Boris is already demonstrating how his government will be all tell and no show

Boris Johnson, the Prime Minister - a phrase that used to sound like a joke - made a lot of promises in his first speech from Downing Street. His announcement of £1.8bn has been reported as the first down payment on these pledges.

Here-in lies a key sample of what we can expect from Boris Johnson and his verbose new government. A big promise and an announcement, with all the PR trimmings to follow, which on inspection fails to live up to the terms.

All tell and no show. The Boris way.

It's also been the Tories way through all of their time in government, whether under Cameron or May. Announcing old funding again as new funding, relabelling and reannouncing, fiscal politics played out in the media rather than in the treasury. And all the while, the cuts go on.

In the present case, Boris has offered up a lump of extra cash for the NHS. But it isn't what it seems. In fact, the £1bn 'upfront' is money that the government had already promised to the NHS - in exchange for three years of trusts slashing their budgets - only to then block hospitals from spending it.

The second half is for what is know as capital spending, long term investment to pay now for projects that will be ready years from now. This kind of spending is deeply important, but does little for struggling hospitals in the present - and even that sum isn't coming right away.

What the government cares about are the flurry of headlines that follow these press releases - often printed wholly and uncritically in the media. While the front pages tell people what the Tories want them to hear, the analysis is buried and with it the debunking of the government's claims.

These headlines are the heart of a long term government strategy, all about governing by telling and not showing. It has allowed them to slash and slash again at budgets, and the services they fund, and to deflect criticism on to others - mostly the vulnerable, exposed by the Tories' own austerity politics.

Don't be fooled by the headlines. Don't let the Tories, as John Harris puts it, sow "discord and resentment via austerity" only to reap the rewards of the chaos with a sharp PR strategy. If we're not sharper ourselves, we'll face the consequences of Tory disaster politics while they profit.

Ideology, NHS funding and money from nothing: Beware politicians bearing gifts

Under Theresa May and Philip Hammond, the Conservative government has continued on from where it left off under David Cameron and George Osborne. Austerity at the top of the agenda, with all else battered before it's ideological wake.

Which makes it all the more remarkable that the Prime Minister at the head of the party of austerity, this weekend, made a pledge to increase NHS funding by £20 billion a year.

How does this happen?

The Conservatives, for sure, in the majority these days ascribe to a "pro-business" ideology. A belief in private sector growth that boosts tax returns, that in turn cuts taxes, that in turn boosts private sector growth.

That is the ideological belief, at least. One that requires the market to play along with the ideal - particularly when the private sector is required to pick up the slack as the public sector is cut back by the government.

However, these ideological ideas must interact with the real world - and with one of the prime movers of compromise in the political sphere: the point at which politics as ideology meets politics as a competition with a lot riding on it.

The Conservatives in government and Labour on the opposition benches have differing ideologies - though the gaps between the two are at times and in places very narrow, and produce primary outcomes that are very similar.

That similarity comes from politics as a high stakes competition. Each party vying to shape public opinion, or to win over the electorate as public opinion stands - shaping what is called the 'centre ground'.

So even as the Tory government cuts with one hand, it looks to deliver a windfall with the other, to shore up electoral support. And, in this case, that means doing precisely that which the party accuses Labour - making large spending commitments, reckless in the absence of a clearly defined statement as to where the money will come from.

But ideology is never far away. Theresa May followed up her offer of new funding with a cautionary word that the health service much watch and account for every penny carefully. And others have pointed out that this injection of cash only brings the NHS back up to level of funding it had between 1948 and 2010 - when the Tories began imposing austerity.

So long as we treat politics like a game of win or lose in the pursuit of power, we can expect belief to be mingled with ambitious pragmatism. And we must remain wary that what we're being sold comes through layers of motivations - especially when it's a windfall of cash with no obvious source.

General Election 2017 - Health & Social Care: Voters ousting Jeremy Hunt would send the Conservatives a very strong message

Health and social care in Britain is under tremendous strain and more Tory cuts won't help.

One of the biggest questions hanging over the 2017 general election is the future of funding for health services in Britain. The Conservatives have overseen one crisis after another over the last seven years.

There is a clear distinction to be made between progressives and Conservatives on how to address them. Under the Conservatives their are going to be more cuts, while the progressive parties have pledged to raise more money.

And this election even offers a symbolic way to reject the Tory approach to healthcare. Dr Louise Irvine - who previously took the government to court and won over the cutting of casualty and maternity services Lewisham Hospital closure - is standing against Health Minister Jeremy Hunt in the South West Surrey constituency.

Tactical Voting

On behalf of the National Health Action Party, Dr Irvine is standing against Jeremy Hunt and the field has been cleared. Local members of the Liberal Democrats and Labour have agreed not to campaign and the Green Party withdrew its own candidate.

The various progressive alliance movements have all offered their endorsement, including Compass - the most well known pressure group for a new more pluralism politics.

