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Andy Street: Our holistic approach to public health in the West Midlands ensures spending is effective

Andy Street is Mayor of the West Midlands, and is a former Managing Director of John Lewis.

As the build-up to the General Election rolls on, the health challenges we face as a nation have been centre stage, and the NHS one of the key campaign battlegrounds.

With our growing and ageing population, the NHS must constantly evolve to meet changing health care needs, from rising levels of obesity and diabetes to the threat of antibiotic resistance.

Here in the West Midlands the health statistics for our large, diverse population lay bare the health challenges we face. In some areas, 40 per cent of our Year 6 pupils are overweight or obese. Around 23.8 per cent of all adults in the West Midlands Region have some kind of mental health problem – a startling statistic which is actually only marginally higher than the national average of 23 per cent.

It is vital that we fund the facilities needed to tackle the future of health care, and investment in the NHS has rightly been one of the central themes of the Conservative campaign. We have run the NHS for 44 of its 71 years, and by committing to the biggest cash boost in its history we are sending a clear message that its future is safe in our hands.

Voters expect to see real investment. £33.9 billion – upgrading 20 hospitals and building 40 new ones – sets out the scale of our ambition. Yet our message may be lost in the heat of an election of competing financial pledges.

As Mayor of the West Midlands, the NHS is not strictly part of my job description – but I have always wanted to play my part in attracting investment and providing a link between the many agencies and organisations that impact on the health of our residents.

What I have seen is that while investment is critical, we also need all of these different organisations to work together – not just the NHS and GPs but hospices, councils, public health officials, academics, pharmacies, businesses and more. If we really want to show the electorate that we have a plan for the nation’s wellbeing, our ambitious investment in infrastructure should be complemented by a holistic approach to public health.

So, what are we doing about it here in the West Midlands?

Looking after our precious NHS

We are already seeing the fruits of new NHS spending. Work will soon resume on the £475 million Midland Metropolitan Hospital in Sandwell.  Construction is expected to resume in December, almost two years on from the collapse of Carillion. This huge state-of-the-art hospital will provide the scale needed to cover Sandwell and West Birmingham.

Down the road in Walsall, more investment is ensuring that care is kept local. Walsall Manor Hospital has been given the green light for a new A&E department after the Government signed off on its £36 million funding bid.

In Birmingham, Health Secretary Matt Hancock has given the go-ahead for an investment in an Ambulatory Care and Diagnostics Centre (ACAD) at Heartlands hospital. The multi-million ACAD building will offer world-class facilities and house a wide range of health services, including outpatients, and endoscopy and imaging. University Hospitals Birmingham Trust estimates the centre will care for up to 1,500 patients every day.

Across the West Midlands, we are seeing real investment in the future of the NHS. We also benefit from a network of cherished hospices, who work hand-in-hand with the health service but rely heavily on the generosity of local people for financial support.

These days hospices not only provide superb palliative care, they also contribute to the mental wellbeing of local communities, organising out-patient care, bereavement counselling and social groups that extend far beyond their original remit.

I recently became patron of a campaign to save the much-loved Acorns children’s hospice in the Black Country, which is threatened with closure because of falling donations and increased costs. A phenomenal response from local people has seen £300,000 raised within just a few weeks towards their goal of £2million, but central support is vital if we are to acknowledge the important contribution of the hospice movement.

A lifeline has been delivered in the form of significant new NHS funding from Black Country healthcare commissioners, while NHS England are to double their central funding support to the country’s children’s hospices over the next five years.

It is great to see the billions being poured into the NHS in the West Midlands, and I have been hugely impressed by the determination shown by Matt Hancock.

Developing a world-class health and life sciences business sector 

As the health challenges faced by our population change, the NHS must evolve, develop and adapt new treatments and approaches. The West Midlands is at the forefront of that medical innovation.

Birmingham is a world centre for accelerated clinical trials. The Institute of Translational Medicine, based on a site between the Queen Elizabeth Hospital and the University of Birmingham, acts as a central hub for clinical trials, bringing experts together to rapidly turn medical science into innovative patient and healthcare system applications.

Birmingham University is building a new Life Sciences Park, supported by investment from the Greater Birmingham and Solihull Local Enterprise Partnership. Working in partnership with local hospitals, the council and industry the park will harness the region’s research strengths to develop better treatment and patient care.

And nowhere is the technological future of healthcare more evident than at University Hospitals in Birmingham, where 5G connectivity is linking hospital staff to ambulance crews to provide on-the-spot diagnostics in a UK-first trial. The same hospital is working on chat services, online symptom checkers and video consultations with doctors and nurses to help relieve the pressure on NHS services.

While disingenuous warnings about privatisation of the health service attempt to drive a wedge between the NHS and business, in the West Midlands we are seeing the tech sector working closely with clinicians to provide better services for people.

Prevention is the key

For the first 70 years of the NHS, we have concentrated on helping people live longer. Now we must move from thinking about life span to healthspan: the number of years we can keep people living healthy, independent lives free from illness or disability.

If the NHS is to truly benefit from the billions we have pledged to it, we need to also ensure that it is not hindered by endemic health problems within the population. That means, quite simply, we have to make people healthier before they get to A&E.

In the West Midlands, our holistic approach is encouraging people to do more exercise. Under the West Midlands ‘On the Move’ Strategic Framework, a variety of programmes are now being delivered, with more due to be launched in the near future, to tackle inactivity.

Programmes supported by the WMCA include Goodgym, through which people are encouraged to run to locations for community work, including befriending the elderly living in isolation. Goodgyms in Birmingham, Coventry and Solihull have attracted 450 volunteers since the first was rolled out in January 2017, completing more than 2,000 community deeds, with a fourth being launched in Warwick and Leamington Spa last month.

