Abu Qatada and the Two Minutes Hate

By Alex Shattock.

Open a newspaper, and what do you see? Yob villain beats up frail old man. House set on fire by welfare villain. Villainous dictator tries to obtain nuclear weapons.

The concept of the Villain, the incurably evil antagonist, is endemic in today’s political discourse. The right-wing press and the Tory-led government are obsessed with explaining the bad things in the world in terms of evil personalities rather than wider issues or events. Why do they do this? And what effect does it have on us, as the consumers of this discourse?

Talking about villains all the time has its benefits. For a start, everybody loves a villain. We like to read about personalities more than we do abstract issues, so a story is more likely to hold our attention if there are heroes fighting the good fight and villains trying to destroy the world. The idea of pantomime-ish heroes and villains also makes it easier for the majority of us who aren’t doctoral students in political history, anthropology or sociology to understand important events. It is far harder to get our heads around the internal mechanics of the National Socialist Party bureaucracy and power structure in Germany in 1939 than it is to say “One day Hitler (the villain) decided to invade Poland, and so he did.” The latter is, of course, what we learn in school. The concept of a “villain” is therefore a useful tool, both to keep us informed and to keep our attention.

But there are dangers with seeing the world only in terms of heroes and villains. One such danger is that the rhetoric of heroes and villains inevitably simplifies what really happens in the real world.

Simplistic explanations of the world can also be exploited to push a political agenda, and this is the greatest danger the concept of the Villain poses. The Villain is such a powerful figure that he poisons everyone and everything associated with him. So Mick Philpott, villain, the embodiment of over-breeding scrounger evil, can be gleefully described as a “VILE PRODUCT OF WELFARE UK” (Daily Mail). The Mail ran this headline to attack the welfare state, using the associated Villain as its tool. George Osborne was complicit in this shameless exploitation of a tragedy. Likewise, Len McClusky, villain (according to the right-wing press and the government), the embodiment of militant trade unionism, has been gleefully used to attack Ed Miliband with, because of Ed’s association with the Villain.

I want to talk about one particular villain, Abu Qatada, an anti-Western extremist who is currently being used by anti-human rights extremists in the Conservative party to attack the European Convention on Human Rights.

Abu Qatada is a suspected associate of terrorists. There is no evidence for this that can be relied on in court, and so he has never been charged or tried. And yet, he has been a prisoner in a government “safe-house” for over ten years, because the government of Jordan want him to be deported to their country to stand trial for terrorist charges there. The UK government has been prevented from doing this because the Jordanians regularly torture their suspects or convict them using evidence obtained by torture. Sending him to Jordan would therefore breach a number of Qatada’s human rights under the European Convention, and so the government, quite rightly, cannot do it.

You wouldn’t have guessed that this was the issue in question from watching the Parliamentary debate on Abu Qatada (for there was a parliamentary debate on the issue of deporting this one individual). The debate was like that harrowing scene in Orwell’s ’1984′, the ‘Two Minutes Hate’, in which the public are encouraged to focus all their anger and loathing against the image of one individual in order to distract them from totalitarian state they lived in. In the Abu Qatada debate, there was a cross-party consensus of indignation that this individual is being allowed to stay in the UK. The Conservatives and their media allies have poisoned public understanding of the issue so successfully, through simplification and outright fabrication, that Labour are helpless to say “actually, we shouldn’t deport this man, because we don’t believe in torture or imprisoning someone with evidence obtained by torture. We believe in human rights”.

And so the Tories and the right-wing press can use the Villain to attack with impunity the human rights Convention they hate so much. But importantly, they can only do so because of the pre-existing consensus that Abu Qatada is a monster, that he is ‘The Villain’.

I’m not suggesting Abu Qatada is an innocent man, or even that we shouldn’t be imprisoning him without trial. But we definitely shouldn’t treat him as a pantomime villain, we definitely shouldn’t hate him, and we definitely shouldn’t be eager to send him to Jordan where he will be tortured or convicted with evidence obtained using torture. The suffering inflicted on terror suspects by Jack Baeur’s special brand of crypto-fascism cannot be replicated in real life, because in real life you are dealing with people, not pantomime villains, and people have rights. If human rights weren’t universal, they wouldn’t be human rights at all.

