Within minutes of last Saturday’s demonstration moving off from its assembly point, Telegraph columnist Asa Bennett wrote: “Jeremy Corbyn has no clue how to help the NHS. That’s why the public wants him nowhere near it”. http://www.telegraph.co.uk/news/2017/03/04/jeremy-corbyn-has-no-clue-help-nhs-public-wants-nowhere-near/. There’s nothing like getting the first punch in.
The show of labour movement force organised by the People’s Assembly and Health Campaigns Together was huge, even if the organisers’ estimate of 250,000 was optimistic. It brought together large numbers of community activists and a wide range of trades unionists around a simple, shared political perspective on the NHS. The much-heralded but infrequently seen Corbynist enrolment finally reached the streets, joining the public sector unions (big battalions: Unite, Unison, GMB) and some professional organisations (the BMA, RCN and Royal College of Midwives).
The simple, shared perspective is well illustrated by the message on one demonstrator’s home-made placard. The catchy and memorable rule of thumb – “underfund, overstretch, demonise, privatise” – makes sense of current events, of personal experiences and of long-standing fears for the NHS. It is grounded in distrust of the Conservatives’ real attitudes towards the public sector and the welfare state as a whole, a deep feeling in the population. It draws on assumptions about conspiracies fomented by devious politicians, also a deep public belief. And it is tinged with despair – another home-made placard, shown in a video clip on the Independent’s website, said this bluntly: “The NHS is all we have left to be proud of”.
None of these feelings, beliefs and political judgements needs to be ‘true’ to work – they are all contestable – because they have unrivalled explanatory power. Slower growth in NHS budgets can be understood as under funding. Efforts to increase NHS productivity (common to all governments since 2002) feel like overstretch. Bullying criticism of professionals (a strong NHS habit trickling down from the very top) easily morphs into demonization. Add all these together and ‘setting the NHS up to fail’ looks like a covert neo-liberal political strategy.
The Conservatives are quick to point out that all this mobilisation means nothing. The balloons and vuvuzelas and chants make a carnival, part of the drama of the NHS, an outpouring of emotion among underlings allowed their one-day ‘festival of fools’. Worse, the demonstration was just a big manifestation of Labour’s current dilemma. On the NHS it can only drum up its own tribe. It cannot convince a broader public which is sceptical about the constant demand for more spending on the NHS. Labour might save the NHS, goes this argument, but the NHS will not save Labour. Evidence? Look at the Copeland by-election campaign and outcome.
This may be right, but it may also be too soon to tell. The convergence of community activism around the NHS with an angry and injured trades union movement may be more potent than the Conservatives think. The NHS is everywhere, and crosses tribal boundaries. Constituencies that seem secure Conservative seats may experience challenges from a growing and increasingly confident coalition of campaigners about the direction in which the local NHS is going. Attempts to reconfigure (as Vanguards, STPs or whatever comes next) or outsource (to private providers or managers) their services may encounter more resistance than ever before.
That resistance will need to speak with a sceptical electorate, with other tribes. It will talk about the differences between cuts and cost-containment, about productivity and overstretch, about holding professionals to account not demonising them, and about the failures of supply-side privatisation, not its success. Then the rules of thumb will no longer be enough, and a new story will have to be told. If we can tell that different story the NHS may well be here to stay. Former Tory Prime Minister John Major, talking recently about Brexit not the health service, put it nicely: “We cannot move to a radical enterprise economy without moving away from a welfare state. Such a direction of policy, once understood by the public, would never command support”.