by Tom Bower
‘Our aim is full choice,’ he said.
‘Why aren’t we doing it now?’
‘We’d be pushing the bulge around the system,’ replied Le Grand. ‘We need to be gradualist.’
Even after Ivan Rogers, Blair’s private secretary, enthused, ‘I think the boss will go further,’ Le Grand held back. ‘Blair feared institutions and didn’t know how to take them on,’ he would say. Inhibited by Brown’s opposition, Le Grand never dared to say, ‘Our final destination is a full market for the NHS.’
The start, in anticipation of the implementation of the new legislation, was momentous nevertheless. In the unheralded return to the 1991 blueprint, the NHS partially reintroduced GP commissioning under the disguise of the Quality Outcomes Framework. Twenty per cent of a GP’s income would be linked to incentives and special payments. Reid handed out contracts for twenty-four additional ISTCs to the private sector. Then he hit an obstacle. ‘Your job is to put forward radical reforms,’ Crisp’s deputy John Bacon told Le Grand. ‘My job is to slow them down.’
In that cause, Bacon unexpectedly discovered in late 2003 that the NHS had ‘sufficient capacity’. Crisp agreed: ‘We don’t need extra capacity from the private sector.’ He added later, ‘We had too much capacity in the NHS.’ He objected to wasting and even closing NHS resources to help private companies earn profits and, to his delight, believed that ‘the politicians had very little room to manoeuvre’.
Some were surprised by Crisp’s misunderstanding of the market. Despite attempting the hard graft of ‘lever-pulling’ to outwit the civil servants, Le Grand found himself stymied. He needed Reid’s support. Unexpectedly, the headline-chaser was a good ally. ‘You deal with the technicalities,’ the minister told Crisp, ‘I’ll deal with the politics.’
‘Reid didn’t care how hospitals worked,’ concluded Alberti.
As a populist, Reid favoured everything opposed by Brown. He had already refused to endorse the proposal put forward in 2004’s NHS Improvement Plan to reduce some waiting times to nine months. ‘I cannot defend this,’ he said. ‘Eighteen weeks maximum.’ He also liked the idea of ‘real choice’ in a patient-centred NHS. Care would be quicker because patients would be allowed to choose free treatment in a private centre if the NHS hospital was unsuitable. He agreed with Blair that if the target for treatment by private providers was substantially increased to 15 per cent of all patients, NHS hospitals would be under pressure to perform.
The challenge, Le Grand noticed, made Blair ‘wobble’. As always, the prime minister feared Brown.
‘You’re the only person who can drive through the reforms we need,’ Le Grand told Blair.
‘I might not be here for long,’ he replied.
Reid himself glowed as Blair’s fireman and protector, not as his mechanic. In the midst of another row with Brown, he met Niall Dickson, the chief executive of the King’s Fund, Britain’s pre-eminent health think tank. After discussing the market incentives Reid was considering for the NHS, Dickson asked casually, ‘But what will happen when 11 moves to 10?’ Reid looked surprised that the question about Brown becoming prime minister was relevant. ‘That is not going to happen,’ he replied apoplectically.
At that moment, Blair was losing his appetite for the fight. Dismayed by the aftermath of Iraq and irritated by his failure to push through membership of the euro, he was also thinking about the 2005 manifesto. He issued an order: the NHS’s vocabulary needed to be sensitive to the Labour Party’s criticisms. Private contracts were to be called ‘co-terminosity’ agreements; competition was ‘contestability’; and ‘markets’ should not be mentioned. Promises of choice should be buried, not least because Blair still could not decide whether a patient should be able to choose a hospital or even a surgeon. ‘The pace became too leisurely,’ noticed Norman Warner, a junior minister of health. ‘Tony had bet the farm on targets and money going to the workforce, and then had other things on his mind.’
The NHS had reached a crossroads. At the end of 2003, George Alberti had recommended that the government should measure whether the extra billions of pounds were being properly spent. Michael Barber’s target system, some believed, was redundant. Gaming by managers had partially corrupted the system, advised Andrew Turnbull. Even Crisp recognised there were ‘too many targets, some badly conceived’. ‘It’s too crude,’ Anderson told Blair. But a stock-take of Barber himself was regarded as a step too far, and Crisp, supported by Blair, rejected Alberti’s suggested review. Any survey that could potentially embarrass the government was resisted. The King’s Fund stepped in, and Derek Wanless, the banker originally hired by Gordon Brown, agreed to undertake the investigation.
The headlines, nevertheless, were positive. Even the Tories pledged higher taxes to pay for the NHS. The proof of good news, said Crisp, was the steady increase in the number of employees. The NHS payroll was rising by 2.5 per cent a year and totalled nearly 1.5 million people. Reid never asked why more staff meant better care, and unquestioningly accepted Crisp’s reports that the billions were being well spent and performance was improving. Corrigan also rarely probed. He simply passed Crisp’s headlines on to Downing Street.
Both Corrigan and Reid were unaware that 130,000 people employed by the PCT managers through agencies did not appear in the records submitted to Crisp. The chief executive had not introduced an accounting system that would reveal how the PCT managers responsible for 80 per cent of the NHS’s budget were allowing cash to disappear. As the money ran out, they relied on Crisp’s executives to juggle the accounts to hide the discrepancies. Reid was allowing the NHS to accumulate a £1 billion deficit.
