The Tories will have to go back to setting targets, as Blair did. This gives Ed Miliband a chance to redraw the battlegroundby James Purnell / January 26, 2011 / Leave a comment
The NHS: the coalition “will end up doing a U-turn” on waiting lists
New Labour spent its first two years dismantling choice and competition—and the next two terms putting them back in. The Conservatives are spending much of their first two years getting rid of targets and Whitehall control. They will end up doing a U-turn and going back to targets—or be unlikely to get another term.
In opposition you spend most of your time with GPs. And teachers. And local authority directors. You go to their conferences. The easiest way to get a cheer is to promise to get rid of meddling by someone, normally politicians or bureaucrats.
David Cameron cleverly turned this fact of life into a rhetoric for opposition. The Big Society gained much of its thrust from attacking Whitehall’s targets and diktats. (By the way, Labour should be wary of saying the Big Society is a failure: it gave the Tories something to say whenever they were accused of being crypto-Thatcherites.) The catch is that you can campaign on the Big Society, but you can’t govern with it. In government, your job is to run the state. Ministers can’t avoid responsibility for results—as health secretary Andrew Lansley has found. It may not be his job to order flu vaccines, but if they run out, it’s certainly his problem.
By the end, the Labour government had lost the will not just to live but to take decisions. No one could accuse this government of that; it’s got reforms coming out of its collective ears. But that has left a contradiction: it has raised expectations of the state while giving away the levers to influence it.
This won’t last. As soon as it abolished the maximum 18-week waiting time for NHS treatments, waiting lists rose. What is Vince Cable going to say to his constituents when they complain? “Yes, I know, but look at the number of targets we’ve abolished?”
As with most of this government’s mistakes, they come from a misreading of Blair and Brown. The Conservatives liked to present Brown as the statist and Blair as the reformer. As the heirs to Blair, they would continue reform, but end centralised control.
But it was Blair who was the real statist. Like this government, he came in promising change. He started with an interventionist approach to markets—from the minimum wage to strengthening competition policy. But after the…