Joined-up government?
April 8, 2002 12:00 AM
By Stephen Williams in Bristol West End News
By Stephen Williams in Bristol West End News
I've spent much of the last 10 years in Bristol politics making the case for a substantial investment in public services, paid for by extra taxation. So to criticise Gordon Brown's budget might to some seem a little churlish. But at the 2001 general election my Labour opponent repeatedly trotted out the Millbank line that there was no need for a rise in taxes. The implication was that the Lib Dems were reckless taxers and spenders. Whatever was the criticism, at least we were honest with the electorate.
To be fair, I think Gordon Brown has made a bold step, largely in the right direction. His increase in national insurance will raise billions of pounds. If spent wisely the money could initiate a transformation in health care.
But why has it taken so long for Labour to act? The country voted for change in 1997. The Lib Dems argued for extra tax for better services in that election. New Labour said no. If they had made a start in 1997 then by now we would be seeing the results of the investment. Instead the health service has deteriorated and it will now be more difficult to turn it around.
The main way to increase capacity in the health service is to recruit and retain more doctors, nurses and other health professionals. In the run up to last years election I met many doctors and nurses. And as Bristol has a first class medical school and teaching hospital, I also met many students training for a future in health care.
The existing professionals felt over worked and under paid. This was a point made by many public sector workers. One of the paradoxes of Gordon Brown's budget is that the extra investment in the NHS will be raised disproportionately from its lowest paid workers. National insurance is a tax that falls most heavily on the low paid. From next year those on earnings up to about £30,000 will pay 11% of their earnings in national insurance. Those with earnings on top of that will pay only an extra 1% Those who can afford to pay the most will actually be paying the least, as a share of their total income. An underpaid nurse might be forgiven for thinking that this was a little unfair.
But the comments of the trainee doctors and nurses gave more cause for concern. Once they qualified many of them weren't sure that they would want to work for the NHS. They would have more satisfactory careers in the private sector or abroad. Why? Because not only could they look forward to lower salaries in the NHS but as a direct result of Labour's scrapping of student grants and the introduction of tuition fees they would start their careers with a debt burden slung round their necks. This does not seem to me to be an example of 'joined up government'.
So Gordon Brown's new money might not deliver what he expects. But for all our sakes I hope this year's budget does mark a change in the attitude of the government to public sector investment. Perhaps the main reason why I am involved in politics is that as a child I watched my father die from a preventable illness. I have often despaired at the nature of the health debate in our country. It should not be focused on which party promises the most money. Rather it should centre on how we use adequately funded health care to transform peoples' lives.
Gordon Brown may have hesitated too long, he may not have raised the money in the fairest way, but if he gives the NHS the resources it needs then at last we can concentrate political debate on health, rather than the level of money we spend on it.
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