We are investing millions in schemes to boost cycling and walking, not only improving exercise rates but helping improve air quality in built-up areas. In the run-up to the 2022 Commonwealth Games in Birmingham, we are unveiling policies that encourage people to try new sports.

Around 200 local businesses have been involved in our innovative Thrive At Work pilot scheme, which helps employers support staff with mental health concerns, as well as providing information on improving physical activity and a number other risk factors including poor diet, smoking and poor financial health.

By committing to the biggest cash boost in the history of the NHS, we Conservatives have shown that the future of the health service is safe in our hands. However, by taking the holistic approach to public health we are pioneering in the West Midlands, we can ensure that investment is effective for generations to come.

Real Estate, and Personal Injury Lawyers. Contact us at: https://westlakelegal.com 

Neil O’Brien: There are still weeks to go, but for backbenchers like me, campaign 2019 feels much, much better than 2017

Westlake Legal Group Screen-Shot-2019-11-17-at-21.08.02 Neil O’Brien: There are still weeks to go, but for backbenchers like me, campaign 2019 feels much, much better than 2017 YouGov The North south SNP Scunthorpe Rother Valley Polling police Philip Larkin Peterborough Opinion Pollster Opinion Polls NHS New Labour Midlands Liberal Democrats Law and order Labour immigration Highlights Great Grimsby General Election Fiona Onasanya MP Don Valley Daniel Finkelstein Culture crime Conservatives Columnists Caroline Flint MP Campaigning Brexit Alasdair Rae

Neil O’Brien is MP for Harborough.

The Midlands sky was November grey, and there was the smell of a coal fire from somewhere. I was out delivering leaflets in a council estate in my constituency. Moments after popping one through the door of a bungalow, I heard a door being flung wide open behind me.

A large and angry man appeared. “You can have that back” he said, thrusting the leaflet into my hands. And with that, he swung back into the house and the door thumped shut.

I went on my way. But moments later, I heard the door swing open again. It was the big guy again, and I braced myself for a free and frank exchange of views.

But this time he was in a more sunny mood.

“Sorry. I thought you were Labour,” he said. “Are you the Conservatives? Can I have another one of those?” He told me he was going to vote for us.

It gave me a little taste of what it’s like to be a candidate today for Jeremy Corbyn’s Labour party.I don’t know what it is about life-long terrorist suck-up Jeremy Corbyn, or self-described Marxist John McDonnell, or police-hating Diane Abbott, or their two-faced approach on Brexit… but in many places where Labour might once have done well, they are now regarded with something approaching hatred.

There are still weeks to go till the election, but for backbenchers like me, campaign 2019 feels much, much better than 2017.

The ideas we are putting forward are more popular. The campaign feels better run, including on line. People massively prefer Boris Johnson to Corbyn. The question is whether it is enough.

As Daniel Finkelstein has pointed out, we have to win outright, while others can win even if they lose. Why? Because we will never team up with the SNP – while Labour are already dangling another separation referendum to cosy up with the nationalists. The Liberal Democrats can form a remain alliance with Labour – but not us. If we are going to win, it means pushing deeper into Labour territory in the north, midlands and south west, while holding off Lib Dems in the south east and the SNP up north.

The signs are encouraging. One set of constituency polls this week showed us holding seats in London, while another national poll showed us ahead among working class voters by a margin of nearly two-to-one (YouGov, 11-12 Nov).

For someone who got involved in politics when we were in the relegation zone in the mid 1990s, this is heady stuff.
We’ve already come a long way. Alasdair Rae at Sheffield has a neat chart which ranks constituencies in England from the most deprived on the left, to the most affluent on the right.

In 2001, we had no seats in the poorest 30 per cent, and Labour had most of the middle third. [See chart at top of article.] By 2017, the blue tide had already flowed into some areas Labour used to dominate. I hope this time it will surge further. [See chart at bottom of article.]

As we expand, the centre of gravity of Conservative voters has shifted and the Prime Minister has been the fastest to catch the mood. My leaflets this year feature our pledges of 20,000 more police, £450 million for our local hospital and funding for our local schools going up 4.6 per cent per pupil next year. Other than the fact that we also pledge tougher sentences for criminals, controlled immigration and securing our exit from the EU, much of this is the space New Labour used to occupy.

Rumours in the papers say that our tax policy is also going to be squarely focused on helping those working hard on low incomes. I think that would be the right approach.

It’s funny what pops into your head as we pound the pavements in the autumn rain.

For some reason I’ve been thinking about Philip Larkin’s poem, The Whitsun Weddings, describing his sun-drenched train journey from Hull in the north, down through the industrial Midlands to London:

“We ran /
Behind the backs of houses, crossed a street /
Of blinding windscreens, smelt the fish-dock; thence /
The river’s level drifting breadth began, /
Where sky and Lincolnshire and water meet. /
All afternoon, through the tall heat that slept  /
    For miles inland, /
A slow and stopping curve southwards we kept.   /
Wide farms went by, short-shadowed cattle, and
Canals with floatings of industrial froth…”

I feel like we as a party are taking the same journey, but in reverse, with the Conservative tide flowing up through the midlands and north.

Today the route from Hull, which goes via Doncaster, would take you past plenty of Labour marginals. Great Grimsby and Scunthorpe across the Humber. Don Valley and Rother Valley in South Yorkshire. Down through Bassetlaw, where sitting Labour MP and fierce Corbyn critic, John Mann has just stood down, then past Lincoln to the east, and down to London through Peterborough, where we hope to replace jailed Labour MP Fiona Onasanya.

I feel like we have a strong leader, good campaign, we stand for the right things, and people are sick of the delay and dither.

But will it be enough. Will our campaign work this time?

It might just.