Let's be realistic: it would be a huge upset for Dr Irvine to defeat Jeremy Hunt. Last time he took 34,000 votes (with UKIP on 5,600), while Irvine took just under 5,000. However, support for the Conservatives is not innate.

Through the 1990s and into the 2000s, the Conservative-progressive split (led by the Lib Dems) averaged out at 26,000 to 26,000. Only since 2010 has Hunt opened up a significant majority. And now he's among the most well known ministers - for all the wrong reasons.

Voters in Surrey have a chance to reject Hunt's management of the NHS and the air of conflict he has created with doctors. Members and campaigners for the progressive parties have already thrown in their backing for Irvine. Now it's down to voters.

Health in Crisis

And there are a lot of reasons voters can be dissatisfied with Hunt. From strikes, to closures, to year and after year cuts to funding, Britain's healthcare system faces some dire years ahead if the Tories remain in power.

Hunt caused plenty of controversy by deciding to go toe and to toe with junior doctors over new contracts and casting them as unreasonable people taking unnecessary action. Fortunately, the public was having none of it: polls showed the public consistently behind the doctors.

The strike action over contracts goes hand in hand with discontent at the ongoing public sector pay capped, limited to a 1% rise. The policy has led to distress particularly among NHS staff, with pay not rising along with prices and the general cost of living.

Hunt's management of the NHS has also antagonised patients. One in six A&E departments across the country face closure under the Tory drive to find £22bn in cuts from the health budget in the next few years. These emergency units have been under severe strain, with waiting times targets consistently missed.

The problems with healthcare in Britain stretch beyond the Health Secretary to his party's wider approach.

One place from where extra pressure is being exerted on the NHS is social care. With no where to go, thanks to a shortage of places, hospital beds are remaining full. Elder patients are finding themselves stuck in hospitals, unable to be discharged because the social care system is at capacity.

That is in part thanks to Conservative cuts to local government funding, that has seen billions cut from social care budgets - with only token efforts to restore minimal amounts, mostly to be raised by local councils themselves, a move that is clearly punitive to poorer communities.

This failure to display compassion has overtaken welfare too. From cuts to disability benefits to attempts, appallingly, to dismiss the needs of those with mental illnesses. In an effort to cut spending on welfare, Tory policy chief George Freeman said the party wants welfare to go only to the "really disabled".

All of fronts, there appears to more concern about producing an immaculate looking balance sheet, than about the comprehensive quality service that balance sheet is supposed to be providing.

Progressive Pitch

The progressive parties are calling for a change in direction and both Labour and the Liberal Democrats have pledged more funding - and not just for the NHS itself. Both parties are calling for more to be restored to the social care system and for health and social care to be seen and treated as a joined-up service.

Labour have pledged to raise around £6 billion a year extra for the NHS, from higher taxes on the wealthy. They accompany that with investment from their proposed National Transformation Fund to upgrade hospitals and their equipment.

The Liberal Democrats go a step further. They plan to add a penny in the pound to tax, affecting all earners - but hitting the richest hardest - specifically to support the NHS and social care.

Both of these plans are a pragmatic step towards addressing the problems in the healthcare system. So would lowering stress for public sector workers by lifting the pay cap, to which both parties have committed.

Labour and the Lib Dems are also pledging to do away with some of the Conservatives more heinous welfare cuts, particularly those affecting people with disabilities.

Stand up for Healthcare

The idea of a progressive alliance is a rejection of the gerrymandering system that forces people to divide according to tribal loyalties. To bring people together who support common values and work together to ensure better representation.

In this election, the progressive alliance movement has brought parts of the Labour Party, the Liberal Democrats and the Greens together around the common values - for which they have stood in most past elections.

But standing aside for National Health Action and their candidate Dr Louise Irvine shows something more: a willingness to put aside narrow interest to fight for something larger. To put a candidate into office who has fought long and hard for the NHS.

Voters have to do two things. To vote for the candidates that stand for their values - not just for a specific party - and they need to be vocal about what is moving them. Healthcare always tops the list of people's concerns in Britain.

Jeremy Hunt has mismanaged the National Health Service. His party in government has sewn division and lacked compassion. Even if you usually vote Conservative, especially if you normally vote Conservative, rejecting Hunt and electing Dr Louise Irvine would be a strong statement.

Choosing Dr Louise Irvine would be a symbolic defence of the NHS and of the principles of compassionate universal care. But it would also put into office a tireless and independent minded local campaigner - who beat the government in the courts to stop closures and isn't afraid to call out any of the parties on their record.

General Election 2017 - Labour Manifesto: Stepping up the role of the public sector

Labour's manifesto, For The Many, Not The Few, proposes a major rethink of the role of the public sector.

At the core of Labour's 2017 manifesto is the role of the public sector. It has a place at the centre of all the party's ideas on how to rebalance Britain's economy.

Labour has promised to be "radical and responsible", to end the years of austerity but to do it "within our means", to address a "growing sense of anxiety and frustration. For the Labour leadership, as represented in this manifesto, that means rethinking the government's approach to public and private, and to restore the public element.

