Cameron’s Tories: the heirs to Blairism

Once upon a time, the UK Conservative Party proclaimed a mix of free-market rhetoric and social moralising. Under Margaret Thatcher, the message (more preached than practised) was that the state was ruining the British economy; the sooner government left business alone to get on with creating wealth, the better. But just as Tony Blair was the product of the domination of the Conservatives in the Eighties and Nineties, so David Cameron is now sounding more and more like a protége of New Labour.

Cameron’s speech to Conservative activists in Bolton, England, last week started by talking about ‘values’. There is, perhaps, nothing so quintessentially New Labour as talking about ‘values’. It’s as if Cameron had been taking advice from Labour deputy PM Peter Mandelson. ‘I know perfectly well that some of the changes we have made in this party over the past few years have not been easy for the party to accept’, Cameron said. ‘But there is one change we’ve made where, frankly, it has felt like pushing on an open door – and that is making crystal clear our wholehearted commitment to the NHS. Why? It’s not to do with ideology, or philosophy, or any abstract political theory. It is the simple, practical, commonsense, human understanding of a fantastic and precious fact of British life.’

In other words, the Conservatives don’t do ideology, philosophy or political theory anymore. All they have is the same pragmatic, managerial approach to politics that New Labour does. It was this principle-lite approach to politics that led Blair to start talking about ‘values’ in the first place. Now, Cameron is so bereft of anything to say that he merely places the National Health Service, as a symbol, where the throbbing heart of his party’s outlook should be. In fairness, Peter Mandelson has been doing exactly the same thing for the Labour government, but the fact that Cameron is now doing it as well hardly augurs well for the prospects for a battle of ideas at the next election.

Cameron then went on to discuss the problems the NHS faces in the future, in particular a combination of falling government spending and an ageing population. He was also happy to parrot some of the scarier figures surrounding lifestyle-related illness: ‘Obesity, drug and alcohol abuse and sexual health problems are all on the rise, putting massive pressure on NHS resources with alcohol misuse costing the NHS £2.7billion a year and obesity estimated to cost it a staggering £4billion a year.’

The good news is that there are lots of really cool new treatments on the way, he added. The bad news is that they cost money. Even though the Conservatives have promised to increase spending in real terms, year on year, Something Must Be Done about the NHS’s finances, he said. His proposal is a return to a very New Labour idea: patient choice. ‘We believe we can make a big improvement in NHS performance – both in terms of quality and efficiency – within the structures that already exist… by extending the competition and patient choice that Labour have started.’

Cameron even namedropped the Blairite former health secretary Alan Milburn as an ‘evangelist’ for market reforms in the NHS. Most commentators saw this as an attempt to stir up divisions in the government. But it also suggests that Cameron wants to take ideas which the government tried, and dropped, and revive them. This may suggest that Cameron is the kind of guy who can follow through on policy in a way that the current government cannot. But it might also be an indication of the utter lack of inspiration there is around solving the NHS’s problems.

As it happens, Cameron is probably quite right to attack another aspect of Labour’s health policy: the proliferation of targets. The result is that care is bent towards meeting the target rather than on a balanced assessment of what local priorities should be. It’s one thing to suggest broad principles for care, it’s quite another for Whitehall to micromanage health by issuing decrees about how quickly certain kinds of patients should be dealt with or how many sexually transmitted diseases there should be in each district.

On the other hand, Cameron seems keen on control at an even more microscopic level: our lifestyles. He claims to believe that government intervention is not the answer: ‘I think that one important explanation for Labour’s frankly disastrous record on public health is their philosophical attachment to state control.’ But then he makes some rather sweeping statements about our lack of personal responsibility: ‘People choosing to binge on junk food; sit on the internet instead of going out for a run; drink till they pass out… instead of blaming external factors for everything, it’s time we recognised that there is a moral choice, that personal responsibility cannot be shirked.’ Yet Labour has banged away at trying to change our wicked ways every day since it came to power in 1997. So what’s new, Dave?

Cameron’s desire to regulate doesn’t stop at individuals. ‘The truth is that many big businesses are making huge profits on the back of poor health choices’, he says. So, if reports elsewhere are to be believed, Cameron would have more displays of calories on restaurant menus, more controls on the sale of alcohol, and more regulation of the content of food. If there is any distinction between this and Labour’s policies, it’s escaped me.

So there we have it. The Conservatives love the NHS, but want to tinker with it to make it work better. They also want both businesses and individuals to take more responsibility for their actions, and they will jolly well regulate and even legislate if necessary to make sure this happens.

The burning political question of the moment is: if the Conservatives do win the next election, will anybody notice?

Rob Lyons is deputy editor of spiked.