Time to get back out there.

Westlake Legal Group Screen-Shot-2019-11-17-at-21.08.55 Neil O’Brien: There are still weeks to go, but for backbenchers like me, campaign 2019 feels much, much better than 2017 YouGov The North south SNP Scunthorpe Rother Valley Polling police Philip Larkin Peterborough Opinion Pollster Opinion Polls NHS New Labour Midlands Liberal Democrats Law and order Labour immigration Highlights Great Grimsby General Election Fiona Onasanya MP Don Valley Daniel Finkelstein Culture crime Conservatives Columnists Caroline Flint MP Campaigning Brexit Alasdair Rae   Real Estate, and Personal Injury Lawyers. Contact us at: https://westlakelegal.com 

Neil O’Brien: There are still weeks to go, but for backbenchers like me, campaign 2019 feels much, much better than 2017

Westlake Legal Group Screen-Shot-2019-11-17-at-21.08.02 Neil O’Brien: There are still weeks to go, but for backbenchers like me, campaign 2019 feels much, much better than 2017 YouGov The North south SNP Scunthorpe Rother Valley Polling police Philip Larkin Peterborough Opinion Pollster Opinion Polls NHS New Labour Midlands Liberal Democrats Law and order Labour immigration Highlights Great Grimsby General Election Fiona Onasanya MP Don Valley Daniel Finkelstein Culture crime Conservatives Columnists Caroline Flint MP Campaigning Brexit Alasdair Rae

Neil O’Brien is MP for Harborough.

The Midlands sky was November grey, and there was the smell of a coal fire from somewhere. I was out delivering leaflets in a council estate in my constituency. Moments after popping one through the door of a bungalow, I heard a door being flung wide open behind me.

A large and angry man appeared. “You can have that back” he said, thrusting the leaflet into my hands. And with that, he swung back into the house and the door thumped shut.

I went on my way. But moments later, I heard the door swing open again. It was the big guy again, and I braced myself for a free and frank exchange of views.

But this time he was in a more sunny mood.

“Sorry. I thought you were Labour,” he said. “Are you the Conservatives? Can I have another one of those?” He told me he was going to vote for us.

It gave me a little taste of what it’s like to be a candidate today for Jeremy Corbyn’s Labour party.I don’t know what it is about life-long terrorist suck-up Jeremy Corbyn, or self-described Marxist John McDonnell, or police-hating Diane Abbott, or their two-faced approach on Brexit… but in many places where Labour might once have done well, they are now regarded with something approaching hatred.

There are still weeks to go till the election, but for backbenchers like me, campaign 2019 feels much, much better than 2017.

The ideas we are putting forward are more popular. The campaign feels better run, including on line. People massively prefer Boris Johnson to Corbyn. The question is whether it is enough.

As Daniel Finkelstein has pointed out, we have to win outright, while others can win even if they lose. Why? Because we will never team up with the SNP – while Labour are already dangling another separation referendum to cosy up with the nationalists. The Liberal Democrats can form a remain alliance with Labour – but not us. If we are going to win, it means pushing deeper into Labour territory in the north, midlands and south west, while holding off Lib Dems in the south east and the SNP up north.

The signs are encouraging. One set of constituency polls this week showed us holding seats in London, while another national poll showed us ahead among working class voters by a margin of nearly two-to-one (YouGov, 11-12 Nov).

For someone who got involved in politics when we were in the relegation zone in the mid 1990s, this is heady stuff.
We’ve already come a long way. Alasdair Rae at Sheffield has a neat chart which ranks constituencies in England from the most deprived on the left, to the most affluent on the right.

In 2001, we had no seats in the poorest 30 per cent, and Labour had most of the middle third. [See chart at top of article.] By 2017, the blue tide had already flowed into some areas Labour used to dominate. I hope this time it will surge further. [See chart at bottom of article.]

As we expand, the centre of gravity of Conservative voters has shifted and the Prime Minister has been the fastest to catch the mood. My leaflets this year feature our pledges of 20,000 more police, £450 million for our local hospital and funding for our local schools going up 4.6 per cent per pupil next year. Other than the fact that we also pledge tougher sentences for criminals, controlled immigration and securing our exit from the EU, much of this is the space New Labour used to occupy.

Rumours in the papers say that our tax policy is also going to be squarely focused on helping those working hard on low incomes. I think that would be the right approach.

It’s funny what pops into your head as we pound the pavements in the autumn rain.

For some reason I’ve been thinking about Philip Larkin’s poem, The Whitsun Weddings, describing his sun-drenched train journey from Hull in the north, down through the industrial Midlands to London:

“We ran /
Behind the backs of houses, crossed a street /
Of blinding windscreens, smelt the fish-dock; thence /
The river’s level drifting breadth began, /
Where sky and Lincolnshire and water meet. /
All afternoon, through the tall heat that slept  /
    For miles inland, /
A slow and stopping curve southwards we kept.   /
Wide farms went by, short-shadowed cattle, and
Canals with floatings of industrial froth…”

I feel like we as a party are taking the same journey, but in reverse, with the Conservative tide flowing up through the midlands and north.

Today the route from Hull, which goes via Doncaster, would take you past plenty of Labour marginals. Great Grimsby and Scunthorpe across the Humber. Don Valley and Rother Valley in South Yorkshire. Down through Bassetlaw, where sitting Labour MP and fierce Corbyn critic, John Mann has just stood down, then past Lincoln to the east, and down to London through Peterborough, where we hope to replace jailed Labour MP Fiona Onasanya.

I feel like we have a strong leader, good campaign, we stand for the right things, and people are sick of the delay and dither.

But will it be enough. Will our campaign work this time?

It might just.

Time to get back out there.