That puts Labour in stark contrast with the Conservatives, and fundamentally questions the government's approach - that would strip away the public in favour of the private. As Labour announced its plans in parts over the past couple of years, there was a surge of criticism for the idea of any policy that would see more public spending. The austerity thinking that public debt, government debt, is a burden that must be lessened has been wielded against Labour at every turn.

There remains a strong current, despite the slow discrediting of austerity economics, that clings to a fawning infatuation with the idea that public debt, not underinvestment, will blight the future and that the market is the great innovator. But, as the economist Mariana Mazzucato has argued, this is at best a half-truth.

In reality, public sector plays the role of innovator and risk taker, not just shaping markets but opening them. Meanwhile, private actors are aggressively risk averse, even stifling innovation, all while opportunistically exploiting the publicly-funded advances - taking the credit and returning little of the wealth created.

A New Public Role

This Labour manifesto seizes upon that idea: an innovative public sector that can take the initiative and intervene, without overbearing state management, to invest and promote growth and support innovation in the name of the common good.

It proposes a National Transformation Fund, for instance, that will invest £250 billion over ten years in improving the country's infrastructure, aimed at promoting and speeding along future economic growth. It pledges improvements to transport links, for renewable and low carbon energy, and an industrial strategy that invests in creating and enabling a high-skill economy.

And, of course, there are the pledges to 'renationalise' energy, rail and water. Having come upon this word, a moment needs to be taken to reiterate something. The word 'renationalise' has been used for Labour's plans, but isn't entirely accurate. The Left (as a positive) and the Right (as a negative) have both used the word, but to be clear: Labour's plans don't propose costly industry takeovers by the state.

Remember: state-ownership is just one form of public-ownership, but it is not the only form. There are municipal, community and co-operative models that are also public options that do not require or propose centralised state management - whether you think that would be a good thing or too overbearing and inefficient.

As for the cost of 'renationalisation'? Well, a rail franchise will lapse at no cost and new public rail and energy companies, while requiring startup, would have the capacity to be self-supporting. In short, 'nationalisation' is a crudely charged word that hides a lot of potential nuance.

In Labour's actual manifesto, the focus is on democratic ownership of the economy. For instance, the party propose a "right to own" policy that makes "employees the buyer of first refusal". So when the party says it wants publicly-owned regional water companies, there is scope to think co-operative and community, rather than state.

As for rail returning to public ownership: it's already publicly-owned. It's just franchised out in pieces for companies to turn a profit from it. Returning these franchises on expiry is not a major outlay, though it could take time, and they could become self-supporting, employee-run services rather than being state-run.

Likewise, the party's plan for public energy is much smaller in scale than the 'renationalised' headlines suggest. Rather than wholesale takeovers, Labour have announced their intention to set up local, decentralised, publicly-owned energy companies to compete with the big energy corporations and lower prices.

The new role for the public sector doesn't end there. The party propose a National Investment Bank, that will work with private investors, to make £250 billion available to lend to "small business, co-operatives and innovative projects" across Britain - offering "patient, long-term finance to R&D-intensive investments".

The NIB's work in getting credit flowing again may be assisted by breaking up the publicly-owned RBS into a series of smaller, "local public banks" - pending a consultation on the proposal.

In housing, there is a public role too. Half of the one million new homes that Labour are promising will be housing association and council homes for affordable rents, promises the manifesto - with higher standards being set for the quality of homes.

The clear purpose behind this is to restore a sense of social security and of communities owned by the people who live in them.

That is why a rethought public role goes hand-in-hand with promises of new rights and protections for renters, a National Education Service that brings childcare, comprehensive education and free higher and further education under one coordinated heading, putting more funding into social care, and taking steps to protect workers by tackling insecure and precarious jobs.

It also chimes well with the proposal to make active use of the national and local spending on procurement of services from the private sector. That means using a bill amounting to £200 billion a year to promote, and invest in, good jobs based in local economies at businesses run to high standards.

A £10 living wage, four more bank holidays, increased paid paternity leave and more secure contracts at work, indicate an intention to create a less precarious everyday environment. While funding ten thousand more police officers and strengthening laws around domestic violence and violence against women and girls, demands that these rebuild communities be safe spaces.

There is even a nod to restoring some judicial oversight to investigatory powers - though the word 'surveillance' does not appear - to ensure than individual rights and civil liberties are not weakened.

And the NHS, Labour's crown jewel, will also see a large injection of new money. The party's plan involves additional funding of more than £30 billion into the service "over the next Parliament", with the NHS also benefiting from the National Transformation Fund to make much needed upgrades to buildings and equipment.

To put Labour's ideas into action will require funding. Te main source for Labour promises will be a tax rise for only the top five percent of earners, all earning over £80,000. There will be higher corporation tax, with small businesses protected by a lower rates and less frequent paperwork.

In all these measures are estimated to raise the extra £50 billion the party needs for it's policies - though the IFS stresses that some of that is conditional on somewhat unpredictable factors.