Kurt Vonnegut wrote in ‘Slaughterhouse Five’ (a novel about the firebombing of Dresden by the RAF) that in the real world, there are no villains. I think it’s important to remember that. The concept of the Villain is ultimately a simplification, a half-truth and a smokescreen. Qatada will probably come to the end of his life like most ‘villains’ do in the real world: as just another frail old man.

Alex Shattock is a Young Fabians Member.

How Osborne abandoned social mobility

By Louie Woodall.

The words and deeds of this government have rarely been in alignment. However, the gulf between aims and actions is at its starkest when it comes to the goal of greater social mobility.

This mission is supposed to be at the heart of the Coalition’s strategy for creating a fairer Britain, one where a child’s life chances are not dictated by the class and income of their parents.

Yet this laudable policy was grossly absent in last week’s budget. Despite the bluster that this was a budget designed to reward hardworking people, the policy announcements that look like routes out of poverty at first, on closer inspection are nothing more than dead ends.

Take childcare. The government trumpeted its additional spend of £150 million on childcare vouchers as proof of its commitment to remove barriers into work for hard-up families. But an analysis of the distributional impact of the policy reveals that fully 80% of the earmarked funds will go to parents  already in the top half of the income scale. Worse, part time workers will receive nothing under the scheme.

What about Osborne’s celebrated help to buy mortgage guarantee scheme? This was the one part of his Budget speech he singled out as a means to boost social mobility:

“The deposits demanded for a mortgage these days have put home ownership beyond the great majority who cannot turn to their parents for a contribution. That’s not just a blow to the most human of aspirations – it’s set back social mobility and it’s been hard for the construction industry. This Budget proposes to put that right – and put it right in a dramatic way.”

Going beyond the strange idea that home ownership = social mobility in the first place, again the benefits are skewed in favour of the better off, (those earning above the median wage)- and even they will struggle to make use of it.

Housing charity Shelter explains that the mortgage guarantee fails to tackle the problem unaffordable homes at its roots, Robbie di Santos says:

“The trouble is, while this makes it easier to get a deposit, you’d be borrowing 95% of already very high house prices, which are way out of kilter with what ordinary people earn. Our calculations – again based on local house prices and local double income households – suggests that the Help to Buy mortgage guarantee would bring the average local home within reach of the average double income household in only 16% of the country.”

Are these the actions of a government committed to a fairer distribution of opportunity across the income scale?

It certainly doesn’t look like it to me. Some argue that faith in social mobility as a weapon against rising inequality is misplaced, and that we should measure our progress in becoming a fairer and more civilized society by how far apart the richest and poorest stand on the income scale rather than by how easy it is to get from one end of that scale to the other.

However, if we understand social mobility as a mechanism for empowering the very poorest to escape the poverty trap, than it does have the potential to change lives and transform society.

Sadly, in the Budget this government has proved it is far, far away from working towards such an end.

Louie Woodall is Editor of Anticipations.

Sharpening the Knives

The frenzied atmosphere of an election season may not seem to be the best time to try and make sense of the strange political manoeuvrings we have witnessed lately.

However, the Council and Mayoral elections taking place on May 3^rd are an important milestone for all the national parties. In a political and media world that seems obsessed with mimicking the drama and dynamism of the American system, the 2012 elections have taken on the character of the US Midterms- with important implications for how the results will be processed by those in the Westminster village.

There has been a noticeable surge in backbench unrest among Conservative MPs. Today, Nadine Dorris launched a blistering attack on the “arrogant posh boys”   (David Cameron and George Osborne) running the country, while another unnamed Tory sneered that Cameron seems to be “putting the school run ahead of the national interest.” These comments can be legitimately dismissed as the bluster of a few loose cannons, but they conceal a deeper malaise in the Parliamentary Tory Party. Badly bruised by a mishandled Budget and suffering the worst polling since 2008, some discontents have been publicly sharpening the knives in a show of defiance toward No. 10, egged on by a press eager to witness a big upset.

