Health Policy InsightEditor's blog Wednesday 6 October 2010: The Canned Heat politics of PM David Cameron
"Let's work together in the national interest" was the final phrase in PM David Cameron's rallying cry to his party conference this afternoon.
Canned Heat's 'Let's Work Together' is clearly on his iPod.
He delivers a good speech, rolling the rhythms of his lists of Labour lassitudes up to a nice fast one-two, one-two pace and an indignant finish to cue audience laughter.
It wasn't a very good speech, if you focus on its content, but he delivered it well.
The health / NHS bits
"The NHS - protected ... A cancer drugs fund - up and running"
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"Today I want to tell you about the part we've all got to play, and the spirit that will take us through. It's the spirit I saw in a group of NHS maternity nurses in my constituency who told me they wanted to form a co-op to use their own ideas and their nous to help new parents ... it's the Big Society spirit".
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"This year, we will borrow more money than we spend on the NHS. Just think about that. Every doctor's salary. Every operation. Every heating bill in every hospital. Every appointment. Every MRI scan. Every drug. Every new stethoscope, scalpel, hospital gown. Everything in our hospitals and surgeries - paid for with borrowed money, much of it from abroad."
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"The spending cuts we do have to make, we'll make in a way that is fair. Fairness includes protecting the service we most rely on - the health service. We said five years ago we were the party of the NHS and now in government, by protecting NHS spending from cuts, we are showing it."
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"(We'll give) new powers to you, to choose the hospital you get treated in"
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"The old way, of just pouring money into public services from on high, didn't make the difference it promised to. Health inequalities got worse ... So if anyone tells you that all we need to improve our hospitals and schools or keep our streets safe is more money, tell them, 'been there, done that and it didn't work'."
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"The old targets and performance indicators that drove doctors, nurses and police officers mad - they're gone"
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"(We're) saying to the people who work in our public services - set up as a co-operative, be your own boss, do things your way. Saying to business, faith groups, charities, social enterprises - come in and provide a great service. Already ... GPs are coming together to deliver local NHS services".
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The broader politics bits
"At this year's election, the result may not have been clear-cut when it came to the political parties. But it was clear enough when it came to political ideas. The old way of doing things: the high-spending, all-controlling, heavy-handed state, those ideas were defeated.
"Statism lost ... society won. That's what happened at the last election and that's the change we're leading. From state power to people power. From unchecked individualism to national unity and purpose. From big government to the Big Society.
"The Big Society is not about creating cover for cuts. I was going on about it years before the cuts. It's not government abdicating its role, it is government changing its role".
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"For too long, we have measured success in tackling poverty by the size of the cheque we give people. We say: let's measure our success by the chance we give. Let's support real routes out of poverty: a strong family; a good education; a job.
"So we'll invest in the early years, help put troubled families back on track, use a pupil premium to make sure kids from the poorest homes go to the best schools not the worst, recognise marriage in the tax system and most of all, make sure that work really pays for every single person in our country"
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"Just as we need the big society spirit to get our economy going, we need it in our society too. Social change is where this coalition has its beating, radical heart. This is what drives us. To change forever the way this country is run. We're going to start by taking power away from central government and giving it to people."
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"Because information is power, we're bringing transparency to government. All those things the last government kept from you, who spends your money, what they spend it on, what the results are, where the waste is, we're putting it in your hands. After all, it's your money - so you should see where it's going.
"This is not about a bit more power for you and a bit less power for central government - it's a revolution.
"Let's leave Labour defending the status quo, the vested interests, the unions, the quangocrats, the elites, the establishment.
"We are the radicals now, breaking apart the old system with a massive transfer for power, from the state to citizens, politicians to people, government to society. That is the power shift this country needs today."
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"This is what radicalism means. No more top-down, bureaucrat-driven public services. We're putting those services in your hands ... The big, giant state monopolies - we're breaking them open to get new ideas in."
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Analysis
There are some odd contradictions in the speech, and one big, straight lie.
The big, straight lie is that the Coalition Government introduced choice of hospitals. Utterly untrue. This was a New Labour policy, fair and square; consolidated in the NHS Constitution.
The glaring health policy-related contradiction is his line about "already ... GPs are coming together to deliver local NHS services". Mmmmm. Well, yes, a handful of existing GP practice-based commissioning consortia are getting up a head of steam. A very few are even taking on their PCT's roles. But - and it's a big 'but' - this is being sold as a 'commissioning' thing; not a 'deliver local services' thing.
There's an important governance issue over the 'make or buy' decision.
There was a very odd sense given by Mr Cameron's fervent condemnation of the Scottish Government's release on medical advice of Abdelbaset El-Megrahi, convicted Lockerbie bomber back to Libya, and a promise never to let this happen again (i.e. bye-bye, devolution, which was not quite his message at Holyrood in the week after forming the coalition) - shortly followed by a purple passage on the importance of the Union.
His economics lecture was frankly ridiculous. Comparing the UK (enormous economy, whose government debt has a 25-year term) with Greece (small economy, whose government debt has a 1-2 year term) is fatuous. And some of the UK's debt is sold abroad! And interest rolls up on debt ... and we start to pay interest on interest!
Fancy!
We're not out of the woods yet economically, by a long way. But this was tantamount to inquiring whether bears shit in them.
The hall's applause for his description of protecting NHS funding as "fairness" won applause that was only just over lukewarm. It is unclear whether his activists, and indeed backbenchers, are fully on-message. Cuts could drive wedges here.
The Prime Minister ended with a reference to the classic Canned Heat track 'Let's Work Together' - "for the good of our country". Canned Heat got their name from a portable petroleum-based cooking fuel (also known as Sterno), immortalised in the classic 1930s blues song Canned Heat Blues by Tommy Johnson.
Despite the manufacturer's addition of methanol to denature it (aiming to make it toxic to drink), Sterno Canned Heat was drunk by the poor dispossessed of the USA of the era, who couldn't afford the cheapest distilled alcohol.
The problem with Canned Heat is that it can blow up in your face.