There is one glaring ommission: the absence of a pledge to end the Tory working age benefit freeze, which has led to deep cuts with further restrictions to come. With the deep impact that welfare cuts have already made it is a remarkable gap.

At the manifesto launch, ITV's Robert Peston raised this point. He asked Jeremy Corbyn why, when there is clear evidence of the coming impact, that ending the welfare freeze isn't mentioned. It isn't in the manifesto, but Corbyn responded that there will be a review of the situation and there will be no benefits freeze. But the lack of costing here is notable.

There are provisions, though, to repeal cuts to the Employment and Support Allowance (ESA), implement the court decision on Personal Independence Payments (PIPs) to protect those with mental health conditions, scrap the Bedroom Tax, scrap the sanctions regime and restore housing benefit for young people.

The Co-operative Party

And let's not forget that Labour is part of a century-long electoral pact with the Co-operative Party, with whom it stands joint candidates. Running and sitting as Labour and Co-operative Party, or Labour Co-op for short, the alliance has had and continues to have a number of well known MPs, such as Ed Balls, Gareth Thomas and Stella Creasy.

In addition to the Labour manifesto that these candidates will be judged against, the Co-op Party has also published its own priorities. These include expanded detail on both employees and consumers having a place in the shake-up of boardrooms, more localism and public services and utilities that are tied closer to their communities.

But there is very much something for the co-operative movement in the Labour manifesto. Along with backing for more democratic public ownership, there is a commitment to doubling the size of the co-operative sector with targeted investment - matching a Co-op Party aim.

In fact, there is a strong sense of the co-operative movement and of co-operative influence running right through the Labour Manifesto proposals. Everywhere the new role for the public sector come appended with 'local', 'regional' and 'democratic'.

Progressive Alliance

This election will not be, however, be a straight contest between the Conservatives and Labour. So the question is, what crossover is there between Labour and the other progressive parties on policy?

Well, there are plenty of crossovers, though cooperation at the party level will be unlikely. The leadership has made it's position clear and that sticks to Labour's longstanding attitude that it alone is the progressive party of Britain and everyone should rally to its standard.

There are, of course, also issues of disunity behind the scenes within the Labour Party itself - never mind between parties. There are many an "independent-minded" Labour MP who in 2017 are standing virtually as independents, disavowing Corbyn, and they look like they may finally be ready to split away - perhaps even to form a new party.

On one level, it might actually be a breath of fresh air, perhaps even making it easier for the two groups to work together in a more amicable fashion. But Labour's relationship with the Co-op Party and with trade unions could make a split a bit messy. And the party's legacy is something over which fights have been bitter.

However - all of the factionalism aside - on housing, on tax, on welfare and healthcare, there are plenty of crossovers and a lot of compatibility to be found between the Left and Centre parties.

For housing, their is a common consensus that Britain needs more homes that are more affordable, and that renters need far more protection and longer term contracts. Both Liberals and Greens match Labour in these ambitions.

As for public utilities, even the Liberal Democrats - seen by some on the Left as too far to the economic Right - maintain a strong vein of support for co-operatives and democratic ownership.

Local, community-owned utilities are no hard Left socialist experiment (as the Right would demonise it). They're a tried and tested system, with broad progressive support and proof of results.

And on health and social care there is broad support both for reversing Tory cuts and for taxation to pay for increased spending - which includes restoring dignity in welfare for people with disabilities and difficulties both physical and mental.

For a grassroots progressive alliance to work, voters need to be able to find common cause across party lines. Labour's pitch is clearly anti-austerity, clearly wishes to restore the public sector, and clearly wants the rich to pay a fair share.

Whether you like Jeremy Corbyn or not, there are plenty of reasons in this manifesto for progressives to vote Labour. But perhaps of more importance, there is plenty to make voting tactically for Labour more than palatable.

References

'For the many, not the few: The Labour Party Manifesto 2017 - A manifesto for a better, fairer Britain'; from the Labour Party; as of 16 May 2017.

'General election 2017: Corbyn launches Labour manifesto'; on the BBC; 16 May 2017.

Mariana Mazzucato's 'Let's rethink the idea of the state: it must be a catalyst for big, bold ideas'; in The Guardian; 15 December 2013.

'General election 2017: Labour pledges to build 1m new homes'; on the BBC; 27 April 2017.

Shehab Khan's 'Labour to pledge an additional £37 billion of funding for the NHS: Jeremy Corbyn is hoping to improve A&E performances and take one million patients off NHS waiting lists'; in The Independent; 15 May 2017.

'General election: Labour's '£7.4bn a year extra for NHS''; on the BBC; 15 May 2017.

Jessica Elgot & Peter Walker's 'Labour looks at new tax bracket for those earning £80k-£150k: Shadow chancellor says highest increases would be for top 1%, and only top 5% of earners would face rise'; in The Guardian; 7 May 2017.

'Labour manifesto: Extra £48.6bn in tax revenue to fund pledges'; on the BBC; 16 May 2017.

