Ed Miliband’s Mission Impossible

Cover for  Five Year Mission

Review of Tim Bale’s ‘Five Year Mission’, OUP, Oxford, 2015

In the end, it was mission impossible. Ed Miliband could not take Labour from opposition to Government in five years. This book, completed just before the 2015 election, does much to explain why.

We know that people experienced the biggest fall in living standards since the Second World War. We know that wages have stagnated even as the economy recovered. The Tories forced poorer and younger voters to clean up the mess they did not create while featherbedding the nests of richer, older voters. The pain of austerity was not shared equally and made a mockery of Cameron’s claim that we were all in it together.

It made no difference. Labour was hobbled by public perceptions of economic incompetence. They borrowed too much to spend too much and, in saving the banks, they left the country broke. Liam Byrne’s notorious note about the money having run out did Labour no favours. No wonder Cameron brandished it about during the 2015 campaign; such things make more impact than authors like Joseph Stiglitz, who most voters have not heard of, let alone read. The Tories’ plan to fix the mess seemed to make sense. Austerity was harsh and unfair but the country accepted the Tories’ logic, which had a force and clarity that Labour could not answer.

Thus, Labour objected to the Tories’ move to stop benefit rates rising in line with inflation. This was unfair but since the wages of those in employment were stagnating, supporting any rise in benefits could be seen as ‘rewarding’ the idle while those in work struggled to make ends meet. Perverse and unfair this logic is. But Osborne knew what he was doing when he spoke of the shift worker leaving early for work on a dark morning while their neighbour, living on benefits, was sleeping. The Tories knew that images count more than words – let alone statistical analysis.

Then there was immigration. This is a taboo subject for Labour’s supporters on the liberal-left but not for voters generally. This issue, after the economy, was the second millstone around Labour’s neck; its salience with many of its traditional voters made the matter all the more vexing. Labour could not assure that it wouldn’t open the floodgates once again, if it was to take power.

Against all this, Miliband tried to square various circles: to keep the Party united, and define a new post-Blair party that could inspire its grassroots while reassuring middle England and business; to try and produce policy that could be both fair and allow the country to live within its means; to try and meet voters’ concerns over immigration without resorting to crowd-pleasing xenophobic demagoguery. This led to dithering and dilating, as Miliband and Labour struggled to reconcile irreconcilables. By contrast, the Tories could talk tough on welfare while UKIP could do the same on immigration and sound less mealy-mouthed in the process – and ‘authentic’, in the sense of genuinely reflecting broad public concerns.

Bale’s account is sympathetic of Ed Miliband’s and Labour’s predicaments. As for the great what-if-David-had-been-elected-leader counterfactual, then Bale is dismissive. He doubts that the older brother would have had the answers to the questions above. Indeed, given his reportedly arrogant and aloof manner, he might have actually done more harm than good. Ed at least kept the Labour party united in the aftermath of the 2010 defeat – no mean feat.

For Labour activists, this book is essential reading. It will tell them much about what sort of electoral realities the party is going to have to overcome, if it wants to take power in 2020. It has some depressing lessons to be learned about trying to promote high ideals against the low realities of voter psychology, fanned (but not created) by an unsympathetic press in cahoots with a cynical Tory party machine.

One thing is for sure, whoever takes the Labour helm later this month is going to have their work cut out for them. I hope that they have read this book.

 

 

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After the Revolution – Part I

At last the revolution is here. Now the people rule. And what does that look like? It looks like a radical extension of democracy, in the world of both politics and economics. The people no longer let others call the shots. They are calling the shots.

First, in politics, Parliament is no longer an assembly of elected representatives. Representatives were elected to rule on the people’s behalf. They would have been unwise to have disregarded the people’s collective preferences altogether but they had the last word. They did not have to share their decision making power with the people. The people could throw their representatives out at the next election, if they were displeased. But, while their representatives were in post, they eschewed any right to dilute their representatives power to decide. Barring gross misdemeanours, their representatives could enjoy immunity from recall and be assured that they could serve out a fixed term.

A Parliament of delegates are not the people’s representatives but their executive agents. The people’s delegates do not enjoy the prerogatives representatives did. They cannot take any decisions without the endorsement of the people. They must consult exhaustively before they make any decision. Decisions they take must be a true reflection of what the people want and not what the delegate thinks they want. If they dare defy the will of the people, and take a decision without having obtained the people’s consent, or by failing to consult widely enough, they can be recalled or dismissed. Delegates have no extended, secure tenure. Delegates terms are short, and prevented from standing more than a handful of times, to prevent the formation of an incumbent, professional political class.

