- 16 июня 2011, 11:52
Rolling coverage of all the day's political developments as they happen
on the New Statesman website. I'm just reading it now.Ed Balls hasn't started yet - I'm monitoring it from Sky and BBC News - but the full text of his speech is
As this chart shows (pdf), the economy is viewed as by far the most important issue facing the country. It gets cited as one of the most important issues facing Britain by 73% of people; immigration comes next on 49%. And, as this chart shows (pdf), voters blame Labour for the spending cuts. Asked who is responsible for the current spending cuts, 40% blame the last Labour government, 24% blame the coalition and 24% blame both.Ed Balls (left) will be delivering his economy speech at 10am. I'll be covering it in full live. And if you want to know why it's so important, just look at the polls.
Balls's task this morning is to try to persuade those 40% that they are wrong.
in the Daily Telegraph. It's one of the most interesting pieces that has been written about the plans unveiled by David Cameron, Nick Clegg and Andrew Lansley on Tuesday, and probably the most damaging, because of Miliburn's own reputation as an enthusiast for using competition and the private sector to reform public services. But in March Milburn wrote an article for the Guardian saying that the government's original plans - which were far more pro-competition than the proposals unveiled this week - were also flawed. Is he being consistent?Do read Alan Milburn's article on the government's revised health reforms
Milburn is particularly strong on the politics of the coalition U-turn. He claims that the debacle has "set back for a generation the cause of market-based NHS reform" and that as a result the government will not achieve the £20bn in efficiency savings that it wants to achieve. And he issues a powerful warning for Cameron.
So how will the NHS books be balanced? By the usual device which policy-makers have deployed every decade or so in the NHS. A very large cheque. It is precisely the situation Cameron and George Osborne were trying to avoid: sorry, George, but the cash you were saving in your pre-election Budget for tax cuts will now have to be spent on a bail-out for the health service.
As for explaining why the revised plans won't work well, Milburn complains about the new commissioning structures being set up.
The U-turn slows the pace of reform and dramatically dilutes its impact. GP consortiums that were supposed to be in place by 2013 now have no deadline for their creation. England will have a patchwork quilt of decision-making for years to come. Worse still, GPs' ability to drive more services out of hospital and into the community has been severely compromised [presumably because hospital doctors will now be represented on the commissioning consortia].
Miliburn also complains that the national NHS Commissioning Board (which was always going to be left in charge of commissioning specialist services worth up to £30bn, and which will also take charge of commissioning in areas where the new clinical commissioning groups are not ready by 2013) will have too much power. This is a point he made strongly in his Guardian article in March. This is what he says about it today.
Instead, the Government's U-turn places real power in the hands of the national NHS Commissioning Board – the daddy of all quangos. The board will control how £60 billion of NHS money is spent in local communities from Darlington to Dartmouth. It is the biggest nationalisation since Nye Bevan created the NHS in 1948. I'm not sure whether he would be laughing or turning in his grave at the prospect of the Conservative Party championing such a policy.
Milburn is on weaker ground when he criticises the way Monitor's scope to promote competition in the NHS has been watered down. This is what he says today.
Monitor, which was to have been charged with promoting competition, will have a duty to promote integration. Words have meaning in the NHS. Every single local decision-maker will read that change as a signal to weaken competition, not strengthen it, and to protect the public sector incumbent over the private or voluntary sector insurgent. The debacle has set back for a generation the cause of market-based NHS reform.
But in the Guardian in March criticised the bill as it then was on the grounds that it did not do enough to promote integration. This is what he wrote.
While it is a good idea to extend competition, in the NHS it is a bad idea to allow this to fragment local services or to be on the basis of price rather than quality. Market mechanisms can work in healthcare but only when properly managed ... The bigger question to pose is whether these reforms can possibly meet the challenge the NHS faces from an explosion in chronic diseases, such as diabetes. That calls for policies that integrate services rather than fragment them, and for more focus on prevention.
One other point is worth mentioning. Today's article is not just an attack on the government. Milburn also says that Labour's response to the announcement on Tuesday suggests that the party is retreating into its "comfort zone".
There is an open goal for Ed Miliband's Labour Party. The temptation, of course, is for Labour to retreat to the comfort zone of public sector producer-interest protectionism – and there were signs of that in the party's response to the Government's U-turn this week. It would be unwise, in my view, for Labour to concede rather than contest the reform territory. It now has an opportunity to restake its claim to be the party of progressive, radical reform. It is only when we are that we win.
As Nicholas Watt reports, based on extracts released yesterday, he will accuse George Osborne of creating a "permanent dent" in the British economy by cutting spending too fast. And, overnight, the BBC has been briefed that Balls will be calling for an emergency tax cut. I'll be covering the speech in detail after 9.30am. I'll be having a look at Alan Miliburn's declaration that the government's revised health reforms will be "the biggest car crash in NHS history". And there are a few other things going on too. Here's a full list.We've got a big speech from Ed Balls this morning.
9am: Sir David Nicholson, the NHS chief executive, speaks at a health commissioning conference.
9.15am: Prof Steve Field, the chairman of the NHS Future Forum, gives evidence to the Commons health committee
10am: Ed Balls, the shadow chancellor, delivers a speech at the LSE.
10.15am: Michael Gove, the education secretary, speaks at the National College for School Leadership conference. As the Guardian reported yesterday, he will say that by 2015 he expects every secondary school in England to be achieving the current national average of at least 50% of pupils achieving five A*-C grades at GCSE, including English and maths.
11am: Lord Fowler, chairman of the Lords communications committee, asks a question in the Lords about what the government is doing about phone hacking.
Lunchtime: David Cameron holdsa PM Direct event.
As usual, I'll be covering all the breaking political news, as well as looking at the papers and bringing you the best politics from the web. I'll post a lunchtime summary at around 12.30pm. After that I'll be off - I've got a meeting to go to - but my colleague Hélène Mulholland will then be taking over.