Transcript: A terminal diagnosis for the NHS?

This is an audio transcript of the Political Fix podcast episode: ‘A terminal diagnosis for the NHS?’

Lucy Fisher
We take it for granted, don’t we, that the NHS is just always going to be there?

Sarah Neville
Yes. I mean, it’s such a big part of how we Britons see ourselves. It consistently tops polls of what makes us proudest to be British. So that’s why it is so unbelievably freighted for politicians. They have to be incredibly careful how they handle this precious institution.

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Lucy Fisher
Hello, I’m Lucy Fisher and this is Political Fix from the Financial Times. Coming up, reform or die, says Starmer, following a damning review into the state of the NHS this week. Plus, we’re now into party conference season. The Greens and the SNP have already kicked off. The Lib Dems are gathering this weekend, and then we’re into Labour and the Tories. The Conservatives of course are now down to the final four in their leadership race. To discuss all of this, I’m joined in the studio by my colleagues George Parker. Hi, George.

George Parker
Hi, Lucy.

Lucy Fisher
Robert Shrimsley. Hi, Robert.

Robert Shrimsley
Hello, Lucy.

Lucy Fisher
And Sarah Neville, our global health editor. Hi, Sarah.

Sarah Neville
Hi, Lucy. Good to be here.

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Lucy Fisher
The big story this week has been Lord Ara Darzi, a highly esteemed surgeon, publishing his 142-page report into the state of the NHS. Sarah, I’m so glad this week we’ve got your expertise. We could sum up this report as essentially every part of the NHS is on its knees. But give us a brief of some of the specifics. And also, I wanted to ask you to put this into context for us. It feels like we’ve had a lot of these reports. Is there anything new we’ve actually learned?

Sarah Neville
I don’t think we have. I think, though, what is quite powerful about his report is just the sheer weight of the data; really chilling statistics like the fact that waits in accident and emergency departments are killing an estimated 14,000 people a year, more than all the people, all the military who’ve died in conflict since the foundation of the NHS in 1948. That’s how Lord Darzi presents that information. Lots of thoroughly alarming data about how we lagged some other countries on cancer care, and particularly reflecting on how the NHS weathered the pandemic.

He does say very clearly that we wound up cancelling much, much more surgery than all comparable countries. And of course the reason for that, as he highlights, is lack of beds, nurses, doctors — all the fruits, as he clearly says, of austerity. He lays so much of this at the door of the austerity that was ushered in in 2010 by the Conservative-led coalition government. And there’s no question about some of the politics going on here, I think.

Certainly from the point of view of Wes Streeting, the health and social care secretary, and Keir Starmer, the prime minister, this document sets a kind of baseline for them, I think. It’s obviously a fabulous alibi for what’s gonna be another extremely difficult winter. We’ve obviously seen this, as my political colleagues will say, in a number of other areas — you know, the public finances, the criminal justice system — all part and parcel of just emphasising the really terrible inheritance, as Labour presents it, that they’ve got from the Tories.

But it also, I think, is aimed at the service, the health service, making very clear to everybody who works in it that Labour is not gonna be satisfied with continuing like this. This is now the springboard for the reforms that they want to bring in.

Lucy Fisher
Robert, let’s just pause a moment on how politically tinged this report is. Sarah rightly points out that Lord Darzi has Labour connections. He was a Labour member up until 2019 when he quit the party over the row over antisemitism. He was a junior health minister under Gordon Brown. But he then also had this role as UK global health ambassador under David Cameron. So is this a very political report or is it sort of a fair assessment of the state of the health service?

Robert Shrimsley
I think it’s a bit of both. I mean, I think Sarah put her finger on the key point, which is that it’s a very powerful diagnosis of all of the ills. The NHS had a full health check-up and he’s diagnosed all the things that are wrong with it. And I don’t think that in itself is particularly partisan, nor do I think actually it’s especially contentious to talk about the way that capital spending and investment has gone down. These are facts since 2010, and even when the money was coming in, it was frequently being raided for more immediate and acute issues. So that I don’t think is especially political. It clearly suits a purpose.

But I think what is political is the areas that are closed off. If, for example, he does this huge report on everything that’s wrong, it’s long on diagnosis and short on answers. But the one answer it absolutely gives is we mustn’t change the funding model in any way. We’re gonna stick the same thing. So it’s not opening up a vista of debate where you can say, well, what about what they do in France or what they do in Ireland or Norway? So in that sense, I thought that was very, very political.