In economics, the workplace looks very different. The old workplace was even less democratic than the old representative system. The people could vote out representatives they did not like but not their bosses at work, whom they did not even vote for in the first place. That meant having to work under people you did not respect and to whom you could not talk back. Unlike politicians, whom you could criticise or ridicule, even to their faces, bosses were protected by an aura of authority. Mocking or criticising your boss could land you in hot water. Bosses decision making power was backed up by workplace cultural norms like deference. That meant that bosses could make bad decisions with bad consequences because the workforce, like the three monkeys, pretended to hear and see nothing, and hence said nothing.

How different this is from the rough and tumble of democratic politics. Nye Bevan once said that you should not go into politics or public life unless you have a thick skin. That is why democratic politicians can endure phenomenal amounts of criticism, much of it personal and abusive, which they have to put with up with just to get elected and carry on putting up with it, after they get elected. Indeed, the higher up the political ladder they go, the worse it gets.

Bosses, by contrast, can be prickly and thin-skinned, and sensitive to criticism, because they are not used to it. They were not elected, and do not expect their ‘right to manage’ to be subjected to public scrutiny and criticism by their workforce. When the boss of a US manufacturing firm announced insouciantly to his workforce that their jobs were going to Mexico, he told distraught workers to ‘quiet down’ so he could finish talking. An elected politician would never dare talk to their constituents like that, for fear of provoking a riot.

This is to digress. Now that the revolution is here, the bosses have been kicked out and are sweeping the streets and cleaning latrines. Workplace democracy reigns, similar to the Parliamentary delegate model. The workers rule. They elect the people who manage the organisation in which they work. The people they elect are not bosses. They are accountable to the workers who have elected them. The delegate-managers, as we shall call them, cannot take any decision around pay, reorganisation without consulting widely beforehand. This consultation has to be more than tick-box exercises management used to run in the bad old days. It has to be a genuine opportunity for the workers to influence the decisions the delegate-managers are going to make, so that these decisions can be said to be the workers’ will. Like Parliamentary delegates, delegate-managers can be recalled and have no security of tenure. There is no professional management class. Unlike today’s managers, they have no ‘right to manage’ and their credentials have to be presented to worker scrutiny before they get elected.

One feature of the old representative system will be retained. Unrelenting scrutiny and criticism will be par for the course for the new Parliamentary delegates and delegate-managers alike. How can it not be? These are features of any democratic system, however defined. Those going into this new sort of politics will have to be thick-skinned types.

This very simple model of politics and economics is not the only conceivable scenario. Perhaps Parliament will abolished and replaced with a plethora of local assemblies. Perhaps large capitalist firms will be broken up altogether. Who knows? There are lots of different ways of conceiving a future that ha s not happened yet. Regardless, I suspect that all these models will share one essential description: no longer can it be said that the people are just being given the opportunity to pull levers every 4 or 5 years or so. They can pull them whenever they like.

The moral basis of this new order will seek to meet Noam Chomsky’s demand to those in power to justify their authority: “[T]hat the burden of proof for anyone in a position of power and authority lies on them.  Their authority is not self-justifying.  They have to give a reason for it, a justification.  And if they can’t justify that authority and power and control, which is the usual case, then the authority ought to be dismantled and replaced by something more free and just.”

For Chomsky, and many radicals, authority is a function of hierarchy and hierarchy is an expression of domination. There is no space here to discuss if this linkage is fair and accurate. Nor is there space to consider the practical question about how anything is ever supposed to get done were Chomsky’s demand to be made in all instances – when cabin crew tells you to fasten seat belts before take off, do they have to justify their reasons?.Here, it will suffice to note that a radical democratic system cannot avoid Chomsky’s demand being made of itself. If the people are to rule, then they must have authority to claim this right. On what basis do they justify this?

The old party-dictatorships, who claimed to be ‘people’s democracies’, denied this question could arise. The people are indivisible and the people are good and wise. Therefore, they will always do the right thing and for their own good. They cannot oppress themselves. This, we know, is nonsense. People are divided and given to quarrel. Against this inevitable reality, decisions have to be made. The discussion about the right decision to take can only go on for so long. At some point, the decision has to be taken and discussion must end.

