Mrs Thatcher was reputed to declare in more than one context that There Is No Alternative – earning herself the sobriquet of TINA . In life that is rarely the case and as an avowed existentialist I am disinclined to believe that is ever the case.
The party will be told that there is no practical alternative to the Lansley Bill. That could be true. I have no doubt that the Bill has been substantially changed and improved as a result of the listening exercise and amendment in the Lords.
It is, however, still a massive set of changes to the NHS and a continuation of the direction set for the NHS by Tony Blair. Fears about the practicality of its implementation, the over centralisation of power and the pro-market philosophy that underpinned the original Bill have seriously upset many, if not most of the people responsible for running the NHS and the public. The unforeseen consequences of implementation were what forced Norman Lamb to speak out.
Few get into the fine detail of the Bill, few will – but many are asking whither the NHS?
We are thus as a party on the horns of a dreadful dilemma.
There are two sharply contrasting schools of thought- one view is that we have a problematic Bill and should drop it; the other view is that we have a problematic Bill and we are stuck with it.
It seems to me that we are at our best as a party when we deal in solutions, not grumbles, and it seems sensible for us to answer the question “Whither the NHS?” other than by suggesting we limit ourselves to cobbling together legislative compromises. Whatever happens at Gateshead, and however people vote, the general direction we want to take the NHS must be made clear.
My paper A Way Through – NHS Reform without strife and upheaval has been already partly circulated and received some positive reaction from both informed medical opinion and party members. It factors in where we could be post -Bill or without-Bill. I would be the last to claim that it is perfect, but I would be the first to acknowledge that in life there are always alternatives.
* John Pugh was Liberal Democrat MP for Southport until 2017 and was elected as a Councillor for the Dukes ward of Sefton Borough Council on 2 November 2017.
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One Comment
The TINA manta is closely associated with wider liberalization issues, and refelcts the behaviour of the major parties since 1997 introducing right wing hyper-consumerism into UK society, recent examples include incopration of primary schools as deregulated academies, contracts leaked last week to outsource police officers and indeed the breakup of the NHS into a new myriad of independent providers in competition for government and private funds.
Many LibDems, as I have observed on LibDem Act seem pretty happy with this 3 party consensus, but this is not healthy for our democracy, with the outcome being a single Neoliberal bloc in Westminster.
The failure of the LibDems to offer a modern social democratic to TINA, as many expected under Clegg in 2010 reflects the growing dissatisfaction of the UK progressive electoral base with mainstream politics. The lack of choice at the ballot box has resulted in creeping separatism in the regions, with New Labour both establishing devolution, then ironically losing control of both Wales and Scotland to a progressive leadership in Welsh Labour and the SNP in Scotland.
Whilst the mainsteam parties seem committed to a TINA agenda, based on the international GATS and EU trade liberalization agreements, there is no guarentee this agenda will reach its logical conclusion in the UK, with increasing pressure in Labour to reform back to centre politics (Ed Milliband’s listening exercise in 2011), and the threat of further UK breakup as regions opt for devolution or independence in the face of a Neoliberal Westminster consensus.
The arrogance of Neoliberal beuracrats in aligning traditional political parties with TINA, thereby eroding both political integrity and democratic choice may therefore backfire spectacularly in the years to come, with polls indicating the return of betwen 3-7 LibDem MPs if there was a general election tomorrow. It is also likely that we will see further calls for separation from Wesminster in the regions following another strongly Neoliberal administration in 2015.