Across England, Scotland and Wales thousands of activists are taking the Labour Party’s manifesto to people’s doorsteps, inspired by the potential for change it offers. Here Pete Gillard, a health campaigner from Shropshire, and Harry Holmes, a climate activist, reflect on the policies the manifesto contains and how it will impact their work.
The NHS is in crisis. Underfunding from successive Tory and Lib Dem Governments has left in in a state where it cannot consistently meet basic goals around timely, safe treatment. The NHS also continues to be picked off by privateers, with large-scale privatisation likely to lie ahead.
The NHS is on the brink. This recognition is the starting point for Labour’s manifesto. ‘Our hospitals are crumbling, equipment is outdated, IT systems are inadequate and community facilities are neglected.’ Labour pledges to ‘repair our health services’ and ‘end NHS privatisation’.
There are many items in the manifesto that move us in the right direction – free prescriptions, extended mental health counselling for young people, and reinstating nursing bursaries for example. These are all things that people have been fighting for and that can make a real difference.
But when it comes to the fundamentals of privatisation and funding, the manifesto is weaker. The major commitment on privatisation is to halt further privatisation. It is weakened, though, by the statement implying the NHS is only a ‘preferred provider’, not the only provider. There is no time scale here for bringing already privatised services back in-house. And PFI contracts are to be taken back ‘over time’.
The reason behind this is Labour’s caution in confronting business. We should be talking about taking back without compensation the privatised services or PFI buildings that companies have used to leech money from the NHS for so long. If they remain, we cannot talk about an NHS where profit is not a motive.
Most importantly, the manifesto does not adequately tackling the issue of underfunding. Historically, under both Tory and Labour Governments, the NHS has had its budget increased by around 4% a year in real terms. This has enabled the NHS to implement medical advances and meet the needs of a growing and ageing population. This all changed in 2010, when the brakes were slammed on for funding. The annual shortfall now stands at around £40bn.
Labour is committing to increasing NHS spending by under £10bn per year by the end of a five-year term. That is less than a quarter of the amount needed to restore NHS funding to the level it would be at if those average increases had applied. The funding crisis is reduced but not ended. Deficits in NHS Trusts this summer had reached a shocking £5bn.
Even when it comes to headline items like the 5% pay increase for all public sector workers, the detail is a disappointment. The payment will be a one off, and then pay increases will be determined by Pay Review Bodies that historically have always sided with the employers. It seems that compulsory sectoral wage bargaining will be available only in the private sector.
Despite good intentions, Labour comes up short. Why? They intend to work with capital rather than directly challenge it. A tougher approach could deliver much more, and would be popular with voters. Just cancelling PFI contracts without compensation would release £55bn, over the lifetime of those contracts, that could be spent on patient care.
The NHS can still be saved – but not without a fundamental shift in policy. Labour’s Manifesto for the NHS, with all its faults, is better than that of 2017. It recognises the problems and seeks to address them. The limitations here come primarily from Labour’s timid economic policy.
This of course is where activity from below can shift things. Health campaigners have been successful in moving Labour’s health policy to the left over the last two years. We should of course be at the heart of grassroots campaigns against cuts and closures, for decent staffing and pay, for a publicly owned and provided NHS, and for healthcare that meets our needs. With a Labour government, there will be scope to push policies and funding beyond the commitments in this manifesto.
The Conservative and Lib Dem parties have a disgusting record where the NHS is concerned. We should have no illusions at all that they offer anything progressive. And health campaigns hold the potential for beating the Tories. Labour’s manifesto isn’t perfect, and it would be wrong to pretend it is more radical than it is. Nevertheless, it opens up possibilities for change. The NHS needs hope.
Climate and the Environment
The first point of commendation for manifesto is how front and centre climate and the ‘Green Industrial Revolution’ is. To have a manifesto open on climate reflects a fundamental shift in how seriously the climate crisis is being taken by the Labour Party.
A particular strength is the focus on the finance and investment industries as the enablers of fossil fuel extraction, and the possibility of kicking companies which fail to act off the London Stock Exchange. Many climate responses reduce the issue to energy and transport. The shift to finance and wide treatment of many industries shows a more mature understanding of the scale of the necessary transition. The focus on regional redistribution and levelling up reflects a recognition of the need to rectify geographic unevenness in climate mitigation and adaptation which is usually ignored.
The focus on one million well-paid, unionised jobs reflects the success of longstanding extra-parliamentary campaigning in this area to link employment and environment. Where and how these jobs are distributed, including a proposal for climate apprenticeships, are further points of uncertainty. A huge amount of work in the environment sector is unpaid – volunteers working late in the evenings over weekends. Low-carbon jobs often take the form of roles within the care, education, and other well-being sectors. GND (Green New Deal) proposals need focus and reflection on these sectors, but this is not explicitly reflected in the climate section of the manifesto.
However, there are a number of weak points. There is limited support for airport expansion, and road-building, which both have a massive carbon impact. Electric cars present a particular problem in achieving a ‘Just Transition’ which avoids replicating unequal relations between the Global North and countries in the South where resources often lay. Failing to acknowledge potential forms of neocolonialism within GND proposals is unacceptable. International equity will have to be demanded as these proposals are introduced. Further, the abandonment of an explicit 2030 target does represent a weakening of the climate commitment. Despite pathways being encouraged and remaining open, it gives space to delay necessary action.
Ultimately, this is the most ambitious the Labour Party has been on the issue of climate change. This is to be warmly welcomed, and is testament to the efforts of climate campaigners. Yet should Labour win, the role of the wider climate movement in ensuring sufficient and just action to tackle the crisis will be more vital than ever.