The larger and more complex a society is, the less likely that decisions can be unanimous. Some will have won the argument and others will have lost. The winners can insist that the decision has to be respected but the losers can claim a right to dissent. Both sides can claim principled authorities for their stances and both sides can demand the other side justify their authority, using Chomsky’s criteria. Even the most democratic of decisions rest on the assumption that dissenters can be coerced, at least in some circumstances. The question is, when is it right to exercise authority and do that?

After the revolution, these dilemmas will not disappear. Indeed, a radical participatory democracy would exacerbate them. We have already touched on one of them – the inevitability of disagreement. Human nature is prone to dissension and schism, because humans have conflicting definitions of what things like freedom and justice mean, and how best to accomplish the good things we all say we want.

Subsequent posts will discuss other problems which bedevil a representative system but would be no less acute under the new, participatory alternative. The new system will still have to deal with a crowded agenda of conflicting demands, against the background of limited information and time. Messy compromises will still need to be made.

There will still be an inequality of talents, which will persist, even when all social inequalities have been eliminated. At the end of it all, there will still be leaders and the led, winners and losers. There will still be hierarchy and times when people are going to have to do things that they want to do. There will be boring jobs to do and there will be unexpected technological and social changes to deal with. To manage these realities, a participatory system will end up resorting to the same props as the representative one.

There is room for argument about how best to cope with these realities, and whether existing representative systems are up to the job. For my mind, they do cope quite well. But that is not what the point of this discussion is. It is show that a radical reform of institutions will not abolish human nature, moral conflict, social and technological change and other enduring facts of human society. To deny otherwise is a dangerous conceit.

What’s wrong with cultural imperialism?

At a human rights activists’ conference I overheard someone fretting about whether objecting to the practice of forced marriage and infibulation of 12 year old girls (on human rights grounds!) was imperialist. This is a common apprehension. The assumption here is that human rights are ‘our’ culture and to impose them on someone elses’ culture is imperialist. The critique of cultural imperialism is premised on cultural relativism. All cultures are supposed to have equal worth. Therefore, it’s bad for one culture to impose itself on another. But why?

Let’s take the United States. Left and Right unite to condemn the ‘Americanisation’ of the world. American culture, crass and commercialised, blots out ‘authentic’ indigenous cultures. Why is American culture like that? Well, it’s an imperialist culture. Expansionism is built into US culture; it’s the country’s original sin, from the first white settlement of the continent to the invasion of Iraq. The Americans – White, Anglo-Saxon, Protestant ones, at any rate – are cultural imperialists par excellence.

But if all cultures are equal then American culture is as good as any other culture, including those it supplants. Therefore, what harm has been done?  We have fewer cultures. Diversity is reduced. But what is so good about diversity? To assume diversity is superior than homogeneity is a value judgement, which the relativist cannot make. It is to assume one state of affairs is better than the other.

More to the point, the relativist argument fails to offer any intellectual basis to oppose cultural imperialism If your culture is superior, then why should anyone object to having its ‘benefits’ thrust upon them? Cultural imperialists – not just American ones – can justify their imperialism on relativist grounds: ours is as good as anyone else’s so why not be imperialists? The relativist can offer no defence to imperialism,  of any stripe.

 Sometimes, the criticism of Western imperialism looks like a relativist argument but is nothing of the sort. iSaudi Arabia and other Muslim-majority nations exempt themselves from human rights treaty obligations (especially in relation to the rights of women) on Islamic grounds. They challenge western universalism with a supposed superior Islamic alternative, which has universalistic pretensions. If a universalistic claim is imperialist, then, by definition, this must apply to non-Western universalist ideologies like Islam.

 In practice, the West’s critics do defend some cultures as superior to another, just not ‘white man’s’ culture. This is usually made on empirical grounds. Non-Western cultures  have spiritual depth – think of the Beatles taking up with some Hindu guru. They live in harmony with the environment. They are less violent. They are more consensual and communal. They love children and animals more than we do. This is a kind of reverse racism, justified on supposedly empirical grounds. Western culture is not as good as anyone else’s – it’s worse.  

This style of thinking is only as sound as the empirical grounds on which it rests. If contrary evidence emerges, the defence is weakened. Take Tibetan Buddhism, whose best-known spokesman is the Dali Lama. The attraction of the Tibetan cause doesn’t just rest on the injustice of China’s invasion and occupation of Tibet. It is boosted by the sanctified status of Buddhism itself. It is not enough that Tibetans’ human rights are violated daily – it is worse because this is happening to good people.