Westlake Legal Group Screen-Shot-2019-11-17-at-21.08.55 Neil O’Brien: There are still weeks to go, but for backbenchers like me, campaign 2019 feels much, much better than 2017 YouGov The North south SNP Scunthorpe Rother Valley Polling police Philip Larkin Peterborough Opinion Pollster Opinion Polls NHS New Labour Midlands Liberal Democrats Law and order Labour immigration Highlights Great Grimsby General Election Fiona Onasanya MP Don Valley Daniel Finkelstein Culture crime Conservatives Columnists Caroline Flint MP Campaigning Brexit Alasdair Rae   Real Estate, and Personal Injury Lawyers. Contact us at: https://westlakelegal.com 

Nick Hargrave: Wanted. A Too Difficult Department to help tackle intractable post-election problems.

Nick Hargrave is a former Downing Street special adviser, where he worked under both David Cameron and Theresa May. He now works at Portland, the communications consultancy.

There is always a tendency in politics to over-correct from the last big mistake. That is certainly the case in Conservative politics when it comes to the art of preparing manifestos.

It is commonly held that the 2017 Conservative Manifesto was a sub-optimal political product – where unpopular and untested policies were unleashed on an unsuspecting electorate. This, so the argument goes, is the reason why the Conservative Party blew a massive poll lead and Jeremy Corbyn came within a sniff of high office.

Learning from this experience, Tory staffers will be leaving nothing to chance this time. A robust political stress-testing operation will dominate the 2019 manifesto process. The signature policies will be focus-grouped within an inch of their life. Hardened and cynical characters from the party’s research department will draw up long lists of difficult questions; these attacks will in turn be tested in focus groups. Anything that goes down badly in Bishop Auckland and Crawley will be noted down in red pen. Safety first will be the overwhelming mantra of the day.

I would argue, however, that there is a danger in over-correcting too much. The 2017 manifesto in its totality was bad politics and an unforced error. However, commentators have over-simplified why it went down so badly. It was not just because the infamous social care policy – the so called ‘dementia tax’ – was unpopular.

Part of the problem with the social care debacle was that it came out of nowhere; difficult issues need time to breath and be socialised.

There is also a convincing argument that Theresa May’s weak and wobbly defence of the u-turn – ‘nothing has changed’ – did as much damage to her proposition at that election as the policy itself.

And it should not be forgotten either that a further deficiency of the 2017 manifesto was its lack of retail friendly, sunny measures to balance the more difficult choices the country faced.

Looking further back in history, there is good evidence that voters will back politicians advancing difficult arguments if they are convinced that they will be competent in their delivery and well-motivated in their values.

This is the test of leadership. Margaret Thatcher’s ambitious privatisations are held up nowadays as a vote-winning policy that spoke to a bracing desire for 1980s-style freedom. In reality, privatisation was more contested and controversial; IPSOS Mori found in 1989 that it was the third most unpopular policy of her tenure behind the poll tax and funding of the NHS. The Conservative commitment to continued deficit reduction in the successful 2015 campaign could be viewed through a similar prism.

At this election, I am not suggesting that the Conservative Party should deliberately court unpopularity. Nor, with a month to go, am I saying that it would be electorally wise to mic drop a wealth tax or breaking up the NHS into the national conversation.

But I am arguing that there is some limited space for radical candour with the electorate on the difficult choices facing the country in the 2020s. If the party fails to signpost these choices at all in its manifesto, then it will find it more difficult to govern than would otherwise be the case. The country will also be badly served given the importance of some of the decisions ahead.

Given the political realities, my preference would be for the manifesto to commit on its back page to a new unit in government under the responsibility of the First Secretary of State. If you wanted to capture attention you could call it the “The Too Difficult Department”. If you wanted to be sober, you could call it the Long-Term Challenges Unit working out of the Cabinet Office. There will already be civil servants whose job it is to think about these things; but it should be the defined responsibility of elected ministers.

The new creation would be founded with the overarching principle that there are some debates our country needs to have but are too controversial and politically explosive to move immediately. I can sort of see Boris Johnson making this case with a unique blend of gravity and humour.

This institution would not deliver any change over the course of five years. Its role would be to think and – more critically – communicate. It would be a focal point for these difficult debates to progress at a controlled pace; probably drawing in citizens’ assemblies to help it deliberate. The conclusion of those debates should in turn form the bedrock of the Conservative Party’s manifesto for the putative election in 2025. Too far in the future some might say – but politics is the art of the possible.

I would in turn isolate this down to five politically difficult issues:

  • How to fund public services given the pressures of an ageing society and ever-increasing consumer expectations. In the near term, the IFS estimate that the NHS will account for almost 40 per cent of all public spending by 2023/24. By the second half of the twenty-first century, the OBR estimate that our debt profile is likely to balloon to eye watering levels well beyond our GDP.
  • Whether increasing inequality of outcomes over the last 40 years – under successive governments – is tolerable or something that needs to be addressed. This is really what drove Brexit. Addressing this will be far less about our future relationship with the Customs Union and far more whether we are willing to have difficult conversations about the taxation of wealth and property.
  • Decarbonisation and whether we are really serious about transitioning to net-zero carbon emissions– which will probably have to involve road charging, eating less meat and linking environmental behaviour to corporate and personal tax rates.
  • The long-term view on automation and what needs to be done to make the most of its disruptive effects – including whether we should incentivise urbanisation in cities as an overriding policy priority.
  • Consideration of whether new global institutions where we pool our sovereignty are needed in order to tackle new macro challenges such as the impact of technology and tax avoidance.

Manifesto day for the Conservative Party should be primarily designed around the retail package it is offering voters for the next five years. But amongst the barrage of jam today and the promises of an easy life, I would suggest that there is both space and an imperative to look a little beyond. Voters are many things but they are not stupid. A manifesto commitment of a ‘Too Difficult Department’ is unlikely to win the next election for the Conservative Party. But it might just help it retain its reputation as the serious party of government in elections to come.