Stuart Adam, Andrew Hood, Robert Joyce & David Phillips' 'Labour’s proposed income tax rises for high-income individuals'; from the Institute for Fiscal Studies (IFS); 16 May 2017.

Robert Peston's 'Will Labour end the benefits freeze? Corbyn says yes - and no'; on ITV; 16 May 2017.

'A Co-operative Plan for a Britain Where Power and Wealth are Shared: The Co-operative Party’s policy platform for the 2017 General Election'; from the Co-operative Party; as of 16 May 2017.

Paul Mason's 'It’s now clear what Corbynism represents – so what does the centre do next? Labour’s new manifesto is popular on the doorsteps and in the polls, and may accelerate the creation of a new party and new alliances'; in The Guardian; 15 May 2017.

'General Election 2017 - Housing: There is a progressive consensus that Britain needs more homes and more protection for renters'; in The Alternative; 15 May 2017.

The Tory Facade: The healthcare crisis in Britain belies the Conservative presentation of their party as responsible stewards

The central claim that the Conservative Party makes, its fundamental promise to the electorate, is that it will be a responsible manager of the state. It tries to present its opponents as reckless ideologues, to be contrasted with their own sensible handling of public duties.

The current condition of the NHS exposes this claim as nothing more than a marketing campaign. The NHS remains the single most popular element of the public apparatus in Britain, even as it has descended into a period of prolonged crisis.

A report released today showed that beds have been filled beyond safe levels in 90% of hospitals over winter, with all the results of overcrowding that follow - in long waiting times and cancellations (Triggle, 2017).

It has been the tendency of the Prime Minister Theresa May at recent renditions of PMQs to deflect blame. On healthcare, her response has been to deflect it to the NHS administrators - claiming bad practice in the use of resources for shortfalls and service delivery (Merrick, 2016).

To back up that claim, the government says it has provided the funding the NHS asked for - but that is a half truth at best. The government has been accused by fact checkers, and Parliament's health committee, of fudging their numbers (Campbell, 2016).

While the government repeats its criticised claims of providing "$10 billion" of extra funds - with the reality being half of that - more parts of Britain's physical, mental health and social care service slide into crisis.

For instance: Social care is critically underfunded (Eichler, 2016). It was not protected from austerity and has been terribly withered by cuts to local government.

The Tories have no 'responsible' remedy. Talk of upfront charges for foreign patients (BBC, 2017), claims of bad practice in administration - these are cheap deflections, taking advantage of anti-immigration myths or falling back on tired austerity.

On social care, the Tories have responded with trivial tax powers for painfully stretched councils. But they will raise more in richer areas and less in poorer, and raise little in either case - only £200m nationally - to counteract the deep cuts that have ravaged the social care infrastructure (Merrick, 2016; BBC, 2016).

Standing back and observing the Conservative stewardship of health and social care, brings one of only two conclusions: incompetence or ideologically driven mismanagement. Whether deliberate or due to incompetence, the NHS is being undermined.

The public stood behind last year's strikes by junior doctors. But the pressure remains and continues to build. Progressives must start to dismantle the façade and show people the reality of the Conservative Party behind the marketing image.

The future of health and social care in Britain depends upon the public understanding its worth and seeing with their own eyes the devastating impact that Tory policies have had on this iconic symbol of progress in Britain.

Social Security: Winter is coming and the Government appears content to leave the ramparts unguarded

A homeless encampment in Manchester last year, one of the signs of the growing strain on Britain's social security safety net. People are falling through the system into poverty.

The first signs are appearing of the hard times ahead, forecast by the Autumn Statement. It has been less than a week since the Government announced its budget priorities and already it is under pressure over the gaps in social security created by the lower funding brought by six years of austerity.

People are falling through the cracks because, from social care to free school meals, the safety net is becoming porous. In some areas, people don't know they have a right to support and in others there simply aren't places for them in programmes.

At the root of these issues is funding. In their quixotic crusade to tackle public spending, that they sees as an unnecessary waste, the Conservatives have chipped, slashed and removed whole sections of Britain's social security safety net.

As Labour Leader Jeremy Corbyn has pointed out, the Conservatives have slashed spending even where spending would ultimately save far more money in the long run than cuts will. The onward rumbling housing crisis has proven particularly expensive for the Government.

As a result of a failure to build new social housing, and the determined sell-off of present stock, far more is spent on Housing Benefit to keep people in more expensive, and often less satisfactory, private rented accommodation.

Investing funds in social housing could, in fact, drastically reduce the housing benefit bill, by perhaps billions, all while tackling one of Britain's a major infrastructural problem. The key that the Conservative seem to be missing is the vital role to be played by smart spending.

The Conservatives have certainly tried to portray themselves as embracing the idea of smart spending. When it comes to funds, the Government has been keen to say that it has extended certain tax raising powers to local government to cover the increased cost of social care. And the Prime Minister continues to repeat the '£10bn for the NHS' figure.