It was not just Reid. No one in Downing Street or the Treasury questioned the NHS accounts. The compartmentalisation installed by Blair and Powell had built a wall around the prime minister’s office. ‘I didn’t realise until later’, recalled Turnbull, ‘that Blair didn’t want mandarins to tell him what he didn’t want to hear.’
THIRTY-TWO
Restoring Tradition
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During summer 2003, senior officials in the Department of Education became increasingly aware of racial segregation in schools in some parts of England. David Normington, the permanent secretary, spent a day visiting some schools in his home city of Bradford and vividly noticed the extent of the separation. Some were 90 per cent Asian, while others were 90 per cent white. In the predominantly Asian primary schools, children were arriving for their first year after growing up in homes where little English was spoken and where Asian television was watched via satellite. Normington returned to London pondering the policy conundrum of how to encourage more integration when communities were so separate and radical solutions like busing and rehousing were not possible practically, ethically or politically.
Although over 450,000 immigrants were arriving in Britain annually and birth rates among those unable to speak English were rising, the civil servants knew that race was a sensitive issue for Labour’s educationalists. Normington had inherited from Michael Bichard an unspoken departmental convention not to discuss the effect of immigration on schools. Teachers, Whitehall knew, resisted interference, so the issue had been delegated to local councils to solve. The few officials tempted to speak were silenced by Blair’s support of immigration and his enthusiasm for multiculturalism.
Beyond that soft toleration was a hard core of educationalists who condemned Britain’s policies for stipulating standards and targets that discriminated in favour of the white middle class. For them, education in Britain was wrongly promoting pro-business ‘white supremacy’ instead of egalitarianism. Any mention of ‘ability’ was condemned as ‘racist educational inequality’ or undesirable ‘colour-blindness’.
Only Blair could have quashed that prejudice outright. But, while rejecting extremism, he never contemplated organising cross-departmental discussions in Whitehall. In deciding which battles to fight, his priority was to promote ‘choice’ and ignore race. He saw no reason to give security clearance
to Normington and his officials so that they could attend Whitehall’s meetings about the dangers of Islamic radicalisation. Education remained, senior officials realised in hindsight, ‘not sensitised to Islam’. The department did not discuss the consequences of multiculturalism in schools with Blair until after four bombs exploded in London in July 2005.
One casualty of the silence was the fate of white working-class children who were failing in school. That embarrassment was hidden under the noise of the Iraq war. The number of white children classified as NEETs – not in education, employment or training – was rising. In 1997, 8.5 per cent of older teenagers were NEETs. In 2004, despite spending millions of pounds to encourage sixteen-year-olds to stay at school, that figure rose to 9.6 per cent. By 2006, 10.4 per cent of the young would be NEETs. Exhaustive research by Professor Robert Cassen and his team of Oxbridge professors of education showed that inadequate teachers were the principal cause of poor educational standards. But, once again, Blair blamed the civil service for pushing back reform. The ‘forces of conservatism’, he believed, were preventing delivery. ‘I’ve been driving with the handbrake on for too long,’ he repeated in May 2003. The cure, he decided, was to be ‘truly radical’. He would abolish the LEAs and give schools independence. He would create a mixed market that embraced the private sector and promoted competition. He would resurrect his inheritance from the Tories.
In a succession of White Papers, the government emphasised both autonomy for schools and teachers and parental choice. Blair signalled a return to traditional values. Schools were encouraged to impose discipline, reintroduce the house system and require pupils to wear uniform. Another batch of White Papers – ‘Excellence and Enjoyment: A Strategy for Primary Schools’, ‘Five-Year Strategy for Children and Learners’, ‘Choice for Parents, the Best Start for Children: A Ten-Year Strategy for Childcare’ and ‘Every Child Matters’ – extolled the new vision and how it might be achieved. David Blunkett’s plans were replaced by other initiatives, regardless of the waste. One followed another, each lasting a few weeks before being forgotten. As with health, as with the military, as with immigration, Blair never questioned the cost of so many abandoned programmes – including £50 million on a behaviour-management course for teachers. He was, in every sense, going for broke.
Billions of pounds were spent on extra pay for teachers, supplying them with support staff, reducing class sizes and refurbishing or building new schools. Hundreds of millions were allocated to hiring teams of advisers to help minorities and poorly performing schools. Again, high-concept titles flowed like water into the debate. The programmes included ‘New Deal for Communities’, ‘The Neighbourhood Renewal Fund’ and ‘The London Challenge and Building Schools for the Future’. The latter, a fifteen-year programme costing about £45 billion, was promoted as a way to remedy Tory negligence. Any challenge from Gordon Brown about the additional spending was quashed by Blair. Education was uniquely his domain. He was particularly proud that Labour had ‘realised the potential of new technology’ by equipping classrooms with computers and replacing blackboards with electronic whiteboards.