Real Estate, and Personal Injury Lawyers. Contact us at: https://westlakelegal.com 

Sunder Katwala: Childcare, not Kashmir. Neither Narendra Modi nor Imran Khan are candidates in this election.

Sunder Katwala is the Director of British Future.

Successive Conservative party leaders have seen the party’s historically distant relationship with British ethnic minorities as an existential challenge. The party has been only half as likely to win the vote of a non-white as a white British citizen. British Future’s research showed how that ethnic vote gap made the difference between a hung parliament and winning a majority in both 2010 and 2017.

This should be a question of values as well as votes. Any party that aspires to govern our country should want to pass a simple one nation test: that no citizen should feel any tension between supporting that party and their ethnic and faith background. All parties have got work to do for that aspiration to be realised.

The Labour Party’s ruptured relationships with the Jewish community will be a significant election issue. The broad majority of British Jews have lost confidence in Labour’s response to anti-semitism, so that the party which proudly pioneered anti-discrimination legislation in Britain finds itself the subject of an EHRC investigation into evidence compiled by Jewish party members about its failure to create a process or party culture to deal with anti-semitism effectively.

The Conservatives have made some progress with Indian voters, somewhat more slowly than the Conservatives had hoped, or than the socio-economic profile of Indian voters would suggest. So the Conservatives are clearly not the party of Enoch Powell anymore, but the focus on “historic baggage” has overlooked the extent to which the party has risked creating new baggage, as the Windrush scandal exemplified.

The Conservative Party has flat-lined or slipped back from a low base with both black British voters and British Muslims. There was little public debate in the party after Zac Goldsmith’s campaign for London Mayor in 2016. and the sluggish progress after Boris Johnson’s commitment to an inquiry into anti-Muslim prejudice in the party, secured by Sajid Javid during the party leadership contest, captures a reactive and reluctant approach to grasping this nettle.

There is an increasingly divergent pattern between different minority groups, but generalising about ethnic groups also over-simplifies if it does not recognise how cleavages of class, education and geography play out within minority groups too. Black British and Asian voters were also Remainers and Leavers . Those who work in the public sector, who lean left, and private sector, who lean right, may prioritise different issues too.

Johnson has said that he is proud to have appointed the most ethnically diverse Cabinet in British history: the party plans to give  Priti Patel, Sajid Javid and rising star Rishi Sunak a prominent role in the election. The Conservative 2019 campaign will seek to narrow the ethnic voting gap, but it may have become a second-order priority in the short-term. The central focus of the party’s Brexit realignment bid in 2019 is on Leave-voting towns held by Labour, that have an older and whiter demographic, rather echoing how the 2015 majority combined some progress with British Asian voters along with heavy gains in the south-west, among England’s least ethnically diverse regions.

There are towns, including Bedford, Keighley and Peterborough where the ethnic minority vote may play a significant role this time around. The gradual geographic spread of ethnic diversity means that ethnic minority voters are not just a large share of the vote in London marginals like Battersea and Kensington, but one part of the electoral jigsaw in suburban marginal seats too.

The Conservatives may be slower to increase their share of Indian voters if they can’t reverse the broader generation gap in British politics, so that young graduates and the under-30s are leaning left across most groups, as part of the polarisation by education and age of post-Brexit politics. Beyond the 2019 campaign, any sustainable majority strategy for the party depends on working how to bridge these generational and ethnic minority gap.

British elections often see noisy, self-promoting claims about the ability to deliver ethnic minority voters en bloc to swing seats from one party or another, with a noisy row over claims to represent the Indian vote in this election.

Foreign policy issues are, doubtless, somewhat more salient to diasporas than to other voters – but to nothing like the extent that media coverage suggests.  The evidence suggests that ethnic minority voters also prioritise domestic issues – the economy, jobs and the NHS – over foreign policy ones.  For most ethnic minority voters, the central questions are who should lead the country; Brexit; jobs, crime, the economy and the NHS.

Views of foreign policy may reinforce broader feelings of trust or mistrust about Johnson or Jeremy Corbyn, but neither Narendra Modi nor Imran Khan are on the ballot paper in a British general election and British voters from Indian and Pakistani backgrounds have mixed views of both leaders.  There will also be British Indian voters for whom crime, childcare or climate change are more pressing issues than Kashmir.

Temples, mosque and gurdwaras remain popular for colourful political photo opportunities. Younger British-born ethnic minority voters will expect to hear from national party leaders or their local candidates about why they deserve their vote – rather than listening to those who claim that their faith or ethnic background should determine their vote. The idea that those in the congregation want to be instructed on how to vote is an outdated form of minority politics that younger British-born voters often want to leave behind.

Efforts to play ‘good minority’ and ‘bad minority’ on either side of the party argument would be bad for social cohesion in Britain – and deserve to fail electorally too. As all parties seek to secure support from these growing sections of the electorate, they need to do so for the right reasons if they want to pass the one nation test.

Real Estate, and Personal Injury Lawyers. Contact us at: https://westlakelegal.com 

Jack Airey: The next Government should revitalise Key Worker Housing

Jack Airey is Head of Housing at Policy Exchange.

For a long time, it was common for certain public sector workers to be provided a home as part of their job. Housing support used to be included in salary packages of Metropolitan Police officers, for example, either as free or subsidised accommodation or a paid housing allowance. Firefighters, teachers and nurses have also been eligible for subsidised housing schemes.

