‘What giving working-class areas more NHS cash reveals about Starmerism’ – LabourList

Half a world from Westminster, in Blackpool yesterday, the Health Secretary unveiled a new approach to allocating NHS cash. While funding formulas might not get your blood pumping, this one really should.

For too long, the NHS has failed to target investment at those places that need it. This can be hard for the left to hear, for whom public services are always a positive force.

But the ‘inverse care law’ – that those most in need of care are least likely to receive it – is a longstanding challenge, first identified by a GP in 1971. Addressing this is about ensuring that, as Wes put it, “working-class areas receive their fair share”.

For a government accused of lacking a clear purpose, here was one clearly laid out: improving working-class communities, particularly in coastal areas like Blackpool.

While this message was delivered by the Health Secretary, it is an idea I associate with much of the Cabinet; the least privately educated in history.

It’s a message I also associate closely with the Prime Minister. For me, this has always been the very essence of Starmerism: a retooling of Labour away from the middle-class, middle England preoccupations of New Labour towards working-class people and communities, not least because of his own personal back story.

This has always been Keir at his best: talking about his father’s working-class profession and channelling that to deliver real policy change, such as a huge expansion of the minimum wage and workers’ rights.

However, this story has sometimes lacked a clear articulation in terms of place – where in the country are you focused on helping? – which can help clarify for the public and the media whose side Starmer is on. But since the political reset in the new year, a new focus has emerged on improving working-class communities.

READ MORE: Welfare reform: ‘So much for new Labour MPs being ultra-loyal Starmtroopers’

‘Governments preferred tax cuts to supporting working class’

In one of the most consequential passages of the Spending Review, the government announced it would be spending half a billion pounds on 25 ‘trailblazer neighbourhoods’. This hyper-targeted investment will help working-class communities across the country, including Stockton-on-Tees, Wythenshawe in Manchester, and Barrow in Cumbria.

The Chancellor’s push to channel capital investment away from London, if delivered, will help too. So too will pushes to bring back neighbourhood policing to our most challenging estates and towns.

That the Health Secretary was in Blackpool is no coincidence. While just a few hours on the train from Westminster, its social and economic outcomes are those of a different country.

How did we get here? De-industrialisation and changing holiday patterns tore the economic heart from much of the North and Midlands, and coastal communities across the country. For too long, governments took a ‘hands off’ approach to the carnage imposed on communities by the loss of traditional industry, preferring to cut taxes rather than supporting working-class areas.

This has proven to be a fiscal, and moral, disaster. Today, we are spending record sums paying people not to work, rather than supporting industries to help people work. We have chosen to defund the places that built modern Britain – that dug the coal, built the ships, staffed the factories – rather than supporting them through times of economic change.

READ MORE: Welfare reform bill: Full text of reasoned amendment and list of rebel Labour MPs

‘Addressing Thatcherism’s original sin’

New Labour recognised these challenges, targeting investment in deprived areas. Programmes like Sure Start helped youngsters in working-class communities the most, boosting grades and improving health. The New Deal for Communities revitalised dozens of deprived areas. But the Coalition government took a sledgehammer to both programmes for nothing more than party political reasons, with the results clear to see.

The ‘two nations’ that have emerged since the 1980s are the original sin of Thatcherism; and addressing this remains the country’s biggest challenge. This won’t just help those outside London; workers in the capital are punished by our lopsided economy, with extortionate rents from an overheated economy shredding their wages.  

This will require throwing the kitchen sink at working-class communities, starting with ex-industrial towns and city peripheries in the North and Midlands, and coastal communities across the country.

First, the government must deliver hyper-targeted investment to the places that need it the most. Money isn’t everything, but without it, you will achieve nothing.

Second, we must start the hard work of public service reform, so that we focus relentlessly on the working class, who have been ignored by public services for too long. This means funding grassroots community organisations to carry out real preventative activity.

Third, we must ensure the ambition of the Industrial Strategy is backed by hard cash at the Budget. Ultimately, the loss of good jobs is the single biggest cause of working-class decline; arresting this must be at the top of this government’s in-tray.

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‘Improving places most at need will tackle disaffection’

The moral case is clear enough – but what about the politics, I hear you ask?

This government, to its credit, has recognised that Reform are the government’s real opposition, not the Conservatives.

This is partly for reasons of ideology. The Tories seem constitutionally unable to ditch their obsession with free markets and tax cuts; ideas rejected at the ballot box the world over and by economists long ago.

But it’s also for electoral reasons. As I have written in these pages previously, Reform – not progressive parties like the Greens or Liberal Democrats – will be the biggest electoral threat at the next election.

Tackling this requires a deep understanding of where Reform is gaining ground. The local elections couldn’t have been clearer: the higher level of disadvantaged, the more Reform gained. This was particularly true in isolated estates and villages, far from the rejuvenated ‘core cities’.

For me, this makes the political, as well as moral, purpose of this government exceptionally straightforward: improving the places of most need, in turn tackling political disaffection.

I hope Wes’s announcement yesterday is just one of many from the government, confirming this new moral mission: the restoration of working-class communities, in places far from Westminster.

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