My mission statement

The times we are working in now need a great deal of accelerated change and there must be no negotiating that down. So my mission statement for this part of my consultancy career is to be clear that there needs to be and will be a lot of change from the work that I do with individuals and organisations and if organisations don’t want that, then it is probably best to go somewhere else.

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Some arguments about political continuities and the creation of Foundation Trusts

Filed Under (BBC, Foundation Trusts) by Paul on 17-01-2013

Some commentators have been kind enough to suggest that I played a role in developing the NHS reform policy that created Foundation Trusts.

Some commentators on this blog have made the same point – only in a very different way – suggesting that this reform was the start of a process that the Tories have continued with their current reforms, and that all of this is bad for the NHS.

(Those of us who were around at the time remember that in 2002 and 2003, on every possible occasion, the Conservative Party voted against the legislation to establish Foundation Trusts. It was, at least at the time, very difficult to recognise the policy as being a part of a Tory plot).

This week there has been a another twist to this debate.

At 11.00 on Monday BBC Radio 4 broadcast a programme called “Where have all the comrades gone?” The programme traced the whereabouts of the very different parts of the Communist Party 20 years after its demise. The trail led them to interview me to see if there was any link between my ideas when a member of the Communist Party (between 1975 and 1983) and, in particular, the creation of Foundation Trusts.

As I tried to explain there was for me a straightforward line between them. Whilst I was born into the right wing of the Labour Party my experiences as a student in the late 1960s moved me sharply to the left. In particular my experiences of politics at the time left me arguing strongly against the creation of an overbearing state. That doesn’t mean that I don’t believe in the importance of Government. Nor, as we shall see, does it stop me believing in the development of a strong, creative public sector. But I did feel that one aspect of the post-war welfare state was to try and control people and to get them to live their lives in a certain way. I didn’t like that, and what I didn’t like for me, I didn’t like for other people.

My politics then and now questioned the inevitability of the left always arguing for a bigger and stronger state, and considered whether people could, through their own self-management, create organisations that belonged to the public and not the state.

In the mid 1970s there was throughout Europe considerable disagreement within the various Communist parties about this issue. One wing of every national CP took a more traditional stance around the state and the other – the “Euro-communists” – argued for a more pluralist approach. In Italy the Euro-communist wing ran the party – and large number of regional and local governments. In most other Communist Parties the more traditional wing held power. In the UK the debate was very finely balanced and in Coventry – where I was living at the time – the Euro-communists had won.

This meant that in the politics of the city at the time the Communist Party was raising questions about the way in which the local council developed the local state and its services. The Communist Party found itself arguing for an ‘opening out’ for pluralism.

Later I worked for the Labour Party on educational policy and later still for the new Labour Government on NHS reform. I found myself arguing for the opening up the state and trying to break up monoliths through pluralism.

Others on the left disagreed.

Foundation Trusts were one such policy. They created fundamentally public organisations which could never be taken over by the private sector but which were also not part of the state.

For some people this was an impossible idea. Monday’s Morning Star was critical. The Morning Star shares the BMA’s belief that by creating non-state public organisations we were in some way fragmenting the NHS.

The passage of the legislation that created Foundation Trusts was a profoundly political moment for the NHS. Separating what is now over one half of the NHS secondary care and mental health providers from the ownership of the Secretary of State mattered a great deal to both ‘sides’ of the debate.

Monday’s programme provided some of the history behind both sides of that debate.

On a personal note I was asked in the programme if I was still a dialectical materialist and had no hesitation in saying that I was. Some tweeters found that odd. How could someone with my approach claim to think that way? But it is just that. It’s a way of thinking that I learnt in the very late 60s and 70s and does not inevitably lead to a certain form of politics.

Dialectical materialism means that wherever I look at anything in the world – I see a lot of movement and change. This is true of the war in Mali, the NHS and the way in which people use my local park. Everywhere everything is in movement. That is the dialectic.

My task, once I have noticed the change (the dialectic), is to understand what the major forces are that create all that movement. What are the material forces that are creating the dialectic?

So much is intellectual.

Values then tell you what to do with that understanding. They tell you where to stand and how to lever change with those movements. They tell you what to do.

That’s politics.

Comments:

2 Responses to “Some arguments about political continuities and the creation of Foundation Trusts”


  1. Is it not reflected in the history that in most of the communist states their people get poorer, whilst the leadership become millionaires.


  2. “My politics then and now questioned the inevitability of the left always arguing for a bigger and stronger state, and considered whether people could, through their own self-management, create organisations that belonged to the public and not the state”

    Is this ideology any different from the Big Society plans of Cameron?

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