Yet their claims are belied by reality. The £10bn figure has been debunked and its continued use criticised. The extra funding for social care, the Social Care Precept - that lets local government keep a 2% greater share council tax receipts - has been dismissed as wholly inadequate. The Chancellor pledge in invest in infrastructure resulted in just 40,000 new homes being promised.

There is even talk today of the pension age being pushed back again. Even as the living standards of all workers, especially the most vulnerable, continue to fall, the Government still whittles away at the public sector and turns to the market.

Winter is coming and the Government appears content to leave the ramparts unguarded - believing perhaps that people should secure their own fences in a market for social security. That is a plan that progressives should comprehensively reject.

Prioritising opportunities for the affluent and thrusting over security for the vulnerable isn't just unethical and economically unsound, its also a social disaster waiting to happen.

It is the very thing that feeds the desperation, that in turn feeds the far right. The neoliberalism of the Centre-Right is laying the shaky foundations of its own collapse.

So what does that leave for progressives to do? Yanis Varoufakis has put it the simplest: first, stabilise and save what we can of value in the present system, and second, develop a real, working and unifying alternative. The costs of letting the house of cards fall - personally, socially, economically - are just far too high to do otherwise.

Caroline Lucas' National Health Service Bill seeks to restore the NHS to its reassuring place in the UK's social security safety net

Almost perfectly timed to follow on the tail of the latest round of Junior Doctors Strikes, Caroline Lucas' backbench National Health Service Bill has its second reading in the Commons today (Friday 11th).

The aim of the bill is to rein in, what has been called, the undemocratic backdoor privatisation of the NHS. The bill seeks to undo internal competition introduced in 1991 and reintroduce local health boards, to streamline the identification of the services needed and to provide them (Lucas, 2016).

Public backing for the NHS remains high, and the bill has received broad support from celebrities and other publicly notable persons (The Guardian, 2016). The good feeling towards the institution can be seen in the still high support for the junior doctors in the ongoing contract dispute between the British Medical Association, the BMA, and Secretary of Health Jeremy Hunt (ITV, 2016; Stone, 2016).

The junior doctors strikes themselves seem almost to be symptomatic of the problems to be found in the NHS' inner workings. Staff have been stretched thin across shifts for years (The Telegraph, 2012).

After a number of strikes, negotiations completely broke down, with Jeremy Hunt attempting to suggest that the doctor's union, the BMA, was trying to hold the government to ransom (Ashmore, 2016). Treating unionised medical professionals like they're mutineers at least doesn't seem to have helped Hunt's standing with the public.

Yet the decision by the Health Secretary to impose the government's newly designed contracts (Tran & Campbell, 2016), without further negotiation or bilateral acceptance, was a potentially damaging but possibly effective escalation of the dispute - effectively calling out doctors in the expectation of grumbling compliance.

For doctors are left with little alternative, besides interminable strikes, than flight - literally abroad, or figuratively, to the private sector. With the NHS in crisis in recent years, this has already been increasingly the case (El Sheika, 2016; Johnson, 2016).

Yet it has also been suggested that Hunt, and others who are actually in favour of a privatised system of healthcare, are unlikely to shed a tear for staff flying to the private sector (Stone, 2016). In fact there are some who see these events as part of a long chain, a long and concerted effort to discredit the NHS in order to pave the way for privatisation (El Gingihy, 2015).

Supporters of the NHS Bill, which is being debated and voted on in parliament today, see the privatisation agenda as both undemocratic and also contrary to the facts. Accusations have been made that the costs of healthcare are being inflated, in all parts of the NHS, by the infiltration of the private sector (Furse, 2016) - completely contrary to the standard narrative of market 'efficiency'.

Caroline Lucas', who is sponsoring the bill, has argued that the virtual army of staff required to manage private contracts is contributing heavily to the growing deficit and debt hanging around the NHS' neck (Lucas, 2016{2}). In fact, it has been pointed to that by the WHO, World Health Organisation, definition, the NHS is all but privatised already (El Gingihy, 2016).

The backbench NHS Bill is an attempt to reverse that direction and keep the institution alive and restore it for the future. The NHS remains an important part of the public safety net that guards against disaster. Alongside future progressive, like the basic income and a shortening of the working day, a free-at-the-point-of-use public healthcare system still has a place in ensuring justice and liberty.

Jeremy Hunt is playing dangerously with escalation in dispute with Doctors over future of NHS as he imposes contracts

Junior doctors and supporters gathered outside the Manchester Royal Infirmary on 10th February, during the latest 24 hour junior doctors strike.

After months of wrangling, Jeremy Hunt has decided to impose contracts on junior doctors (Tran & Campbell, 2016). Hunt's decision came just an hour after the second major strike by Junior doctors, where strikers walked out for 24 hours in protest against extension of hours across the weekend (Triggle, 2016).

Negotiations have been ongoing for months, but had broken down on Tuesday after what Hunt, the Conservative Health Secretary, called his 'final offer' had been rejected (Campbell, 2016). Accusations were also flying that all parties had agreed an alternative deal in principle, only for Hunt to veto it (Stone, 2016).