But the big point is that we’re still waiting for what Labour’s response to this is. This report is out now. Wes Streeting’s gonna look at it for about three months or so. Then we’re gonna start seeing some proposals in the spring. Social care looks like it’s gonna be kicked down the road into another Royal Commission. So the truth is we’re gonna be well into next year before we have any sense of what they’re going to do about what they’re telling us, and rightly telling us, is an absolutely appalling crisis in our most important and cherished public service.

Lucy Fisher
George, do you think it’s fair enough for Labour to take their time on this? Because what we’re hearing so far in the response from Keir Starmer to this report, in the response from Wes Streeting, the health secretary, is very familiar, it seems to me. It is that we need to move from analogue to digital, health service needs to move from treating sickness to preventing ill health and it needs to move from hospital to community care. I mean, these are all sort of direction of travel that people have been talking about for many years.

George Parker
There’s nothing new. I think the purpose of the report is partly political in pinning the blame on the Tories. And in that respect, it’s kind of the health equivalent of Rachel Reeves’s statement back in July which had blamed all the problems of the public finances on the Conservatives.                                      

Partly buying time, Robert wrote a very good column on this this week, the sort of strange gap between the Labour government being elected on July the 5th and actually doing stuff in certain areas. This is a bit of a buying time operation.

I think it’s also holding up the mirror Sarah was suggesting to the NHS workforce. This is not acceptable. And I thought what was really interesting though was the Starmer response. And the overarching message was no more money without reform. And “no more money” is a very strong message. I mean, there will be reform. There will be more money, as Robert said, to fill in gaps in the capital side, particularly in bringing AI into the health service and using more technology. But the idea that extra money, in the way that we remember in the Gordon Brown and Tony Blair years where I think there was an 8 per cent annual increase one year in the NHS budget, (inaudible) that. Those days are over. Reform is very much gonna be the key to the whole thing.

Robert Shrimsley
Although I mean, to be fair, you’re right, of course. But the idea that you can achieve these reforms without spending money first I mean is for the birds. If you want a much-improved primary care sector, preventative care sector, you’ve got to spend money to do it. So the money’s coming before the reform is my bet.

Lucy Fisher
And what do you make of talking about primary care? I mean, Wes Streeting’s talked a lot about maybe ripping up the contract with the GPs. Can he remodel how general practitioners work, Sarah?

Sarah Neville
I think he’s obviously love-bombing general practitioners at the moment in an attempt to get them onside. You know, he’s been emphatising with them on Twitter, he’s been changing the rules so it’s easier for practices to hire GPs and not just adjunct staff like physician associates and that sort of thing.

He wants, I think from everything we’ve heard from him, to change the current partnership model to have GPs as salaried practitioners. And that is even though many, particularly in the younger generation, would actually far rather be salaried because the responsibilities of being a partner are obviously absolutely enormous and you have to sink equity into your practice. But nevertheless, I think this is going to run into some resistance, certainly from the slightly older generation.

But I think he’s absolutely right to position general practice as the motor of everything that needs to change here. Prevention is, you know, the entire game, as far as I’m concerned, you know, to making a health service in the 21st century affordable, you know, given our ageing population, huge problems of obesity, other chronic diseases. So I think he’s absolutely right about that prescription.

But it’s particularly difficult given they’ve set their face against additional resources to switch money out of the hospital sector into general practice. You know, other countries that have done this have found that they’ve had to have quite a long period of double-running where they’re still investing at absolutely the same levels in hospitals but then simultaneously investing in general practice and community, because it does take a number of years for the renewed focus on prevention to pay off in terms of easing pressure on hospital admissions. It’s very hard to take money out of hospitals and immediately expect to see the benefit in terms of less pressure there.

Lucy Fisher
That makes total sense. I mean, Robert, does Labour have more leeway to look to more radical solutions for fixing the NHS than the Tories, given that, you know, they’re more trusted by the public with the health service?

Robert Shrimsley
Well, in one sense, yes, for the reason you’ve just said, because the public do believe that Labour, actually the government that created the National Health Service, is committed to it, although you have to say that if the Conservatives really wanted to destroy it, it would have been destroyed by now. They’ve been in power a hell of a long time. But yes, Labour has that degree of public trust.

But the flipside is that Labour also has other constituencies. It has its own MPs, it has the public service unions, and they in many respects could be more of an obstacle because they are much more uneasy about the kind of reforms that we’re talking about change the nature of jobs, change the nature of contracts. Obviously they resisted in the past, bringing in private suppliers, so . . . 

Lucy Fisher
And have they changed on that, do you think?

Robert Shrimsley
I don’t think they have particularly. But you’re right in your major point, which is that the public is a little bit more trusting.

George Parker
And things like introducing more AI into the health service, having the public’s trust that you’re doing the right thing by patients will be absolutely essential because you quickly run into ethical problems there very, very quickly.

