, about his chairmanship of NHSUnlimited, an organisation which exists to monitor and
campaign against all manifestations of private health
provision, on the grounds that private provision always andinevitably weakens the NHS. Mr Dobson stands by theLabour Conference’s commitment to abolish privatemedicine, and has no doubts about the wisdom of his party’savowed intention to take a "major public stake" in the
pharmaceutical industry. While these policies might causethe NHS some disruption, they were necessary andbeneficial. Yet Mr Dobson urgently and affably denies allcharges of sectarianism. "Even my enemies would not saythat of me," he insists optimistically. His constituencyincludes several major hospitals and the headquarters of theBritish Postgraduate Medical Federation. He says he washeavily involved in resisting recent Government increases infees for postgraduate study, and had long dealings with thepostgraduate deans, who did not find him sectarian. Further-more, he and Mr Meacher will be seeking meetings with allgroups involved in the NHS, including the BMA and theRoyal Colleges, whose views will be listened to as attentivelyas will those of NUPE and COHSE. "We are interested in
getting a health service in which morale is high, and wecannot do that by attending to the needs of just one
grouping," he promises. Nevertheless, it remains to be seenwhether Labour’s campaign to safeguard the NHS will besidetracked into the blind-alley of a campaign to re-elect theLabour Party.
Binder Hamlyn Draws Near
Meanwhile, the wolf is still at the door. The Social ServicesSecretary, Mr Norman Fowler, is planning to publish withina month the report on funding of the family practitionerservice, compiled by accountants, Binder Hamlyn. Theywere charged with assessing whether a cash limit can beapplied to the FPS, but they concluded it could not. Theyhave, however, offered a range of options for reducing thecost of primary care, the financial management of which is,they say, incompetent at present. Mr Fowler will not publishthe report with any specific plans for Government action, buthe will offer it as a list of suggestions which he would likeGPs, family practitioner committees, health authorities, andCHCs to comment on. In view of the forecasts about many ofBinder Hamlyn’s options, Mr Fowler may decide thatdiscretion is the better part of valour. Among the suggestions,apparently, are a proposal to cut the cost of capitation feespaid to GPs, alternative systems for reducing the near 78million annual cost of items of service, proposals for somelimitation of reimbursement of staff costs, and a plan forlimited and self-imposed generic prescribing by GPs.