Support with finding a home allowed people whose job necessitated them to be close to the community they serve to do just that. The outgoing Labour Member of Parliament for Poplar and Limehouse, Jim Fitzpatrick, has spoken of how “When working as a firefighter in the 1970s, I was provided a home… [It] allowed me to get on with serving the public rather than worrying about next month’s rent.”

Although many of these homes have been sold off over recent decades, the extreme costs of buying or renting a home in some parts of the country in relation to public sector wages means that it is time to look again at how vital local workers can be supported with housing.

Many of the most valued and important front-line public sector workers are simply struggling to live in or near the community they serve. Instead, vital local public servants like police officers, teachers, nurses and firefighters have to commute from further and further away. This is a danger to local public services, making it more difficult to recruit and retain staff at the same time as impacting service delivery.

The NHS is a case in point. Recruitment and retention challenges are causing a high rate of vacancies for a range of roles which means that NHS trusts are using more short-term agency staff – at significant taxpayer expense. Staff health and well-being is also a major concern. Nurses, for instance, report that long shift work is a burden on their health and causing tiredness that puts their lives at risk if driving home after work.

The cost of housing compounds these issues in places where it is most unaffordable. Healthcare workers are competing for the same homes as private sector workers who are often better paid. It should come as no surprise, then, that four in ten nurses plan to leave London because of high housing costs.

The Metropolitan Police Service is similarly challenged by the cost of housing. Up until recently, the Met had a policy of recruiting new constables that had lived in London for a minimum of three years within the last six. This was because the police needs a workforce that understands and reflects the communities it serves. Past recruits who did not come from London were much more likely to transfer to another force outside the capital after a few years, lured by cheaper housing and family links. The Met’s residency criteria have now been relaxed, largely because they could not attract enough Londoners to apply. Again, the cost of housing is a deterrent to people choosing to work in a vital public service.

There are some public sector workers, of course, that require no housing support at all, either because they earn enough money or because they live in a place where the cost of housing is affordable relative to public sector wages. However, for the many vital local public sector workers who are struggling to pay next month’s rent or save enough to buy a home anytime soon, a helping hand would go a long way. The next government should commit to helping them as part of their housing agenda.

A report published today by Policy Exchange, the think tank I work for, outlines some of the steps the Government can take to support nurses, police officers and other vital public sector workers like firefighters and teachers in the housing market. We argue for the Key Worker Housing policy (first introduced by the Blair Government but later dropped during the Coalition era) to be revitalised.

This initiative allowed certain public sector workers – those who met ‘Key Worker’ eligibility criteria – to access affordable homes. It included demand-side measures, like equity loans, and supply-side measures, like funding for new Key Worker homes built for intermediate rental and for discounted ownership.

The Blair Government’s Key Worker Housing scheme had its flaws. Eligibility criteria for Key Worker Housing, for example, sprawled wider than necessary. A more narrow focus is needed in the criteria on workers from the local area who genuinely are a necessary part of the community infrastructure. The guiding principles of the Key Worker Housing programme, however, offer the next government a platform to support front-line public sector workers whose job requires them to live close to their workplace the chance to do so. A mix of new measures is then required involving local authorities and housing associations.

Reforms are firstly needed to increase the stock of Key Worker homes. Future capital funding programmes for Affordable Housing should be directed more towards the building of Key Worker homes. Public sector landowners like the NHS should also be encouraged to partner with housing associations that can build and manage affordable homes reserved for local Key Workers on their surplus land and property.

Local authorities and housing associations in areas where high housing costs are causing the most acute staffing challenges for front-line public services should, secondly, give greater priority to local Key Workers when allocating social housing. This will provide Key Workers a more immediate opportunity to access an affordable home.

Lastly, the Government should announce a Met Police Key Worker Housing Deal. This would be an important part of the Met’s recruitment drive, especially if the proposed 5,000 new officers are to come from London. To this end, London’s Affordable Homes Funding Programme should be topped up by £70 million to help finance the building of 2,500 affordable Key Worker homes specifically reserved for Met officers. Ministers should also consider extending the Forces Help to Buy scheme – this is a more generous version of the standard Help to Buy scheme – to help Met officers buy a home in London.

Both candidates hoping to lead the country after December’s election talk a lot about boosting public services and supporting vital public sector workers. Revitalising Key Worker Housing would show that they mean it.

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Roger Gale: Parents and doctors should be spared court when debating the best treatment for ill children

Sir Roger Gale is MP for North Thanet.

The parents of Tafida Raqeeb will be relieved that the High Court has given its consent to her being taken to Italy for specialist medical treatment for the serious brain injury the five-year-old suffered, leaving her on life support. But they, like all parents who find themselves in the traumatic situation of doctors withholding treatment or preventing access to it elsewhere, have been ill-served by the confrontational legal process that pits clinicians against families.

Such court cases are a distraction for medical and nursing teams, a costly frustration for NHS managers, and a nightmare for caring parents, all of whom quite genuinely want the best for the sick child. The only beneficiaries from these emotional and often protracted cases, sometimes heard in the full glare of the gawping media, are the lawyers.

We must find a way of striking a better balance so that where genuine disagreements arise, and they inevitably will, there are ways of resolving the situation through mediation and conciliation, avoiding the need to go to court. That is why I support the Children (Access to Medical Treatment) Bill proposed by Bambos Charalambous, the Labour MP.

The purpose of the Bill is to reduce the number of confrontational court cases that arise, and there are many more going on behind the scenes that don’t make the headlines, distressing parents and distracting doctors every day. We intend to do this by ensuring that clinicians and parents have access to mediation and conciliation services, that there is access in place to second opinions (that may or may not provide a different view), by identifying sources of practical advice on ethical challenges, and by building upon the current test of the best interests of the child so that potential treatment options can only be blocked by the courts if they present the risk of significant harm.

