Blair's NHS U-Turn

Who Scares New Labour?

"Average" is hardly a revolutionary demand. But the promise means increasing the Health Service budget by somewhere between 40% and 60% over the next six years, bumping it up by between 5% and 8% a year after inflation.

Nothing utopian about that: the amount is not much more than the government's budget surplus this year, and only a bit over one per cent of national income. Yet it would make a huge difference. The promise is big enough - and specific enough, unlike Blair's obviously windy talk about ending child poverty - to make people expect real improvements and protest when they do not come.

If we rely on Blair's promises alone, the improvements will be small. Already, in the few days since he made his pledge on 16 January, Blair has been backpedalling. If Blair now thinks that the "New Labour" stance of promising the working class nothing better then future gravy spills from the feast of "modernisation" has become untenable, he has a large and dismal repertoire of "Old Labour" deceit to fall back on.

But in history, the downfall of dictatorships and absolute monarchies has often started when they begin to reform. The reforms are designed to placate people, but in fact stir them up. By signalling that improvement is possible, they incite people to demand real, radical and rapid improvements. For 23 years now, since Harold Wilson's Labour government began drastic cuts at the behest of the IMF, our Health Service has lived under the absolute monarchy of Cuts. Blair's promise should open the door for the republicans who demand free state-of-the-art health care for all, as a human right, to come onto the streets.

What shook Blair into making his promise? Was it the fact, flashed at him each day in the media, that the big majority of London trade unionists and Labour Party members will vote for Ken Livingstone as Labour candidate for London mayor in defiance of Blair's personal and strident demands that they not do so? Was it opinion polls which showed that 69% flatly disbelieve the government's claims that hospital waiting lists are getting shorter, and only 14% believe them?

Was it the polls' report that a four-to-one majority wants the government to scrap its planned income-tax cuts and put the money into the Health Service instead? Or their finding that the proportion who think that the NHS has improved under New Labour has gone down from 11% in June 1998 to just 8% now?

Or was it the dissent in his own ranks, when the Blair-loyalist lord and famous hospital consultant Robert Winston damned the government's health budget as "not as good as Poland's"?

Winston told the New Statesman that health care was "just gradually deteriorating because we blame everything on the previous government". "I think we've been quite deceitful about it. We haven't told the truth, and I'm afraid there will come a time when it will be impossible to disguise the inequality of the health service from the general population. We gave categorical promises that we would abolish the internal market. We have not done that. Our reorganisation of the health service was very bad. We have made medical care deeply unsatisfactory for a lot of people".

Even after the New Labour hierarchy put the screws on him to recant, Winston still said: "Successive governments - and this one included - have not yet paid sufficient attention to the needs for funding that are going to be required for the future".

Another Blair loyalist, Peter Kellner, wrote in the Observer: "Tony Blair is lucky to have such weak opponents. Were the Tories more credible and the Liberal Democrats more popular, the Government would be in serious trouble over its stewardship of the Health Service".

Maybe that is what pushed Blair. He has to have a general election in the next year-and-a-bit, and cannot rely on the Tories self-destructing. But Kellner's comment should be a challenge to us. "Weak opponents"? Why doesn't Kellner even have to bother mentioning Blair's opponents on the left - the socialists, trade unionists, labour activists, and community campaigners who want the NHS restored as a proper taxpayer-funded public service?

Our cause has public support. The opinion polls show that. There have been many big campaigns about particular Health Service cuts, some of which have scored successes. But the mass feeling has not been pulled together in an effective movement.

Such a movement could draw in many other issues, closely connected with the Health Service. Education is being privatised, "marketised", and starved of resources. The value of pensions and benefits is being eroded. New Labour plans to privatise many other services, from social housing through the Tube to air traffic control and soon, probably, the Post Office, creating fresh honeypots of profit at the expense of workers and users. There is widespread, and sometimes active and organised, opposition on all these fronts.

The general issue is the defence of public services - the defence of the non-profit, non-market elements of the "political economy of the working class" won by the labour movement over many decades. The rich few should be taxed to restore civilised conditions for the many! A mass movement on that issue is the best way for the working class to regain the dignity and the confidence battered out of us over 21 years of Tory and New Labour government. It connects directly with the battle for jobs - restoring the public services, and renationalising privatised sectors, is the simple way to create worthwhile new jobs for large numbers of workers in a short time - and with the battle for trade union rights.

If socialists work within it to press the case for workers' and community control, and to explain that working-class socialism is nothing other than the extension of the principle of non-profit social provision under such democratic control to the whole economy, then that mass movement can also be a seedbed for the revival of socialist politics.

There are some reasons outside the reach of the activist left for our failure to build such a movement so far. Before the 1997 general election, many millions chose to ignore Blair's explicit warnings and to hope instead that New Labour would bring a generous, responsive regime committed to reversing Tory damage. After Blair's election victory, many were inclined to "give him time". Then that mood tended to slip into demoralised fatalism: all politicians were the same, and nothing could be done to save the welfare state, not in the foreseeable future anyway.

The activists in the trade unions and the Labour Party, who necessarily must make up a large part of the core of any movement mobilising wider numbers, were jaded and subdued after years of defeat. Many had slid into a routine of doing their best in defensive battles in their own little corner, but leaving any wider perspectives on the shelf for now. To guard themselves against yet further disappointments, they narrowed their aspirations.

But those broad reasons are changing, or beginning to change. The current NHS crisis, and Blair's startling new promise, will help them change further. The opportunities for the activist left will expand.

The activist left has been affected by the same moods as the wider labour movement. Many factions have withdrawn into sectarian routines, or catchpenny gimmicks designed only for immediate gate-receipts. Only a few have put consistent effort into the building of a broad movement to defend the public services.

There too, however, there are some hopeful signs. On the whole, and despite many falterings and reverses, there is a greater spirit of unity and cooperation on the activist left now than for years past.

A number of trade union and Labour bodies have already passed resolutions calling for broad campaigns in defence of public services and against privatisation. Linked together, they could be the nucleus for an enterprise which draws in many people not now active in the labour movement, but angry and willing to act for the Health Service (or social housing, or state education, or pensions...)

The job of the socialists, here as always, is to to blaze the trail and to make ourselves as strong as possible a force against passivity, demoralisation, resignation and narrowed aspirations. The wealth and resources are there to rebuild the Health Service. The problem is that they are in the hands of a rich few. Let us build a mass movement to take that wealth back and make a civilised society for the many.