Imposing the contract could easily further inflame an already controversial situation. Public opinion has been firmly on the side of the junior doctors strikes (Stone, 2016{2}), with Hunt being seen as personally culpable for the ongoing action called by the BMA - the British Medical Association, the doctor's trade union.

What Hunt may be counting on is that, in the initial phase, doctor's will have little choice but to put up and begrudgingly acquiesce. Then, to simply let the matter to blow over with time - gambling on the public having a short memory.

Yet the move could instead lead to escalation. So far the strikes have been 24 hours in duration and left emergency care intact. This move by the Health Secretary could push the opposition to longer strikes, with Healthcare provision reduced to a minimum, other medical professions walking in solidarity and larger public protests.

There have also been reports that the numbers of medical trainees have been dropping and that trained medical professionals have been moving abroad (El Sheika, 2016; Johnson, 2016). The BMA has been using these facts during the negotiations as leverage - and warning of a further exodus if unsafe conditions are extended.

However Hunt's move has called out doctors, expecting them to grumble but ultimately comply. Or may be for them to move into the private sector. There have been doubts about Hunt's commitment to a public, tax-funded NHS - the Health Secretary was a contributor to a book calling for a privatised health market in the UK (Stone, 2016{3}; El Gingihy, 2015).

The general feeling amongst Conservatives seems to be favourable towards a long term future of private sector solutions to social security. Work and Pensions Secretary Iain Duncan Smith won some agreement from Prime Minister David Cameron for the idea of, in essence, privatising sick pay and unemployment benefits by forcing people to pay into savings accounts or to buy social insurance as cover (Mason, 2015).

Health Secretary Jeremy Hunt has risked escalation with his latest move. The BMA says it will consider all options to continue the fight, against changes it believes to be dangerous to public health (Triggle, 2016{2}). Who blinks first matters. Most outcomes could likely be considered a win of some sort for the Conservatives - which shows the cleverness of the game they're playing.

But the game they're playing gambles with social security, the safety net that ensures the common good. In this big moment in the future of the NHS, the Conservatives are showing a ruthless side by pitting the NHS's future against the interests of medical professionals. Its a reckless game in pursuit of prices and profits, but which ignores value - and the fundamental social justice of universal public healthcare.

Rainbow celebration needs to fuel fresh momentum in the long struggle to create societies that take consent seriously

Photograph: Rainbow American via photopin (license) (cropped)

In two terms, mired in partisan politics bitterly divided between Liberals and Conservatives, US President Barack Obama has struggled to give his administration a definitive identity. A pair of Supreme Court (SCOTUS) rulings from the past week have certainly helped make that task a little easier.

The first Supreme Court ruling ensured the continued existence of Obama's flagship healthcare reforms, for the near future at least (Roberts & Jacobs, 2015). The ruling decided that the Federal government could deliver its affordable health insurance plan in all fifty states.

The second ruling confirmed equal marriage as a constitutional right (Roberts & Siddiqui, 2015). That means that in all fifty states same-sex couples will have the right to marry, and that marriages from other states have to be recognised.

These rulings, lauded as successes by Obama (Jacobs, 2015), have been heralded as a triumph for liberalism and individual freedoms, over the conservatism of the established social order. Along with having earlier overseen the end of the ban on openly gay military service (McVeigh & Harris, 2011), these rulings have made civic equality into a major theme of the Obama administration.

Although there clearly is still resistance, some of which has been aggressively intolerant (Butterworth, 2015), people will adapt. But that doesn't mean that the work is over. Combined, these steps have established a new social plateau, which represents a renewed acknowledgement of the rights of consenting adults to live on equal terms with their peers. Yet, those who have won equal marriage will still face discrimination and legal hurdles (Roberts and Siddiqui, 2015; Buncombe, 2015).

Though by themselves these rulings are huge victories for human rights, civil rights and individual liberty, they also represent smaller parts of a broader human struggle, towards the attainment of respect for consent as a central human value.

The ideal of a representative democracy is based around consent. Government by the consent of the governed, laws created with the consent of those who have to abide by them, economics with the consent of the community, and social interactions with the consent of the participants.

Without the removal of coercion and fear, whether from economic conditions in which you cannot afford to get ill or from social conditions where you cannot openly define your own identity due to discrimination, there can be no civic participation on the basis of consent. Without liberty from coercion and fear, there can be no free choices.

To get there, the Supreme Court rulings need now to be the inspiration for the next step (Thrasher, 2015). They are breakthroughs in their own right and just cause for celebration, but that energy and solidarity needs to be poured into renewed motivation to keep moving forward.

Election 2015: Healthcare, public funding and the future of the NHS

One of the central issues for voters as they cast their ballot in the 2015 UK general election will be the future of the NHS. All the parties have made their pitch, each party setting out their position by juxtaposing it with the plans of their rivals. The trouble is, upon closer inspection, all of the parties are making very similar promises (Triggle, 2015).