In the monthly stock-takes, Blair was reassured by Michael Barber that, despite Iraq, the domestic agenda was not being ignored. He was encouraged by David Miliband, the junior education minister, that targets and scrutiny were enabling him to ‘get his way’. The simplicity of the process was appealing. Barber’s graphs and headline judgements, honed into digestible soundbites, presented what appeared to be an accurate snapshot of performance and progress in schools. Only those on the sidelines, observing Barber being inundated with statistics about the punctuality of trains and the tapestry of roadworks across Britain, wondered whether ‘deliverology’ could reflect reality in classrooms. Maths and English tests for eleven-to fourteen-year-olds (Key Stage 3) had been abandoned as unworkable without any discussion with Blair, but then again he was not expected to confront detailed problems.
Among those who experienced the routine of his stock-take was Naomi Eisenstadt, Sure Start’s founder and director. In January 2003, Barber invited her to address Blair. ‘We’ll need good data,’ he told her. Sure Start was still being praised by Tessa Jowell and other women supporters as one of Labour’s flagship policies, but Eisenstadt sensed that No. 10 had become mystified about a programme costing £680 million a year, which the following year would rise to £921 million. There was also the feeling in some quarters that its original intention of helping poor children had become diluted by the middle classes’ capture of the programme, and that under the Treasury’s influence the educational purpose was being submerged to provide basic childcare centres.
No one even knew if Blair was genuinely interested. Ever since Blunkett had sensed that Blair’s eyes were wandering during the original presentation in 1998, Sure Start had been mentioned only occasionally in his hearing. His aides appeared to be keener on branding the scheme as a success in order to win political kudos rather than caring about its content. Signalling his own mindset about securing immediate results, Blair had quipped, ‘Won’t all this early years’ funding only bring benefits long after I’m PM?’
At the stock-take, Barber summarised his assessment of Sure Start’s achievements and ambitions. Then Eisenstadt read out her presentation. ‘How many centres are there?’ Blair asked. ‘And what are the costs?’
Eisenstadt became tongue-tied, and Blair was clearly irritated. She got the meeting, she confessed, ‘wrong … We were short on quick wins. The government liked having new things to announce.’ Even so, Blair failed to ask the key question: was Eisenstadt’s ambition of encouraging social mobility succeeding? The answer would have been negative. The old inequalities, she knew, stubbornly remained.
Research by academics at Durham University would confirm the absence of any proof that, after seven years at school, children had materially benefited from a programme that would eventually cost £1.1 billion annually, and a National Evaluation report in 2007 would show that Sure Start had failed to deliver. Her ambitions, Eisenstadt would admit, ‘have not yet borne fruit’. She left Downing Street depressed, and was not invited to discuss the programme again. Nevertheless, in 2010, Blair would acclaim Sure Start as ‘one of New Labour’s greatest achievements’.
Beyond Sure Start, Blair’s attention was focused on the academy programme, based on the city technology colleges inherited from the Tories and replacing the grant-maintained schools. The beacon was Mossbourne Community Academy, which would be built on the site of Hackney Downs School, once an outstanding grammar school in north London. Instead of converting the existing building for a cost of about £15 million, Blair encouraged the construction of an entirely new school designed by Richard Rogers, one of Britain’s most famous architects, and costing about £30 million. Of the seventeen academies to be opened during 2004, Mossbourne would count among the best.
Forty-two more academies were planned to meet Blair’s target of 200 by 2010. The standard cost of a new school was about £23 million; the Business Academy in Bexley that Blair opened cost £31 million. He was not worried by the civil servants’ reports that sponsors who had promised to contribute £2 million were slow in producing their cash. Money was still not his priority; he wanted a legacy. At the very moment of yet another battle with Brown, Jonathan Powell told a journalist, ‘It’s a Shakespearean tragedy. Gordon Brown is like the guy who thinks he’s going to be king and never gets it. He’s never going to be prime minister.’ At the same time, the prime minister’s spokesman was telling journalists, ‘Blair will stay to fight and win the battle of ideas.’ The only problem was that he was struggling to make any idea come to fruition.
Unlike the health unions, he was prepared, out of his passion for education, to confront the teaching unions and ignore the warning by David Bell, the new chief inspector of Ofsted, that parental choice should be revoked. Bell, a left-wing educationalist, complained that choice was dividing rich from poor, propelling unpopular schools even further behind. Blair had
given up trying to persuade the Left about the benefits of private finance and selection, and was deaf to the protests that choice in education would cause the ‘social destruction’ of deprived communities or even that the new academies would not improve education. Instead, he finally demanded that inadequate head teachers be fired.
All that activity concealed the bad news about children’s numeracy and literacy. The results had not genuinely improved since 2001. Charles Clarke naturally claimed that the numeracy strategy ‘has made huge progress since 1997’. The very next year, the top 4 per cent of eleven-year-olds, said Clarke, had achieved a 7 per cent improvement. Professor Margaret Brown of King’s College, London, disagreed strongly with Clarke’s announcement. Ofsted’s results, she argued, had been distorted by focusing on small groups of pupils and excluding unhelpful results from their reports. The inspectorate’s inadequate figures, she concluded, cast doubt on politicians saying ‘we know what works’.