There is no suggestion that there will be a leadership challenge any time soon- if at all. However, it is possible that those Conservatives who have been put off by Cameron’s wishy washy social agenda and perceived capitulation to the Liberal Democrats on issues like Lords Reform and internet surveillance are trying to ‘talk down’ the party in the run-up to the elections. Why? So that they can use a bad result to force the Prime Minister down a more Conservative path, by claiming that Tory voters are deserting Cameron’s party because he is not conservative enough.

What about Labour? England’s ‘mid-terms’ will serve as a useful indicator of the party’s revival in the South.  Labour’s next majority cannot be attained without the help of at least some of those seats wooed by Tony Blair in 1997. A strong result here could act as the green light for the party to begin rolling out a more detailed policy plan and tell the nation just how it would do things differently. There have been glimpses here and there of Labour’s plans, fromenergy companies to the NHS. A resounding win on May 3^rd would give Miliband the momentum he needs to really press how Labour would govern in 2015 and beyond.

However, the knives haven’t been sheathed for him, yet, either. A failure to topple the Tories nationwide, and a Livingstone defeat in London, could throw the polling gains tortuously won over the last few weeks out of the window. The press will emphasise that even after all the Coalition’s failings, Labour are still not capable of winning back the people’s trust. Miliband himself will be blamed for failing to articulate a clear message to win back votes, and the vultures will begin circling again. One rumour doing the rounds is that a Labour defeat on May 3^rd will prompt an attempt by disgruntled MPs to push Yvette Cooper forward as Miliband’s successor. Naturally, this is all hearsay and smokescreen. What is certain, however, is that the forthcoming elections will be used by anti-Milibands and pro-Milibands alike to push their own agendas on the leadership.

Will the Council and Mayoral Elections be for Britain what the Midterms are to America- namely, a political gamechanger? Obama has certainly had to change his tune since losing the Senate to the Republicans. Perhaps Cameron will have to obey the more hardline elements in his party in the wake of a defeat. Miliband must also be wary too- a big win will place big expectations on him that he might struggle to fulfil, while a loss will bring the old naysayers out of the woodwork again. For both parties, it’s all to play for.

Louie Woodall is Assistant Editor of the Young Fabians Blog

In politics, mud sticks- but does gravy stain?

The political reporting of the last week bears some resemblance to the art of making a discount sausage roll. You take some meaty substance- in this case, the fact that this government is run by a cabinet of millionaires, that they have introduced a tax cut for the rich while slapping VAT on all manner of working-man lunch fare, and most recently started a fuel panic in the total absence of any impending strike- process the hell out of it on Twitter and the blogosphere and wrap it all up in an appealing, though haplessly flaky, veneer of ‘serious reportage.’

What many already knew and believed of Cameron and pals was spread across the nation thanks to ‘pastygate’- the embarrassing revelation that George Osborne can’t remember when he last ate at Greggs bakery, and that David Cameron was caught lying about when he last bought one of Cornwall’s finest baked exports. The scandal had the unexpected side effect of summing up all the issues of class and wealth surrounding the Budget and cash-for-access debacle, and communicating more effectively than any Guardian front-page just how out of touch this government is.

Fantastically for Labour, the end result has been a ten-point poll boost and the revelation that 2 out of 3 voters think that the Conservatives are the “party of the rich.” However, Ed and co should be hesitant about popping the champagne corks just yet. As damaging as ‘pastygate’ may seem to the Tories reputation now, it has to be remembered that such storms have been weathered before by politicians of all stripes, and that public perceptions that seem striking in the immediate wake of these PR disasters simply emphasise underlying trends.

A YouGov survey of public opinion on the three leading parties held at the beginning of this month showed that 49% of people thought that the Conservatives “seem to appeal to one section of society rather than to the whole country”. The Tories have always been seen as the party of the rich. They will never be able to clear themselves of this charge, so they can take hits on issues like ‘pastygate’ as it simply affirms what the public already know. Increasing the tax on pies and other baked goods that they don’t eat in the first place will not change their reputation. That mud will stick forever. The addition of a few splashes of gravy won’t make a difference.

