My taxi driver the other morning, at around 6am on the way to the station, was telling me about his operation. He was getting his garden sorted early this year, because for three months he will not be able to tend to his plants because of his hip replacement. He found out he needed the operation in January, and is getting the new hip this month. It’s being conducted at one of the independent sector treatment centres (ISTC) established under Labour, and of course it’s all on the NHS.
ISTCs are a small example of use of the private sector to improve the performance of a public sector service. When they were introduced by Labour, waiting lists and times for operations such as knees, hips and cataracts almost vanished. The challenge from the independent sector led to improved efficiency and performance from the public sector. Surgeons discovered that they could work for the NHS on Fridays after all. Most importantly, the public got a much better service as a result, within the founding framework of the NHS: free at the point of use, based on medical need.
I was reminded of this Labour reform which so demonstrably benefitted patients last night at a fundraiser for Liam Byrne MP’s local party. Alan Johnson MP as the guest speaker. Johnson’s speech was brilliant. But at its heart was a simple message: don’t be ashamed of what Labour did in office, and be clear that Labour is on the side of public service reform. A few months ago, at another fundraiser, Dennis Skinner MP made similar points. He talked about the former miners in his constituency, now in their 60s and 70s, able to get about Bolsover thanks to the new knees and hips they got on the NHS. Under the Tories, never forget, they would have been waiting for months, even years. Many would have died on waiting lists.
The better we get at opposition, the less we look and sound like an alternative government. The NHS is a good example. The rally yesterday at Methodist Central Hall against the Lansley reforms (which I bitterly oppose) was packed to the rafters with opponents of the NHS Bill. But the people there – Unison, the Royal Colleges, the British Medical Association (BMA), the Labour left – were all opposed to Labour’s reforms to the health service too. Successive Labour secretaries of state – Millburn, Reid, Hewitt, Johnson and Burnham – were booed and barracked at their annual conferences, denounced by them in the press, and shouted at by the same placard-waving protestors. A future Labour health secretary would face the same fate. Yet we seem to be allied with these strange bedfellows, who would soon turn to bitter enemies the moment Labour took office again.
Take the police. The announcement this week that two forces are putting out a tender for private suppliers to conduct certain functions was met with howls of protest. These included John Prescott, who claims to have invented the public-private partnership model in the 1980s. I happen to think that the types of function which the two police forces in Gwent and the West Midlands want to contract out are best conducted by warranted police officers – investigating murder scenes, patrolling communities and guarding suspects. These are jobs best done by the police, not private security firms. But I don’t think warranted police officers should be cleaning the offices, doing the filing, serving up lunch or building new police stations. My point is that the private sector, as with the NHS, always has and always will supply services to the police force. Our political argument should be about getting the best service for citizens, getting the best value for money from efficiency and modern management, and ensuring that police get to do what they signed up for – preventing crime and catching criminals. We should rightly oppose profiteering, not the private sector.
The Labour Party is not opposed to private sector delivery of public services. We don’t believe the state should employ battalions of public employees. We value choice and competition within large public services such as health and education. We like social enterprises, SMEs and co-ops. We spent 13 years in office reforming public services, always with the parent, patient, passenger and public in mind, using choice and competition to drive up standards and performance. The next Labour government should do the same, unless we want to preside over failing public services which do worst for the poorest, and which are deserted by the affluent. ‘Poor services for poor people’ is not a helpful slogan for the 2015 election.
Labour’s next manifesto must have a central theme of reform to public services, but based on the world of 2015. By 2015 there’ll be a 40p top rate of tax, free schools, police commissioners, GP consortia commissioning NHS services, fewer parliamentary seats, a more narrow definition of the welfare state and elected Mayors. If all Labour offers is the dismantling of everything the Tories have done, to recreate our perfect world of 2010, the public will judge us deluded.