The choice between very similar sounding options on 7th May is the product of the development of the NHS over decades. The NHS was established by the Atlee's Labour government in 1948 to be free at point of use and funded by taxation. Based on the report of the liberal William Beveridge, it represented the next step in the reform and modernisation of social welfare begun by the Liberal Party just after the turn of the century.

The free at the point of use principal was soon put to the test. With funding the service proving expensive, it was not long before charges were introduced - beginning with prescription charges. Over the years more costs have been gradually pushed away from the public purse - road accident charges to car insurers, and dental care charges, eye care charges, hospital car parking charges all to the service user.

Toward the end of her time as Prime Minister, Margaret Thatcher introduced a new 'internal market' system, where the state would not directly provide the healthcare. Instead it would procure it, on behalf of the service user, from independent hospital trusts that would have to compete to provide the service (Laurance, 2013).

Those changes initiated a direction of travel arguably continued in the Labour Party's embracing of Private Financial Initiatives (PFIs) under Blair and Brown. The benefits of the system to which Labour clung were that it opened up a short term source of funding to get hospitals built (BBC, 2002). But in the long term it has led to a huge build up of debt for hospital trusts, while allowing the private companies to profit massively (Cooper, 2014).

As for the Lib Dems, there has long been a broad party consensus on finding ways to increase choice and to ensure oversight and to devolve power (Brack et al, 2007). That made the Health and Social Care Act 2012 a complicated matter, with strong campaigning opposition to elements of the reform from within the party led by the likes of Dr Evan Harris (Harris, 2012).

Yet even with these ways of extending the means of funding the NHS and trying to find increase in service 'efficiency', the NHS is still falling short and there are fears that it will affect services (Campbell, 2015). There is little belief that Andrew Lansley's reforms have helped to ease the pressures. NHS chief executive Simon Stevens has said that the institution needs an extra £8bn a year to meet an expected £30bn shortfall by 2020 (Baker et al, 2015).

In response, all of the main parties of offered more funding, each with their own priority (Wright & Moodley, 2015).

Labour's primary position has been to distance itself from, first, the coalition's policies, and then, second, from those of New Labour. This means promising to repeal the Health and Social Care Act 2012 and introducing a cap of private profits from NHS contracts (Wintour, 2015). With NHS funding a major issue, Labour have also promised an increase of £2bn by 2016, and a £2.5bn fund for recruiting more nurses, GPs and midwives.

The Conservatives have promised to ringfence healthcare spending to protect it from cuts and to increase the budget by £2bn each year of the next parliament. However, that increase in funding is tempered by Cameron's announcement that his party would also be extending NHS services to full 24 hour coverage (Channel 4, 2015). They also later announced - to criticism of making unfunded pledges - that they would match the £8bn increase called for by the NHS (BBC, 2015).

By contrast to the other two main parties, the Liberal Democrats were initially the only party to pledge to increase NHS funding each year through to 2020 to ensure it will be, in real terms (adjusting for inflation), £8bn more than today - the amount that the NHS has stated is needed. Their main priority will the treatment of mental health, which they would put on parity with physical health and for which they would provide more funding (Perraudin, 2015).

UKIP have once again shown their chameleon-like skill at identifying the most popular mainstream policy and jumping on board - being sure to propose funding the NHS through their usual obsessions (Mason, 2015). However the personal views on the NHS of their leader Nigel Farage have been criticised by Dr John Lamport of the National Health Action Party (Lamport, 2015). He criticised Farage's praise for the Dutch and French style insurance-based system as an expensive doorway to privatisation.

However, despite their differing priorities, the similarities between the main parties and the general direction of travel towards privatisation has, for many, been a long term concern (BBC, 2003). Senior health professionals have criticised the coalition (Boseley, 2015), and others have called for whoever forms the next government to provide the funding that the NHS needs (Baker et al, 2015). These calls come with fears amongst medical professionals that after the election, charges may be introduced for basic NHS services (Campbell, 2015{2}).

Smaller third parties have taken up the fight against this perceived drift into privatisation. The National Health Action Party (NHA) represents a broadly Left-wing vision of rolling back privatisation. The NHA supports 1p rise in tax to pay for an increase of funding of £4.5m a year, phasing out prescription charges and repealing the Health and Social Care Act 2012 (BBC, 2015{2}).

However, regardless of who wins the next election, the closeness of the main parties' policies makes it likely that there will be some sort of cross-party commission to figure out the future of the NHS (Triggle, 2015). That commission will have to face the same questions that the public will at this election: do we want lower taxes or well funded public services? Because trying to have both means stretching those services ever more thinly (Toynbee, 2015).

When considering that question it's worth noting that the UK has comprehensive healthcare for which it spends far less, as a share of GDP, than most other comparable countries (Campbell & Watt, 2014). The NHS also remains an overwhelming popularly supported service (NatCen, 2015). In order to keep that service functioning, we need to understand the choices on offer about its future and to ask ourselves: when the future of the NHS is being debated, what values do we want to be represented and to underwrite its future?