Well, it’s a strange one, the Cameron-Clegg, Lib-Con, Con-Dem, whatever government — on the one hand they look like such a soft bunch, compared to the old Thatcher gang, a group of Oxbridge PPE policy types, soft-faced and handed. You couldn’t imagine them breaking wind, much less a miner’s strike.
But they’re either crazy-brave or stunningly inept to judge from the recent Barnsley Central byelection — a safe Labour constituency to be sure, but one where the Tories lost half their vote — thus coming second to the further-right UKIP — and the Lib-Dems came sixth, behind everyone, including the BNP and an independent. Clearly a whole left bloc of the Lib-Dem vote moved back to Labour, in protest at the cuts, and the Tory vote moved en masse to UKIP, out of exasperation at Dave’s vague ideas about the “big society”, and his failure to stand up to Europe.
In opposition, Dave Cameron loved to talk about “the big society”, and how it would take over from “the big state” and mitigate the harsh side of the market. He still does, even though his backbenchers beg him not to, and there’s no money for anything.
Cameron pitched a new conservatism, post-Thatcherite, reconciling social conservatives with the new young suburbanites who were liberal by inclination. The old guard loathed him more than they did the poor, and would have voted for Tony Blair if he was still around.
But Cameron is surprising them, and everyone, with one of the most radical agendas in recent British history. Surprising, because his government appears to be doing three things at once — administering deep cuts to services, especially at local government level, pushing ahead with a whole series of privatisations on thin political capital — and running a culture war.
The privatisations strike at the heart of two places Thatcher never really monstered — the NHS and the universities. Though she changed the admin structure of both, by the time the Tories left office, the NHS was still a totally cashless, wholly public, socialist institution for all necessary health treatment, and university tuition fees were derisory.
The Cameron-Clegg government has launched huge transformations of both in ways that defy description as “conservative”. In attacking the funding of universities, the department that has government funding effectively removed — removed — is the humanities.
Since the humanities (plus physics) are the university — all other faculties are just attached training colleges — it’s an attack on the very idea of a university, as a public good, at all. The humanities must now be funded from fees — thus obliging most universities to impose the maximum £9000, as allowed by the recent review.
The continued direct funding of the applied departments is a measure of the government’s nihilism — the essence of the university, reasoning, reflection and interpretation is unimportant. All that matters is the ways in which it can be plugged into industry.
The announcement of £9000 pa fees has contributed to a wave of protests taking over the country, spawning groups such as UK Uncut and 38 degrees. The NHS revolution has attracted less concerted attention but is as radical.
It re-centres care management on the GP surgery, who become the entrepreneurial care managers of their patients, controlling budgets that would once have been managed by local health authorities, hospitals, etc. This includes a capacity for them to draw in private providers — paid with public funds — to provide part of that care. The rhetoric around the move is “patient choice”, care managed by “doctors not bureaucrats”, etc, etc.
This is bollocks of course. Unless you have enough money to pay for every conceivable treatment, bureaucrats will always play a role in what care you get — setting hospital budgets, priorities, subsidies, etc, etc. That’s all the more so when you start to bring in private health corporations, as US users of HMOs know all too well.
GP s are entirely split on the move — some welcome the chance to be able to follow through on their patients, and ensure continuity of care. There are certainly enough horror stories from the NHS machine to make that a desirable goal. But other GP s have misgivings about the big presupposition behind the move — that a GP can make effective decisions about complex care options, in fields where specialists take decades to train to effectiveness.
The idea of GP-centred care actually threatens a nightmare for GP s, who must now combine themselves into middle-sized trusts to administer huge billion-pound funds. A group of people who made a life decision to offer individual care to patients, in a room, in a clinic, year-in year-out, will now become health-fund managers.
Should they do what they want to do — ensure best care for their patients, champion them — they will blow the funds out to massive deficits and distortions. Should they knuckle under, and manage within funding limits, they will have to make the same hard choices as administrators currently make — and they will probably hire administrators made redundant from the recently abolished regional health care trusts to do it anyway. Many of those who take a more hands-on role will be bilked clean by the sharks in Big Pharma and Big Insurance.
By 2015 and the next election — if it has not happened before — the NHS will still be halfway through this dubious change — neither genuine consumer choice, nor optimised public service delivery — and chaos will be maximised. Chaotically run regional trusts will require central bail-outs if they are to avoid collapse, and the absence of basic health services, a situation up with the great British public would not put.
Why is the Tory party heading into this battle, off the back of a disappointing election win, and no parliamentary majority? Part of it is pure clientalism. The party is broke, and needs industry donors, and there is keen competition for health industry donations. But they also have a weird attachment to a hybrid ideology of “choice” and “management”.
Thus “choice” ideology has little to do with Thatcherism, because it is less concerned with the core issue of the public/private split — i.e. with ownership of production — than with the management of consumption,and the behaviour of consumers.
Thatcher left the NHS front-end and other institutions such as the BBC alone, because she knew that privatising them was politically impossible — and without a shift in ownership, the rest was mere tinkering. The Cameroons see privatisation as in service to the idea that freedom is wholly represented by increased “choice”, provided by various means.
Thus, they push privatisation in some areas, increased public choice options in others, the “big society” in others — where volunteers are encouraged to find a “Churchill spirit” to get together to run publicly funded but parent-controlled “free” schools schools, dying post-offices, uneconomic pubs in villages, etc — and also leads them to an obsession with so-called “nudge” theory, the idea that people can and should be manipulated into “good” behaviours, by the redesign of “choice architecture”. Lindsay Tanner was very keen on it — apparently the way to attract people back to the Labor party is to treat them like lab rats, rather than to represent them.
The Tories like “nudge” theory, because it legitimates the same crude social and behavioural management New Labour indulged in, while being a rebranded form of it, in line with “choice” New Labour? CCTVs and ASBOs. Big society conservatism? “Nudge”, and a whole series of behavioural control orders.
This all-fronts cultural push has already created some problems — after attempting to sell off about 300 forests, managed separately from the national parks system — the government was forced into an abject retreat in the face of a massive social alliance of protest across left and right, urban and rural, all classes, all persuasions.
Some Tories contemplate a yet more specific cultural attack, trying to abolish the May Day holiday, and move it to either St George’s Day, or the anniversary of Trafalgar.
The substitution of nation for citizen is obvious — and May Day, commemorating the eight-hour day, among other achievements, is a universal holiday by its very nature — and bizarrely could be the one thing that revives May Day as a celebration meaning something, rather than a mere spring long weekend.
Given another year, and a lot of this exuberant nonsense will be history. As the government’s hopelessly confused response to the Libyan crisis demonstrated, it does not handle genuine emergencies well — and it will have them domestically soon, as the cuts bite and the Lib-Dems split. At which point it will need the Churchill spirit to keep a lot more than the local post office going.