The choice is not between decent hospitals and a properly defended country

Luke Akehurst

I’m a big fan of John Prescott. His role in the OMOV debate at Annual Conference in 1993 was critical to setting Labour on the path to electability. The extent to which he galvanised the grassroots and our core vote with his battle bus tours in three General Elections is an overlooked part of the winning formula that delivered a Labour hat trick. He was an incredibly loyal Deputy Leader and PM who provided a much needed voice for common sense when Blair sometimes became over-ideological. And more recently I have sometimes felt he was the only senior figure loudly defending our record of delivery in government.

So I was disappointed by his Daily Mirror article yesterday calling for extra funding for the NHS to come from not investing in the replacement submarine fleet for Britain’s nuclear deterrent.


This isn’t because I disagree with John about the necessity to properly fund the NHS and the integration of social care with it. I would be a hypocrite if I did because the NHS literally saved my life in 2009 when I had a life-threatening neurological disease caused by a bone marrow cancer, which saw me hospitalised for five months and in a wheelchair for a year afterwards. I then spent four years as Chair of Health Scrutiny in Hackney trying to expose the damage the Tory NHS reforms and hidden cuts were doing to the services that save lives.

It’s just I don’t think it is morally or politically right to present voters with a binary choice between defence and the NHS. If you say to them “heads you get decent hospitals, tails you get a properly defended country” then they will rightly give you a blunt Anglo-Saxon answer and go vote for a party that says it can deliver both these fundamental roles of the state.

We didn’t present voters with that kind of choice in the 1945 era. The Attlee Government created both the NHS and welfare state and NATO and the independent British nuclear deterrent. We could be trusted both to build a new Jerusalem at home and to take the tough stances needed to defend democracy from external threats, in those days the Soviet Union. We did that at a time when austerity literally meant rationing and the country was trying to rebuild bomb-damaged cities and repay massive war debts. The idea we can’t afford both health and defence now when despite the recession we are still the world’s sixth largest economy is a false one.

We did present voters with that choice in 1983 and 1987. We had great, idealistic, popular policies for the NHS, schools, job creation. But our unilateralist stance on nuclear weapons was a big factor in the Tories being able to portray us as unfit for government, unserious about the threats the UK had to be able to stand up to. It meant people felt they could not trust us in government and had to accept the damage to public services wrought by the Tories. If we present people with a choice of national security or the NHS, fear is likely to conquer hope, and in the impotence of opposition our love for the NHS will be worthless, as we will be sitting on the sidelines watching while a Tory government destroys it.

I campaigned for Ed Miliband to be Leader in part because I wanted us to move on from some of the ideological errors and excesses of the later period of the Blair years. I explained this here.

What I will never sign up to is to throw into reverse the fundamental steps back towards electability that we took painstakingly between 1987 and 1997. In three key areas Labour triangulated – removed our disadvantage and unpopularity vis-a-vis the Tories – not just for electoral advantage but because it was the right thing to do to align ourselves with the political instincts of the same working class voters who love and need the NHS and state education. These three areas were tackling crime, not excessively increasing personal taxation, and properly defending the country. Each is a litmus test for whether Labour is serious about being in government. Go back on any of these and we don’t deserve to win. John was part of the party leadership that made those changes, he should know why we had to make them.

I make the detailed case for Trident renewal here.

The bottom line is that there are countries out there that are already nuclear armed or who aspire to be and may achieve that during the period between now and the 2050s when the submarines John proposes scrapping would go out of service. Not all of these countries are benign towards the UK even now, let alone what threats may emerge in a changing and dangerous world. Some of them may threaten us during the next 35 years and we need to be able to deter them. We can either have a strategic nuclear deterrent, or we can spend far more than we do on Trident on conventional forces, or we can just hope everyone will be nice to us. I don’t think that Russia or China, let alone and God forbid Iran or North Korea, would resist the urge to bully and threaten us if we were not adequately armed. It isn’t how non-democratic states behave. As long as dictatorships have nuclear weapons I want us to have the same weapons so we can deter and stand up to them. If we can rid the world of them once and for all through a multilateral treaty, great, but until then we shouldn’t casually propose unilaterally giving them away to release funds for other domestic policy priorities.

I object to John’s characterisation that nuclear submarines “take lives”. A deterrent saves lives by making war between major powers unthinkable.

And John’s numbers are misleading. The £30 billion he cites is the capital cost of buying submarines that take many years to build and are then in service for decades more. Some of that cost has already been spent on design and early stages of the boats and is no longer available. The rest isn’t all available now for the NHS as it is spread over the lifetime of the programme between now and the 2050s. There is no pot of £30 billion available now for the NHS by raiding the Trident programme. The entire MoD annual budget is only just over the £30 billion John cites, at £36 billion, of which only £2 billion a year goes on Trident. Two billion a year does buy an independent nuclear deterrent, it wouldn’t deliver the kind of changes John identifies that the £130 billion a year NHS needs (for those of you who are councillors it equals the funding for a couple of London boroughs, inclusive of housing revenue). John himself says “Throwing in the odd billion here or there is just putting a sticking plaster on a gaping wound.” But that is all the saving from not replacing the Trident submarines would be.

In his article John suggests but then almost dismisses getting extra funding for the NHS from increasing National Insurance contributions. That’s what the last Labour Government, with John as Deputy Prime Minister, did. Voters backed this as a fair and sensible way to get extra funds into health. They would again. Why do employee NI contributions drop to 2% above £41,865? What I would beg him not to pursue is the idea that we have to make voters choose between the NHS we all love and the proper defence of our country. Just as in 1945, Labour must be credible on both these issues.

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