It was interesting, I thought, hearing Professor Sir John Bell, the Covid adviser, talking on the radio about the deeply conservative BMA and the medical profession generally. I think that is, as Robert alluded to, that is gonna be the big issue I think facing this government. I think there’ll be problems around the ethics of AI and I think there’ll be resistance from the medical profession itself to some of the changes.

I think that’s really the real significance of this Darzi report — to try to mobilise public opinion, to say this is really unacceptable and hold a mirror up to the whole thing because, you know, Wes Streeting’s favourite soundbite I think is a really good one, is the NHS is a service, not a shrine. And to my mind, for too long the NHS has been protected from the kind of public criticism other public services would receive if they were offering such a substandard service because of the fact that we venerate the NHS and the people who work in it. Now I think that’s right because a lot of people do heroic work on the front line. I don’t want to disparage that at all.

But listening to Wes Streeting’s own personal experiences of interfacing with the NHS when he had kidney cancer, you know, brilliant treatment when he was on the table, as you know, anyone who’s been involved had it, the treatment at the end is great. But getting there on to the operating table is an absolute nightmare. And frankly, there are lots of people in the NHS not doing their jobs and the public are right to expect more from them.

Lucy Fisher
And can I introduce a sacrilegious sort of idea off the back of what you said, George, which is I just wonder, you know, with so many millennials and Gen Z in particular, I think being very used to just going to apps to, you know, book a GP appointment, maybe pay up to £50 or even diagnose themselves via Google and pay even less just to get an eprescription online.

Is there any sense that, Sarah, in the research you’ve seen, that this sort of the universality of the NHS, being free at the point of use, is that fracturing at all, at least among maybe a small cohort of metropolitan, wealthier, perhaps younger people?

Sarah Neville
I don’t think it’s yet showing up in the data, but I do think it’s a fascinating question as to whether the younger generations, as you said, you know, shall we say, some of the under-40s perhaps, are going to have that same fidelity to the model that, you know, our generation much older than us has had because as you say, you know, when you’re young, you’re only very intermittently going to need to interact with the NHS. If you can do that by means of, you know, a quick one-off appointment with a private GP. You know, you might pay £100 but you’re in an hour or two. You don’t have to wait two weeks for an appointment. So I think that whole sort of, you know, Amazonisation of healthcare is something that the younger generation does sort of hugely relate to.

Robert Shrimsley
I’m a bit sceptical about younger people undermining the basic model and the Amazonisation of the NHS for the reasons Sarah said, which is that you don’t really, if you’re healthy, you don’t really interact with it much until you become a parent or something like that.

Where I think they will have absolutely no tolerance is for the ludicrous booking systems and the bureaucracy of the management where you get letters and texts that it’s shocking. And I think that’s, you know, they’ll look at your wife, why can’t I just make my booking?

The one area where I do think, however, the model will be questioned is if Labour goes out of power whenever in the future it does and the NHS is still, you know, on its knees, you are going to have a Conservative party which is saying, look, it’s really time. We do have to look at other models, we do have to look at co-payment, we do have to look at charging for certain things. And so I think that’s the one thing that will, I think, spur even the professions and the unions to look at this a bit more openly, which is that if the NHS isn’t made to work this time, there’s another party which will actually look at the model.

George Parker
And the morale in the service just needs to be rebuilt. I mean, there was a fascinating statistic, Sarah, in the Darzi. I don’t know whether you saw this and you may have known this already, actually, that he concluded that the nurses and midwives, typically they were taking one working month of sick leave every year.

Sarah Neville
I thought it was absolutely extraordinary and I didn’t know it until I read it in the report. Yeah.

George Parker
That’s just an incredible statistic. So restoring the morale and giving the NHS a sense of purpose, moving in the right direction and doing that very quickly is absolutely essential, I think, for Wes Streeting and Keir Starmer.

Lucy Fisher
Robert, you interviewed Wes Streeting at the FT Weekend Festival last Saturday. You know him quite well. What do you make of him and his ability to sort of try and lead this transformation of the NHS?

Robert Shrimsley
I think he’s a very impressive politician in a number of ways that we’ve seen. I think he’s a brilliant speaker. He’s a brilliant performer. He’s someone who knows his mind. He’s very much like Tony Blair in this respect as someone who’s really worked out what he thinks about all the big issues and finds it easy to position himself on an issue, that knows where he wants to be, knows whose side (inaudible) he’s on. He’s very, very articulate. He’s very impressive and able to appeal to voters beyond the traditional Labour tent. That’s all his strengths.