But not all strands of Buddhist thought or practice are peaceful and not all Buddhists are tolerant. The independent Tibetan kingdoms could be warlike. In today’s Burma, gangs of Buddhists commit pogroms against Burmese Muslims, egged on a Buddhist priest. If not all Buddhists are good, or have always been good, does this mean they forfeit their rights? This is the thinking the Chinese express in rationalising  their invasion. The Chinese point to the backward, reactionary social practices of pre-invasion Tibet. Therefore, Tibet was not conquered, it was liberated. China’s self-serving rationale does not make the continuing occupation of the country any less just. It does however undermine those in the West who consider the Tibetan cause worthier on account of the supposed people’s purity. This is a mistake. China violates Tibetans’ human rights. The Tibetans have a legitimate grievance against the Chinese invasion and occupation of their country. They do not have to wait until they prove they live up to some impossible standard of purity before they can make this complaint.

We assume that the critique of imperialism is linked o respect for cultures. But there is no such logical relationship. It is possible to critique imperialism from the opposite perspective that it is too tolerant and respectful of cultures that deserve to be swept aside.

A case in point is British imperialism in India. Critics of British imperialism claim it retarded the country’s development. There is much truth in this. India’s textiles industry was deliberately destroyed in order to protect British producers. The assumption here is that the British did the wrong thing. They should have developed Indian industries, not retarded them.

Of course, if the British had sponsored an industrial revolution in the subcontinent, then this would have promoted massive social and cultural change. Modernisation of India could not have been achieved without the overthrow of traditions like the caste system. This probably would not have happened without a great deal of social upheaval and violence. It would have been akin to what the Bolsheviks did in the Soviet Union during the 1930s, when they modernised  the country by hammering traditional social forms in the countryside, such as the Russian villagers or Kazakh nomads, inspired by notions of modernity and progress that originated in the West – in other words, cultural imperialism. At the end of this process, the country had built an industrial system that withstood Hitler’s invasion in 1941.

Many commentators, especially on the left, who consider themselves anti-imperialists, celebrate this achievement, without pausing for a moment to consider what they celebrate was a form of cultural imperialism. The same people are unlikely to be great fans of British imperialism in India but what they condemn in India is not imperialism per se but the wrong sort of imperialism. It destroyed incipient industries and hence the seed of modernity and progress but left other backward institutions – like the caste system – intact.

The broader point is that is no need to link the critique of imperialism on relativist grounds. It is possible to criticise it on universalist grounds. Conversely, imperialism can be defended on relativist grounds. The term cultural imperialism is less about explaining what is wrong with the world and more about signalling what sort of person you think you are. If you are against cultural imperialism, then you mark you are for diversity and tolerance, and against bigotry and racism. Closer examination reveals that the phrase and the assumptions it expresses are just muddled thinking.

Three Cheers for the House of Lords

Here in the UK we have a deficit and the Tories thought they had won the argument about how to reduce it. Until last week that is, when George Osborn’s plans to cut tax credits for the working poor met defeat in the House of Lords.

Of course, though he has lost a battle, albeit a major one, he hasn’t lost the war. Predictably, he and his supporters have tried to define the issue as an uppity unelected chamber thwarting the democratic will of the Commons. Hence the tedious talk about whether the Lords’ move was constitutional. Given that the UK does not have a written constitution, this debate is bound to be a sterile one. And anyway Osborne and his apologists cannot see the wood for the trees. They are missing the wider issues of principle this defeat raises, issues that won’t cease to dog the Chancellor even if he manages to force through the cuts tomorrow.

For the government, it’s about legitimacy and the right to do what people elected them to do. Of course, not all people voted for them but the fact remains the Commons are elected and the Lords are not. This means that they are limits to what the Lords can do by way of blocking the will of Commons. This holds true even though the Tories’ Commons’ majority is based on winning around a third of popular vote (and a lesser share of the country as a whole) at last May’s General Election. Despite this, the Tories still have a mandate to govern. They can only be denied this carte blanche if it can be shown that the Tories’ victory in May 2015 was somehow stolen from the deserved winner and/or that the voters generally were not offered a genuine opportunity to throw them out. No, the Tories won fair and square in May 2015 so have a right to set the agenda and govern by it.

Having said that, a democracy, if it is to ensure competing interests are reconciled fairly, must reconcile the losers to the result. Just because the Tories won in May 2015, they do not have licence to do whatever they like. This observation is hardly new – it is expressed in the phrase ‘checks and balances’, and well-governed democratic systems allow mechanisms like an independent judiciary or a second chamber to prevent majoritarian – but democratic – tyrannies from developing. The House of Lords can indeed make just such an argument to justify why it did what it did. If the Tories cuts to tax credits are unfair, then the Lords can act to check them, even if they have been democratically endorsed by the first chamber.