Importantly, such labels do not change voting intention when push comes to shove. Margaret Thatcher was an infamous ‘milk snatcher’ before she even became leader of the opposition. She went on to win three general elections. Tony Blair became ‘Tony Bliar’ in the wake of the scandal over tobacco advertising (in an incident uncannily similar to the cash-for-access scandal engulfing David Cameron right now), and again following the Iraq War. It didn’t stop him achieving a historic third term.

Despite what those championing ‘pastygate’ think, the public have a general understanding of the character of their leaders before such scandals break. This is especially true of that part of the population that actually votes. What all the PR scandals of the last 30 years show is that the people know what they think- they just don’t vote on that knowledge.

Louie Woodall is Assistant Editor of the Young Fabians Blog

A PM held to ransom

David Cameron returned from the European Summit last week announcing that he had vetoed a new treaty in the ‘national interest’. It would be more accurate to say he was ‘held to ransom’ by the Conservative Party’s friends in the City.

Cameron’s Conservatives are a new breed of Tory. It would be wrong to say that, like the resurgent Wispa bars, they are the same 80’s product in a shiny new wrapper. Nearly 150 Tory MPs are ‘newbies’ who took their seats in 2010. Fewer of them attended private school then in years past- 54% today compared with 70% in 1983. The party is a different shade of blue from Thatcher’s time.

One thing that has not changed is the party’s vested interest in protecting the perceived generators of national wealth. The Smith Institute reports that 27% of the current Conservative crop have a history in financial services. According to Aditya Chakrabortty of The Guardian, the financial sector in this country employs about 1 million people. This means that an industry that employs less than one-thirtieth of the working population is represented by one-quarter of MPs in the dominant governing party.

The Conservatives and the financial sector are entwined in other ways too. A report by GMB reveals that nearly 60% of donations to the Tory party come from individuals and companies linked to finance, hedge funds and other City interests. The Square Mile has often been touted as the beating heart of London. In many ways, it’s the beating heart of the Conservative party too.

In light of such figures, it should come as no surprise that a Conservative Prime Minister should fight tooth and nail in the most prestigious of arenas to protect City interests. Cameron’s so-called ‘veto’ was not a free decision made by a plucky little Englander taking on would-be tyrants overseas, it was the ransom he was forced to pay in return for the continued sponsorship of the financial wizards of the City. On Newsnight, the Minister for Europe effectively conceded this point when he argued that: “There was a real risk that without the safeguards [Cameron] wanted…you would over time have a read across from the closer fiscal integration that the Eurozone countries want to do towards measures that would influence financial services in particular.” The ‘national interest’ was revealed by the bumbling Minister to be code for ‘financial services’.

Is it right that the diplomatic strategy of the British government should be dictated by a closeted club of multi-millionaires detached from the everyday experiences of the vast majority of Britons? Once again the formidable array of interests that profit or benefit from the mysterious operations of finance capital have shifted into gear in spirited defence of the sector. Financial services provide billions in corporation tax. Financial services are one of very few sectors that Britain can boast of being a world leader in. Financial services have a noble heritage reaching back to the dawn of empire, and deserve their vaunted position at the apex of our commercial society.

These are all true statements. What is interesting is that very similar things were said of the coalmining industry in this country thirty years ago, of shipbuilding, and of manufacturing. Other things were true of these industries. They were inefficient, could no longer compete with other nations, and required huge public subsidies just to keep going.

Curiously, the same could be said of the financial sector today. It is no longer efficiently allocating credit to those businesses that need it. It is losing ground to American and European competitors, a process that will only speed up as Britain is left out in the cold while closer fiscal consolidation of the Eurozone takes place. It has required £289 billion of direct financing by the taxpayer since 2008 just to stay afloat, far more that the £193 billion it pumped into the treasury in corporation tax between 2002-2008.

