By Calum Paton
In 2010 Britain was broken. We know this because a very important man referred to our ‘broken society’. His election manifesto proffered to voters ‘an invitation to join the government of Britain’, and he offered us a ‘big society’. That went well, Mr. Cameron. We always knew the slogan was just a dishonest way of dissing the state, but nice try. Trouble was, the austerity you then ushered in left people with little time or energy to put on their best volunteering dress, look in the mirror and ask, ‘Does my society look big in this?’
Dave campaigned as a Eurosceptic and in 2009 the (Eurosceptic) European Conservatives and Reformists group in the European Parliament was founded at his behest. He renegotiated our terms of membership of the European Union…allegedly: nobody noticed that anything of any significance had changed. Then, fresh from that triumph, in the referendum of 2016, he oversaw ‘Project Fear’, warning us of the dire consequences of leaving the EU. Not surprising we voted Leave: how can you knock the EU for years and then implausibly try to persuade folks they will be up shit creek without it. If that poorly-executed volte-face showcased his negotiating skills, then God help us now, as he dusts them off as Foreign Secretary.
Lex Greensill worked for Dave when he was PM, then Dave worked for Lex after leaving office. Nice and cosy. Dave tried (unsuccessfully) to persuade Ministers to invest taxpayers’ money in Greensill Capital loans. He sent 56 messages lobbying Ministers and civil servants, among them ‘Dear Rishi’ the Chancellor. Although the Bank of England turned Greensill down, the company was approved as a lender under a government scheme aimed at getting dosh to companies affected by the pandemic: the British Business Bank’s Coronavirus Large Business Interruption Loan scheme allowed Greensill to make loans backed by an 80% taxpayer guarantee. Greensill went bust. It is still the focus of criminal investigations, inquiries by authorities and legal proceedings.
Prior to all this, Dave had allegedly made, according to BBC Panorama, about £7 million from his Greensill work including cashing in Greensill shares in 2019 and being paid a bonus of $700,000 in 2019 on top of his salary of $1million a year as a part-time adviser. The Treasury Select Committee concluded in 2021 that Cameron had showed a “significant lack of judgement”. Gosh, really?
One could mention how Dave’s decisions helped lead to a failed state in Libya (despite having promised not to be a ‘neo con’ interventionist in a 2006 speech.) It is probably just as well that his attempts to meddle in Syria were defeated.
Complacency after the 2014 Scottish referendum led to him being humiliated in the EU referendum in 2016, as described above, then leaving office despite promising to stay on as PM whatever the result.
Dave had been photographed with huskies in the Arctic to display his green credentials, and photographed cycling to work (with his car bringing up the rear with his briefcase)…but alas, he then allegedly talked of ‘green crap’ to his aides. So Dave was a pioneer of greenwashing. And now he joins a government which seems to want to be the Dirty Man of Europe.
Yet for us health policy buffs, the Lansley reforms to the long-suffering NHS best characterised the complacent incompetence of the guy who wanted to be Prime Minister because he thought he’d be rather good at it. Dubbed the ‘essay crisis’ PM (in a reference to students who have been partying all week then staying up all night just before their Oxford tutorial), it seems he didn’t read his Health Secretary’s barmy plans until too late (let’s assume he hadn’t read them…if he had, it’s even worse). Ok, he ordered a ‘pause’, when his Coalition partners the Liberal Democrats kicked up a stink. But the NHS Future Forum, created to suggest changes, laboured to produce a mouse (or a headless chicken? a rabbit in the headlights?…choose your metaphor, dear reader): the reforms still went ahead. And these reforms, implemented and later reversed, both at great cost, did indeed cost billions…and even more in demoralisation, not to mention a boost to fly-by-night private contractors.
What an irony that the Johnson government ushered in the Bill (in 2021) to get rid of them finally, with the Health and Care Act passed in 2022. When Boris was Foreign Secretary, Sir Alan Duncan was appointed as his deputy…and ‘pooper scooper’ (as one Foreign Minister described him), to clear up the various messes made by Boris. Whoever would have thought that Johnson would be a pooper-scooper himself, that there was someone capable of making a worse mess? But on NHS reform, Dave was that guy.
Even worse, though, was the effect that austerity had on pandemic preparedness from 2010 onwards. As Chris Whitty made clear last week at the Covid Inquiry, we didn’t even have a proper flu plan, let alone the capacity to deal with a severe respiratory disease. To add insult to injury, the Cameron-Osborne line to the Covid Inquiry was that austerity had got the economy in shape and so helped us when the pandemic came along. Yeah, right, boys. That’s why our plans, testing capacity and PPE were so top-notch? (For all I know, Dave may have thought all the talk about PPE when Covid hit was a reference to his Oxford degree, and the need for PPE graduates to get us through it…)
We are now told that Cameron’s reemergence signals the rehabilitation of centrist or moderate Tories…even one-nation ones – remember Cammy’s slogan back in the day to soothe us through austerity: ‘We’re all in it this together’?) Poppycock. Cameron is a Thatcherite on the economy. He cut his economic teeth as special advisor to right-wing Chancellor Norman Lamont. His reinvention in 2005 was powder-and-puff so that he could be presented as a sanitised modern Heir to Blair – the ‘nasty party’ defanged, and electable once again.
The problem with the likes of Dave is that they have the confidence to be it but not necessarily the ability to do it. Ed Miliband’s best line as Leader of the Opposition was that Dave was born to rule but not very good at it. So, Rishi, what is the question to which Dave is the answer? Britain must indeed be broken if you are turning to the guy whose policies broke it. Dave wears his failure lightly. You don’t seem to have that knack. You had better find it soon, if you want to live down the next election result.
But even if Rishi is dumped at the next election, the NHS will be in deep doo-doo, to use a phrase favoured by the late President George Bush Senior. Another of those nice moderate Tories, Jeremy Hunt, the Chancellor, has favoured business tax cuts over financing the effect of inflation on the NHS. But don’t worry: productivity can save the day. Hunt has told us that the NHS is doing less with more money and that better productivity is the answer. It was ever thus: there are usually special reasons for ‘low productivity’. Blair panicked at some simplistic data, just as Thatcher did before him. This time, the reason is the crisis in social care (i.e. delayed discharge) plus the fallout from Covid (on patients and staff), along with staff vacancies. So, Jeremy, if folk don’t want to work in the NHS because of stress and low pay, why not slam their productivity? Good idea, no? Your former self (as Health Secretary) was beginning to be wiser than this. You are a shadow of your former self, I am afraid. And let’s hope you are the Shadow of your current self after the next election.
About the author
Calum Paton is Emeritus Professor of Public Policy at Keele University, UK. He was Editor-in-Chief of the International Journal of Health Planning and Management between 1998 and 2019. He has advised UK politicians and various international agencies. He has authored ten books and numerous articles on health policy and politics. He chaired a major NHS hospital board in the UK from 2000 to 2006.
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