Are the cuts unfair? Without doubt they are. They will make the working poor worse off. The highly respected Institute of Fiscal Studies calculates that 13 million families will lose an average of £260 a year as a result of just one measure, extending the freeze in working age benefits, tax credits and local housing till 2020. By 2017, this means that most benefit rates will have fallen back behind their 2008 levels, compared to price inflation and earnings growth. Cuts to Universal Credit will leave 3 million families £1,000 a year worse off. This is a big deal – the families affected are among the lowest paid, earning below the average national salary. The government has claimed that increases in the living wage will compensate for these losses. But the IFS has found that gross increase of £4 billion in the living wage will not cover for the fall of £12 billion in tax credit and other related cuts. ‘Unequivocally’, the IFS concludes, ‘tax credit recipients in work will be made worse off by the measures in the [July 2015] Budget on average’.

If that is not fair then I don’t know what is. The Lords, in rejecting Osborne’s proposed cuts as they currently stand, have done a great democratic service. They have spoken for the millions of people whose interests the government is simply riding over roughshod. It’s not just about the tax credit cuts. The whole burden of deficit-reduction is being imposed on the poor. Cameron once claimed that we were all in together, when it came to reducing the deficit. That’s simply nonsense. While the government tries to snatch tax credits from the working poor, it is handing out perks to the rich like cutting inheritance and corporation taxes.

This argument is not just about constitutional procedure but about the wider principles of fairness that democracy should protect and promote. The broader significance of the Lords’ vote is that it is an expression of deep unease about how the Tories are spreading the burden of reducing the deficit and this extends well beyond the Lords. This disquiet about the cuts is not just confined to the usual suspects on the liberal-left. The free market think tank, the Adam Smith Institute, opposes them. Discontent has spread to government ranks. Twenty Tory MPs, five of them from 2015’s intake, have spoken out against them. The Sun, usually a government cheerleader, has described the cuts as bonkers. No wonder the government wants the debate to focus on procedure, the form of democracy, but not the principles expressed, the content of democracy.

How will the Tories respond? I suspect that the Tories are not going to seek to embark on any major constitutional reform. They are not showing much appetite for that. Instead, ways will be found to overcome the Lords’ resistance. In doing this, the government will kill two birds with one stone: to make the House of Commons and de facto unicameral legislature but without having to undertake any major constitutional reform to do that.

Were it to succeed in doing this, then British democracy will be weaker because of it. Government power will be subjected to weaker checks on its powers. The Commons alone is too weak to do this. The contention that once legislation has cleared the Commons then no further argument is required because the necessary democratic safety-testing for fairness and moderation have already been made is a debatable one. It is also perfectly possible to pass legislation that meets a democratic test but fails on other considerations which are just as essential to the proper functioning of a democracy.

As it stands, we do not have a unicameral legislature; the second, unelected chamber, for all its faults, is not meant to rubber stamp the first, elected chamber. If we are to have a second chamber, then it must be allowed some power to check the first one. Not for nothing did the Lord Hailsham caution against a drift toward an ‘elected dictatorship’ and it was an overbearing executive with weak parliamentary checks he was thinking about when he said that. The Lords’ vote last week means that we have taken one step away from that grim outcome. That is good for democracy. Three cheers for the House of Lords.

Development: democracy or autocracy?

http://blogs.worldbank.org/publicsphere/bill-easterly-and-denial-inconvenient-truths

Brief one – this is a review of William Easterly’s Book, The Tyranny of Experts. It’s a fascinating discussion of whether development is best achieved under democratic or democratic auspices. I have not read Easterly’s book so cannot comment on how fair the criticisms are. I will comment when I do!

Refugee or Migrant?

Many tedious political debates revolve around the correct definition and application of words. The current migration/refugee crisis in Europe is no exception. A person can both be a migrant – in search of a better life – and a refugee, fleeing from political persecution. The right insists that they are migrants hence undeserving of our political protection while the left insists otherwise.  Yet so much of the debate seems to assume that the two motives are mutually exclusive. The fact is, the mass of Syrian refugees escaping the hell hole Syria has become are both migrants and refugees. For the purpose of simplicity, I will use the term refugee rather than some clumsy compound or some neologism. Just bear in mind I am talking about people who want both to be safe and have a better life.