Easy access by parents to medical information is vital not only in the interests of openness, trust and transparency, but also so that parents are able to make informed decisions and other, alternative medical advice can be sought. We hope to provide for this access.

If there is a credible alternative medical opinion, and a reputable institution is willing to provide the treatment, then that treatment option should be available.

We are particularly encouraged that two former Presidents of the British Medical Association have already publicly supported our approach. Baroness Hollins spoke recently in the House of Lords to support the principle of the Bill and Baroness Finlay has done so on Radio 4’s Today Programme. Demonstrating cross-party support with those two crossbenchers, Baroness Jolly, the Liberal Democrat Health Spokesperson, is also on the case, and many leading lawyers and medical ethicists are supportive, including Raanon Gillon, emeritus professor of medical ethics at Imperial College and currently President of the BMA.

At the heart of this issue is the relationship of trust between families and clinicians, and what we want to do is to ensure that trust is nurtured, not undermined, when differences of perspective inevitably arise in these complex and deeply distressing cases. The confrontational nature of our legal system is the antithesis of such nurturing of trust.

We are motivated in our mission by the death in 2017 of baby Charlie Gard who was cared for by Great Ormond Street Hospital, but who sadly died when the courts preventing his parents, Chris and Connie, taking him abroad for an alternative treatment option. I make no comments on the medical aspects of the case, but the way it was handled brings shame upon our existing legislation and adversarial legal system.

The law must be brought up to date, so that it is fit for the 21st Century, and so that clinicians, parents and NHS executives are spared the trauma of court proceedings. That would be a fitting legacy for Charlie.

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James Frayne: Voters would welcome a Brexit deal. But it might harm and not help the Conservatives with working class voters.

James Frayne is Director of Public First and author of Meet the People, a guide to moving public opinion.

You can’t credibly poll how people might think or feel in the future. We can’t therefore know what the public will think if Boris Johnson secures a deal that looks vaguely similar to Theresa May’s.

But there’s been enough polling to guess. It’s reasonable to assume – hardcore Remainers aside – most voters will be so relieved it’s nearly over they’ll back a deal regardless of any friendly fire from Eurosceptics or Unionists. The Conservatives’ conference slogan – ‘Get Brexit Done’ – perfectly summed up what most people think about the whole thing. It also seems reasonable to assume most people would be exasperated and angry with those standing in the way of a deal – and there’ll likely be little interest in a betrayal narrative from eurosceptic purists.

The next stage in the electoral cycle writes itself: Boris Johnson’s ratings rise as a Prime Minister that delivers on his word, and the Conservative Party’s ratings rise too; Jeremy Corbyn and Nigel Farage look irrelevant; and the Liberal Democrats’ position as a vehicle for disaffected middle-class Remainers is threatened as the world moves on. What do the Lib Dems stand for at that point? Amid the wreckage, Johnson at some point runs a short campaign securing a workable majority, and the Party goes back to the happy days of 2015 when it looked briefly truly ascendant.

While there’s a clear political logic to all this, delivery of a deal at least raises the prospect that the Conservative Party could become a victim of its own success on Brexit with a big chunk of its coalition. What if delivering Brexit ended up costing it working class votes?

As I’ve been arguing for the last few months here, the Conservatives’ hold on working class voters is extremely precarious. Depending on which polls you look at, the Conservatives are currently on course to secure between a third and a half of the working class vote. And working class voters have been coming over to the Party slowly for the last decade.

But they have come over overwhelmingly because of Brexit and immigration – and the Conservatives’ relative position on these issues compared to Labour. Amongst working class voters, there’s no love for the Party and there’s precious little for Boris Johnson either. The Conservatives are seen as a useful vehicle for their views on Brexit and immigration – as well as taxation and welfare. There’s no cultural affinity to those they see as “posh Tories”.

The fact is that, over the last three years, the Conservatives have talked obsessively about working class voters without doing much for them. The Conservatives’ working class strategy has amounted to little more than people saying they have one. Until Johnson became Prime Minister, the only thing the Party really did in recent times for working class voters was pledge to increase NHS spending. He has transformed the Party’s approach – as yesterday’s Queen’s Speech showed. Under him, it has pledged further funds to the NHS, schools and the police, and promised to end automatic early release of prisoners and paved the way for a points-based immigration system. It has also promised new funds for towns.

This is all progress and should not be under-estimated. But imagine that Brexit was “done”, would these things be enough to keep working class voters onside? Would they actually think that, now Brexit’s done and immigration back under control, that they can return to their natural home in the Labour Party? After all, Labour will be chucking a lot more cash about even than the Conservatives.

We don’t know the answer to this, and we won’t until Brexit is resolved. My sense is that, as long as Jeremy Corbyn is leader of the Labour Party, even a halfway decent campaign on working class priorities will carry a big proportion of the working class vote.

However, my sense is also that the Party has done so little of recent practical benefit to working class voters, that Brexit and immigration done, a change anytime soon in the Labour leader to someone even vaguely moderate and competent would be a disaster for the Conservatives. The announcements that Johnson has made recently have been spot on, but they’ve come so late in the day there’s a chance they won’t filter through in time, and certainly a big chance that nothing will be felt on the ground in working class communities.

There are two implications from all this. The first is that the Party needs to view the Queen’s Speech as being the beginning of a major campaign to create a working class base that currently doesn’t exist. Similar sorts of policy announcements must follow in coming months, and obviously above all during the election campaign.

Just as the saner parts of the Labour Party are obsessing over provincial English towns (although bizarrely they’re still threatening to raise their taxes), so the Conservatives must develop the same obsession. Amongst other things, to do this they must re-form old alliances with the business community in provincial England to help them create a credible supporter base (admittedly a longer-term goal). This will likely be their starting point for the growth of a working class activist base.

