TO THOSE living in the real world of crumbling classrooms and crowded A&E wards, it must have seemed as important as a spat between neighbours on Coronation Street. But the battle between the neighbours on Downing Street could prove the best thing for years to have happened for Britain’s still unsaved public services.
It’s reassuring that the Prime Minister has discovered, after seven years in the job, that he is actually the Prime Minister, and so can over-rule the Chancellor. It’s even more reassuring that he appointed Alan Milburn, the former Health Secretary and former Chief Secretary to the Treasury, as Chancellor of the Duchy of Lancaster. It isn’t Mr Milburn’s technical responsibilities managing the 600-year-old royal duchy that make my heart beat a little faster — it ‘s his other role, as a new overlord of public policy reform, writing the next Labour manifesto and with a seat in Cabinet.
Importantly, and the reason for the bitter stand-off, the Chancellor of the Duchy of Lancaster will be able to tell the Chancellor of Britain to mind his own business. Just why this is so important for Mr Milburn was revealed last week in a book by Mr Blair’s former economic adviser, Derek Scott, who wrote that Mr Brown had ordered an audit of the NHS without telling Mr Milburn. Two months later the fiercely ambitious Mr Milburn resigned — and you can take your pick here — to spend more time with his family, or in frustration that his attempts to introduce some sort of market reforms in the NHS were being undermined by the Chancellor, whose solution for everything is more money, more targets and more power for himself.
Having messed up on foreign policy, it is not surprising that Mr Blair has decided to get serious about finally delivering on his election-before-last promise of seriously reforming public services, rather than just tinkering with them.
I hold no candle for Mr Milburn. When I wrote a story for the New Statesman lambasting his assault on patient rights, it was summed up on the cover with a picture of Mr Milburn as Hannibal Lecter and the title: “The Minister Who Ate the Patients.” He replied that he would never come to a lunch cooked by me.
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When Labour came to power it immediately abolished the Tories’ half-cooked NHS internal market, and when Mr Milburn was Chief Secretary to the Treasury he used to try to manage public services by setting endless targets for them. But when he actually got to run the NHS, he had a remarkable conversion. When I challenged him that his reforms were just reintroducing the internal market, he said proudly: “Yes, with knobs on.”
Unlike Mr Brown, Mr Milburn understands the root cause of the NHS’s problems, and that there is simply no workable alternative to introducing market incentives. Unlike the ideological left in this country, he understands that Sweden and left-wing US mayors use education vouchers because they improve standards for all, rich and poor alike.
The ultimate proof that Mr Milburn is in the right is that the self-serving public sector unions warned Mr Blair to control Mr Milburn’s “wild ways”. But the public should hope that Mr Blair makes Mr Milburn’s wild ways become real.
Anthony Browne is Europe correspondent of The Times
E-mail: anthony.browne@thetimes.co.uk