This is the final damning reason why Cameron’s Conservatives are a kind apart from Thatcher’s. Her government identified failing industries, stripped them of their workforce and let them loose to explore the seemingly endless opportunities promised by the ‘knowledge economy.’ Cameron’s government is being held hostage by a failing industry that continues to suck up the resources of the British state and dictate policy terms to a country that no longer sees it as a source of any worth.

Louie Woodall is a member of the Young Fabians and Assistant Editor of the Young Fabians Blog

Cameron: a reluctant Captain

What kind of Prime Minister is David Cameron? What does it matter for the future of his premiership?

The ongoing saga surrounding the passage of the Health and Social Care Bill has unwittingly revealed a great deal about the sort of Prime Minister David Cameron was, and the sort he is changing into. As the story of NHS reform has unfolded we have witnessed his transformation from Major-General, happy to oversee his ministers’ march against the opposition from a safe distance, into hands-on Captain, at the heart of the fight getting bruised and burned along with the rest of his government.

Cameron was undoubtedly sensitive to the fact that he entered office in a climate of hostility towards the “old politics” and, forced into a shotgun marriage with the bright young face of the “new politics”, was encouraged to conduct himself differently from his predecessors. According to the media narrative, Gordon Brown was the Machiavellian tyrant, who enforced his will by tantrum and the occasional thrown telephone; Tony Blair was the obsessive centraliser, the king of sofa government who selfishly prised his Ministers’ fingers off the levers of power; in contrast, Cameron chose to become chairman, rather than captain of his Cabinet.  He allowed his ministers plenty of freedom to run their own departments, an arrangement closely aligned to the ideal of Prime Minister as “first among equals”.

But it also had its costs. Many of the reforms contained within the Health and Social Care Bill appear to have been concocted by the Andrew Lansley, Secretary of State for Health, with little input from Cameron. Unison denounced the bill as a Lansley “vanity project”, and it is certainly true that some of his proposed reforms- especially those encouraging a competitive market in healthcare provision- did not reflect the policy goals of the Conservatives as outlined in their manifesto.

In recent weeks, Lansley has been heavily criticised for the Bill. But so has Cameron for letting his minister ‘off the leash’, and allowing poorly conceived ideas to escape the secrecy of the Cabinet and damage the coalition’s reputation. This led to embarrassing scenes for both men when Cameron publicly overruled Lansley on the pace of reform, and subsequently initiated a “listening exercise” on the legislation. The experience forced the Prime Minister to dive headfirst into the detail of the bill to restore the image of calm control he has so patiently cultivated.

His reputation as a domestic legislator may now sink or swim on the passage of the Health and Social Welfare Bill, as Blair’s did with the battle over academies six years ago.

There is nothing wrong with Cameron’s style of government. He is exhibiting a mature attitude by granting his ministers the freedom to develop policies within their own departments. However, he is now aware of the risks involved in letting Ministers’ pet projects wriggle from his grip.

No matter who the original culprit is, the PM is the one in the firing line when policies go awry.

Louie Woodall is a Young Fabian Member and Assistant Editor of the Young Fabian blog.

Happy Birthday NHS, you might not survive to see 64

Ahead of tomorrow’s Young Fabian Science and Society Network event with Shadow Health Secretary, John Healey, Young Fabian member Amanjit Jhund argues the Government’s reforms are just cuts by any other name.

On Tuesday the NHS turns 63. It’s a time for many of us to celebrate: for most of us it is difficult to imagine life without it.

Yet the Health and Social Care Bill is an attack on the NHS on an unprecedented scale. The concerns for many on the left and in the medical community is that while the aims of the coalition proposals are laudable they are simply being used to mask both spending cuts within the service and the increased privatisation of the NHS.

In fact,  many of the GPs that I have spoken to are fully aware that their budgets for commissioning will only be a fraction of those administered by Primary Care Trusts currently. One GP told me recently that “it’s just a way of pushing through cuts”. While most GPs are pragmatic about the changes and will do their best for their patients no matter which system they have to work within, it is vital that the coalition are held to account on this issue.

With David Cameron purporting to defend the NHS, we must expose the hypocrisy of his words as he presides over changes that will not only slash budgets but will also take the ‘N’ out of ‘NHS’.

