It is indeed good news that there is substantial new money for the National Health Service in the budget. It is estimated that by 2004 national spending on health will be 7.8 % of GDP per annum, compared with the European average of 8% per annum. . After many years at that level it would be fair to expect standards almost up to the European average. However we are not an average European power, we are one of the leaders. Two things follow, firstly the increase is not really enough, and secondly that it would be wrong to expect transformation overnight.

Tony Blair, if he is really to take charge of the new spending, needs to tread carefully. Firstly the public need to be shown that he cares desperately about good clinical outcomes, rather than shallow headline grabbing. Secondly he needs to understand professional ethos. Doctors, nurses, and midwives, work to their own self-imposed standards of dedication and skill, a far higher standard than anything that can be required by contract, or than that is usually found in the commercial world. Professionals should welcome being freed up from routine tasks to concentrate on practising their skills. However there is no scope for de-skilling or union busting. Browbeating hospital trusts or withholding funds from laggards will not do much for their patients. Why not first try an independent body made available to them to teach and inculcate best practice. In short the NHS is a good place for labour politicians to try quiet sincerity and dedication, with a view to government which is not only joined up but also adult.

Traditional Labour supporters like myself insist that labour must be a moral force for good. I do not believe that all in middle England are selfish bastards, although some of the super-rich may be.

I also think we would like something to be genuinely proud of, which would take our minds off pathetic attempts to throw our weight about abroad, or pick on minorities at home.

Suppose 20% of our defence budget were spent on the things that really threaten us, ecological disasters. We could then have disaster relief forces ready to help at home or abroad, perhaps shoring up our coastal defences in the meantime. We could be proud of such efforts (and no amount of managing news will make thoughtful people proud of dropping bombs and missiles on civilians, which of course causes lasting traumas and bitterness and never reduces them.)

Ever since the industrial revolution it has been necessary to provide a regulated framework within which modern creativity can flourish. Laws were necessary to stop women and children going down the mines. Laws are necessary to promote minimum wages, and safe and decent working conditions. You do not need to bribe entrepreneurs or industrialists to take top jobs, which are satisfying in their own right. So when company directors foolishly vote themselves obscenely high salaries, we have every right to require from them a higher rate of tax, to demonstrate that we all live together here, and to assist hard pressed public services. Labour has the admirable pledge to eliminate poverty in 20 years. However poverty is defined in relation to average and top wealth, so you cannot deal with poverty in isolation. Labour sensibly stresses the work ethic. With fair treatment for all at work, our full creative energies can be released, and work can indeed be something to be proud of. This should of course be within a government framework which encourages individual and group enterprise, and does not needlessly frustrate it. We should surely understand however that, even when the greed selfishness and ruthlessness of market forces are properly and sensitively regulated, work for most will largely be a means to an end, the good life being reserved for weekends, holidays and retirement.

Britain is good at art sport and culture. We must spend public money on them, and keep crude and exploitative moneymaking under control. That way we shall have things together to be proud of. This is the most important point in this article. It is one of self-respect. It may well point the way to a self-confident multi-racial healthy nation to which all are proud to belong. (We will never achieve this if we concentrate solely on becoming Internet buffs, or crudely concentrate on employability, putting out begging bowls to multi-national companies, in pathetic competition with the Taiwanese).

John Champneys.

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