The second implication is that the Party needs to look to build bridges with the middle class Remainers that have recently left the Party (or been removed from it). With the working class vote far from assured, the Party needs all the support it can get. The Party should be thinking of policies that appeal directly to middle class professionals – childcare, workplace, personal finance – that don’t risk any interference with their messages to the working class. And there should be a pathway back for MPs like David Gauke.

Time will tell, but it could be that the high watermark of the Conservatives’ attractiveness to working class voters was the autumn of 2019 – when the Party was led by a PM that would apparently do anything to deliver Brexit, amid hostile opposition from all sides. What better rallying call to the working class than to say “vote Conservative and get Brexit done”? The Party needs to do a lot more for working class voters – and very fast – so it can say “vote Conservative because we got Brexit done”.

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Matthew Lesh: The radical neoliberal programme which can revitalise the Conservatives

Matthew Lesh is the Head of Research at the Adam Smith Institute.

As the flus from last week’s Conservative Party Conference slowly fade, it is worth turning our minds back to a conference that we must never forget.

It was the autumn of 1980. The country was facing economic turmoil. Decades of Keynesianism was taking its toll with high inflation and low growth.  But there was a leader, a radical neoliberal, who refused to accept the status quo or allow the doomsters to take her off course.  “You turn if you want to, the lady’s not for turning,” Margaret Thatcher told Conservative Party Conference.

Thatcher unashamedly spoke not just of policy change but creating “a new independence of spirit and zest for achievement”. She called her administration “one of the truly radical ministries of post-war Britain”.

Boris Johnson’s party conference speech last week has been lauded for its political nous: get Brexit done, and fund the NHS and other public services.

This makes a lot of political sense, particularly for the party’s ‘Go Midlands, Go North’ strategy: the plan to win northern Leave working class areas who traditionally voted Labour Party.

But Johnson’s spending is frustrating to many free marketeers, who have traditionally found their home in the Conservative Party. Boris speaks of a “dynamic enterprise culture” and the Conservative Party’s history in pioneering “free markets and privatisation”. But so far there has been little meat on the bone, while the party is giving up its reputation for fiscal conservatism by committing to big-spending plans.

Politically, this approach undermines support from economic liberals in London and the Southeast. This danger is heightened by the likes of Sam Gyimah’s defection, signalling the acceptability of the Liberal Democrats to Tory economic liberals. With the Lib Dems also winning over the likes of Chuka Umunna there’s a danger the two main parties are seen by voters to leave the centre stage to the Liberal Democrats — and leave governing alone to the scrap heap of history.

To get a strong majority, Boris needs to win both Chelsea and Fulham as well as Stoke-on-Trent. He needs to be able to hold up his economic credentials to win back Remain-voting Conservatives voters – not just give them another reason to abandon the party.

But this balancing act is nothing new. Thatcher, despite some reforms to childcare and housing subsidies, oversaw a huge increase in social spending. She declared that the NHS is “safe with us” and bragged about “enormous increases in the amount spent on social welfare to help the less fortunate”. David Cameron similarly declared that the NHS is “safe in my hands,” while cutting taxes, introducing free schools and reforming welfare.

Thatcher and Cameron balanced public spending with undertaking fundamental free market economic reform to boost the economy. To ensure the Conservative Party remains a broad coalition, it is important that Boris’ free market rhetoric is given meaning. There needs to be some meat on the bone. The Conservative Party will be much weaker if it does not have a serious economic policy offering that creates a clear distinction with Labour.

On the political left, while many may disagree with their approach and ideas, there is undeniably a radical reimagining of policy and a clear agenda: a four day work week, shutting down private schools and nationalising industry.

Some on the Right have chosen to respond to the emboldened Left by adopting parts of their agenda in the hope of placating and preventing the worst. But, as Theresa May’s premiership displays being Labour-lite and adopting policies like the energy price gap, or nanny state policies like the sugar tax, simply does not work.

The Neoliberal Manifesto, a joint project between the Adam Smith Institute and 1828 released last week at the Conservative Party Conference, presents a positive vision for Britain’s future. In the past, the word “neoliberalism” has been twisted by those seeking to manufacture a strawman on which to blame every societal ill.

But it doesn’t have to be this way. Neoliberals are champions of freedom. We want government to protect and facilitate your ability to flourish; we believe in the power and ability of each individual; we believe in doing what is most effective; we are optimistic about the future; we support market intervention to address specific issues but reject paternalism; we are cosmopolitan and outward-looking to the world.

The manifesto calls for a liberal, free market approach to trade that encompasses cutting tariffs and pursuing deals based on the principle of mutual recognition. It declares that need to reform Britain’s outdated planning laws to allow for the building of more houses to fix Britain’s housing crisis. The manifesto also calls for a simpler, fairer tax system by getting rid of stamp duty and allowing capital expenditures to be expensed in full immediately.

On migration, it calls for a liberal system that brings the most talented people to our nation. On education, it explains the need for more choice. On innovation and technology, it calls for an optimistic approach defined by permissionless innovation.  It also calls for a liberal approach to drugs and personal choices, a compassionate but cost-effective approach to welfare, and addressing climate change without sinking our economy.

Many of these ideas are radical, and today can be expected to receive a mixed reception. But we think that our politicians should lead from the front, not the back. These policies are not designed with the idea of what may or may not be popular today, but rather setting the agenda for the future.

While not every action she took was immediately popular, Thatcher’s agenda transformed the country for the better and proved a politically successful formula across three general election victories. Cameron similarly won a majority after undertaking difficult decisions.

If the Government does not have an offering for people who want lower taxes and the state to live within its means, they risk unexpected losses.  Johnson can follow in the footsteps of successful leaders with his own liberal, free market agenda.

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