Happy 63rd birthday NHS. I just hope you’re still around when I’m 63.

Further reading:

• NHS needs evolution, not Tory revolution
• Briefing: Exposing the continuing flaws in the NHS reorganisation
• NHS forum GP admits private patient doubts

A ‘maxed out credit card’?

Ahead of the Chancellor’s Budget announcement this week, Young Fabian Member Mark Anderson takes the coalition government to task over its positioning of its austerity measures.

One argument given by the UK government for its vast programme of public sector cuts is that the UK has ‘maxed out its credit card’.  Such a crude and misleading analogy bears no resemblance to the reality of Britain’s financial situation, yet it goes largely uncontested in public debate and serves to legitimise the devastation that is being wreaked on public services, the welfare state and public and private sector jobs and working conditions.

Far from the UK being no longer able to borrow money on the international financial markets, the interest that the UK pays on its debt is currently at a historically low level, as is the UK’s debt-to-GDP ratio. UK ten year bond yields are marginally higher than those for the US and far healthier than those for Australia and New Zealand, for example. In the run up to last year’s General Election, amid scaremongering about a potential debt crisis and the dangers of a hung parliament, yields on government bonds remained stable.

In a September 2010 article entitled ‘Can bond yields fall even further from these historic lows?’, Ross Watson, portfolio manager with Securities and Trust of Scotland told the financial journal Investment Week that:

“For the taxpayer, it is excellent news that the Government can fund its deficit at such low returns.”

Such sentiment presumes against a country close to bankruptcy.

Another argument the coalition government gives for frontloading public sector cuts is that it is unfair to saddle future generations with a mountain of debt. This argument is a perversion of the realities of private sector-induced deficits on several counts.

Firstly, it fails to take account of the fact that over 70 per cent of interest payments on government debt remains within the UK, going into savings and pension schemes – yours and mine.

Secondly, it bypasses the fact that you can’t cut your way out of a private sector-created budget deficit. Trying to do so simply condemns an economy to years of low growth – as seen in Japan over the last decade (when the Japanese government cut its stimulus too soon after recession, before Japan’s private sector had had a chance to recover) or in the UK in the 1930s (the last time that a post-recession public sector cuts programme was implemented in the UK on such a scale). Economic slowdowns make it harder to address structural deficits and repay government debt.

Thirdly, taking demand out of the economy when the private sector has not fully recovered risks a double dip recession which would increase government debt, not decrease it. Despite the Coalition’s best efforts to mislead the public, the UK’s structural deficit is a product not of Labour overspending, but of the collapse in output of the private sector following the collapse of Lehman Brothers in 2008.

Fourthly, at a time when the economy is already on its knees, it leaves the economy ill-equipped to compete against its healthier, better educated and better connected, more meritocratic international competitors.

Ending the previous Labour government’s fiscal stimulus, public sector cuts, a contraction in UK GDP at the end of 2010 and increases in unemployment and associated welfare payments, combined with the damage that the prospect of deeper cuts to come has done to business confidence and investment, have exposed the continued weakness of the UK’s private sector and led to a rise in government bond yields, thus further increasing the amount that the UK has to pay to service its debt.

Austerity is doing the opposite of what we are told it is aimed at achieving, and all this before the cuts have really started to bite.

A version of this post has previously appeared on Left Foot Forward.

Libya: The End Game

In this member post, Martin Edobor, a member of the Young Fabian Science and Society Network, discusses the current situation in Libya.

In the past few weeks we have seen a wind of change sweep through the Arab nations; a roaring voice calling for change. The first to fall was Ben Ali in Tunisia, and then Mubarak in Egypt and now on the brink is Libya’s Muammar Gadaffi.

Yet despite Tunisia and Egypt’s relatively peaceful uprisings, the Libyan revolution is proving to be both bloody and horrific. More than 200 people have been killed in Benghazi following protest, the use of mercenaries has been reported and a media blackout enforced.