Many of these refugees are from camps in Turkey where they were perfectly safe. This is true but misses the point. The masses deserting the camps do not want to live a life of safe but stagnant exile, which is the fate that probably awaits them, even if the war in Syria ends tomorrow. For neither conceivable outcome can possibly entice them back. Either the Assad regime collapses and we end up with a Somalia on the shores of the Mediterranean or it triumphs, but at the cost of reducing the country to a wasteland. And, while the war still rages, there is absolutely no question of going back. In many cases, what is there actually to go back to?

It’s not just safety that refugees seek in Europe as I have said before but a better life and there is nothing wrong with seeking both. The right condemns the desire for material improvement as ‘selfish’ but this is unfair and hypocritical. It’s unfair because anyone who lives in a country so dysfunctional that it cannot even provide the prospect of material improvement is one anyone with the wit to do so will desert. The right lack the political imagination to place themselves in other people’s shoes. It’s hypocritical because the right tends to extol the desire for material improvement among some people but not others. It is fine for white people to want higher living standards but not anyone else.

But the left cannot be let off the hook so easily here for they likewise share the right’s distaste for refugees’ material motives, albeit from a different perspective. The left can only love people of darker hues if they are fleeing for noble reasons, like artists and writers fleeing an oppressive climate of censorship. The left feels comfortable carrying placards saying, ‘I love refugees’ rather than ‘I love migrants’ but ‘refugees’ are no more or no less deserving of our ‘love’ than ‘migrants’ are. The left loves the oppressed masses just so long as they don’t lower themselves by talking about wanting cars, bigger houses (preferably not in a municipal tower block) and flat screen TVs. For different reasons, left and right assume the natives can and should make do with less. People will risk their lives not only to escape barrel bombs.

The reason why Western European societies are such a lure for the world’s poor is because they offer better prospects of both safety and riches. They offer this because they are better governed. The operative word here is ‘better’. They are not perfect by any means but they are better. Although many contemporary pundits on both left and right can find nothing good to say about western democracies, the world’s poor disagree. It is patronizing to assume that the only reason they think so is that they have been brainwashed by western media propaganda. By far the greater lure is from friends and relatives who have already made the trip and seen and tasted it for themselves (such as Mexicans in the United States). As George Bernard Shaw once said, the lack of money is the root of all evil. The poor already knew that.

The NHS: the Cuckoo in the Nest?

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Many years ago, when I was a student in the United States, my roommate asked if it was true that  ‘bums in the UK knocked down in the street’ got free treatment. I was proud to reply yes. My room mate marvelled at our ‘communist’ system.

Twenty-five years later, I am no less proud; there is no doubt that a mark of a civilised society – and of civilised politics – is the provision we make for the most vulnerable. Alas, the fact is that the price of civilisation is getting steeper and steeper. According to economist Anatol Kerensky:

‘The fiscal costs of ageing to the British government—even assuming some moderation in the relentless rise of healthcare prices and no further expansions of health or pension entitlements—are calculated by the IMF as 335 per cent of GDP. That is equivalent to roughly £5 trillion, or almost £200,000 for every British household. In comparison with such figures, concerns about bank bailout costs and fiscal stimulus plans should pale into insignificance. The situation is broadly similar in the US and Japan.’

If this projection is correct, then any government, Labour or Tory, if it is to keep the NHS free at point of provision, and paid for from taxes, will have to do one of two things (or both):  it will either have to cut back entitlements or raise taxes to meet them.

The spectre of ever-rising NHS costs also raises the prospect of the NHS becoming the cuckoo in the nest, with other public services sacrificed to keep it fed.

This does not mean we should want to see the NHS privatised or uninsured ‘bums in the street’ left to die.

It means that we need to think about the correct balance between state and private provision within the NHS. Perhaps the NHS continues to provide acute and emergency services, but a mixture of state-private provision applies elsewhere and the state carries on paying medics’ salaries, to ensure that doctors will work in remote or poorer corners of the country.

It means we have to accept that any public service needs not only money but a civic culture that tempers the demand for unlimited entitlement.

It means questioning just how far we want to go in financing the NHS at the expense of other public services.  In the UK, we are a long way away from even beginning to consider these matters seriously.

Politicians treat the NHS like a political football but also like a political hot potato. That tells us one reason why politicians lie when it comes to the NHS: perhaps the public don’t want to hear the truth.