International criticism from the west is intensifying. Gadaffi has defied calls from the world leaders to stand down and halt his act of aggression against the people of Libya. Political leaders in Europe and the US began are beginning to raise the pressure, pushing for a more concrete plan of action against Gaddafi, including a possible no-fly Zone. David Cameron has even talked up the possibility of military intervention. He made the strong statement: “We do not in any way rule out the use of military assets”, echoed by Italy Foreign minister Franco Frattini who has offered their Mediterranean military bases if the plan for military action were to go ahead.

What’s apparent is that there is a stalemate in Libya: a standoff between the rebel army and Gadaffi loyalists. The options being weighed are whether the West should militarily intervene, and support attempts by rebel leaders to oust Gadaffi, or to stand back and indirectly facilitate the current rebel movement (possibly by imposing a no-fly zone), which may risk a bloody and drawn-out revolution.

This is a tricky dilemma, with both options filled with pitfalls and drawbacks. The question now is what will Obama, Cameron and other western leaders choose to do?

Cameron is right to not completely rule out military intervention – when it comes to a tyrant like Gadaffi all options should be kept open. Yet Western leaders should tread carefully, as military intervention carries risk.

This is an Arab revolution, formed from the cries of freedom and the blood of the Libyan people. If the West intervenes militarily the movement may be jeopardised, changing it from revolution to war.

Unnecessary surgery

In this guest post, Young Fabian Member Tom Keeley argues against the latest set of NHS reforms.

Listening to Andrew Lansley you might believe that GP Consortia are the cure for everything wrong in the NHS.  An idea that will, at once, improve care, reduce cost and give people a say in their treatment.  The “silver bullet” bringing our health outcomes in line with Europe’s.

However, a cursory glance back at two decades of attempts to move care closer to general practitioners should leave anyone in doubt of these claims.  Or perhaps anyone without their ministerial career staked on it.

Governments of all colours have repeatedly returned to the idea of GP commissioning.  Their stated aim is always “improving care”; while in reality their concern is cost control.  Initiatives from GP fundholding to Practice-based Commissioning from total purchasing pilots to locality commissioning have all shown the limitations of GPs buying health care.  Limitations that should be great enough to stop anybody from handing over the majority of the £110 billion NHS budget.

Acting as the buyers of health care doctors can modify their referral rates, make very limited “one off” savings in their prescription costs and exert a downward pressure on waiting times.  But, this comes at the sizeable cost of increasing inequity and reducing patient satisfaction.  GPs have been shown to be incapable of reliably influencing the organisation and delivery of hospital care through budget negotiations.  And, with this ineffectualness comes increased management and transaction costs, as the buyers of health care lose their economy of scale.

When GPs are given a budget responsibility they understandably, and quite wisely, revert to what they know: providing more community services.  While there is good evidence to suggest that the provision of primary care services can improve health and reduce the pressure on hospitals, it is far from being the answer to every health problem.  Furthermore, this throws up an obvious and unavoidable conflict of interests.  GP consortia could commission themselves to provide care.

The greatest problem however, is reserved for the fact that in general GPs are not keen on the idea, or prepared for the reality.  While a good number of “pathfinder” consortia have voluntarily formed, this is about self-preservation.  These pathfinders have, very wisely, given themselves two years to gain experience in the buying of health care, before taking full control of and responsibility for the budget in April 2013.  Lansley should not mistake this for enthusiasm: when a gun is held to your head, jumping off the cliff is a good option.

The obstacles to consortia succeeding are considerable.  Lansley has perceived the limited success of past efforts to be an indication of potential; when in fact it is simply the limit.  GPs should have a role in the commissioning of health care, but this should be limited to a role in the commissioning of primary care, without full devolution of the budget.  If the government of the day seriously wants GPs to succeed in doing anything more, a full 5-year regional trial of policy and a massive overhaul of medical training should be considered an absolute minimum.

In his shadow role Lansley had every potential of being a competent Secretary of State for Health.  A knowledgeable minister who would protect the NHS from the worst of the cuts, while allowing it a period of calm in which to make the required budgetary savings.  As it is, he has, to quote David Nicholson (NHS chief exec), proposed the biggest change management system in the world – one so large “that you can see it from space”.  He has done this with little grounds for hope of success.