What we simply don’t know yet is whether he can deliver in a most intractable space at a time when people’s patience is not enormous. That’s a different question. I mean, I think when I look at the people in the Labour cabinet, I would be glad it’s him rather than many others. But it’s a monstrous challenge and he’s gonna need a lot of support.

Lucy Fisher
George, the stakes are just so high, aren’t they? There’s an economic impact of fixing this problem. 2.8mn people are currently unable to work because of poor health. As you’ve alluded to, it’s a big part of what Labour’s promising that they will get the waiting lists down, make it easier to see your GP. And if people don’t feel that by the time of the next election, Labour could pay the price at the ballot box.

George Parker
The rise in economic inactivity in this country is an absolute disaster for the economy. The NHS has got to be putting its weight into getting those people back into work. And you need to reimagine the whole system, don’t you, and it’s basically focus on those people because we’ll hear a lot in the Budget, I’m sure, about welfare reform to try to sort of the stick approach to getting people back into work. But the NHS needs to be playing its part in providing the services needed to get those people back into the workplace.

Sarah Neville
And perhaps reconceiving health investment, which the Treasury has always regarded, you know, has seen the NHS as a massive black hole into which they pour endless billions with very little tangible results. So I think what Starmer and Streeting need to do is to reframe spending on health as an investment, you know, with a very clear economic pay-off.

Lucy Fisher
Keir Starmer says the health service is in critical condition. George, surely that means there’s gonna have to be significant amounts more money to put into it despite him trying to manage expectations on that front.

George Parker
I think what we will see in the Budget is an allocation of quite significant amounts of money for capital projects of the kind Robert was mentioning earlier, whether it’s new technology or the use of AI in the system. And one way you could release that money, it would be quite a neat political switch, would be for the government to announce it’s changing the way in which they define debt relating to the Bank of England. That could spare up £10bn or more potentially, which could be earmarked for capital expenditure, including on the NHS. But the days when the answer to all the problems were simply to chuck more doctors or nurses into the system, I think that’s over.

Lucy Fisher
And Sarah, just final word to you on possibly the most tricky question. Are you optimistic that major improvements can be made before the next election?

Sarah Neville
I don’t think I am particularly, actually. I mean, I think it can be made better than it is, but I think the forces pushing against it are so intractable. This ageing population and this dreadful issue of obesity, we are an incredibly unfit nation, much more so than many of our European peers. Those forces are gonna be incredibly difficult to fight back against.

I mean, I think waiting lists can be reduced and, you know, waiting times can be reduced. But as to a sort of wholesale transformation, which is going to take us back, let us say to, you know, 2009, 2010 when the service, you know, looking back was really in remarkably good shape. I think that’s gonna be very hard to achieve, you know, without the level of investment that you mentioned earlier, George, you know, those huge sort of 8 per cent annual rises. It’s a wicked challenge.

Lucy Fisher
Sarah Neville, thanks for joining.

Sarah Neville
Thanks very much.

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Lucy Fisher
Well, parliament’s been back less than a fortnight and it’s already rising again for recess. And that is because party conference season is upon us. In fact, it’s already begun. We’ve had the TUC meet in Brighton, the Greens in Manchester. We’ll come on to them, but let’s start with the two main parties. George, Labour meeting in Liverpool in many ways is gonna be a victory rally, isn’t it, the chance to kind of enjoy the massive success in the general election. But beyond that, what might the flashpoints be?

George Parker
Yeah, I mean, it will be a victory rally for sure. I think what we’ll hear Keir Starmer talking about is what the light at the end of the tunnel looks like. You know, mapping out the sunlit uplands beyond the painful decisions that are coming down the track in the Budget and so forth. And I’m told that Rachel Reeves will also be playing up the kind of things that Labour activists want to hear about in terms of future investments and prudence with a purpose, but a bit more of what the purpose is beyond her Budget.

But plainly you can see what the flashpoints are gonna be. They’re gonna be a lot of nervous Labour members wondering whether this is actually what they elected a Labour government for, particularly of course, in relation to the withdrawal of winter fuel payments from 10mn people. So that will certainly be a flashpoint. And people will be worried and sending out signals in advance to Rachel Reeves about what’s coming down the track in her Budget. So I think that’s gonna be the main flashpoint.

But, you know, parties which have just won their first election victory for 14 years with a massive landslide — I mean, you’ve got to take it with a pinch of salt. Even the TUC conference, which is taking place this week in Brighton, although there was a lot of criticism of the winter fuel payment decision, nevertheless the general ambience was pretty positive, I’m told by Jim Pickard, our colleague who was down there.

Lucy Fisher
Robert, let’s move on to the Conservatives in Birmingham. It’s gonna be a beauty parade with the final four candidates.

Robert Shrimsley
It’s interesting we’d choose that word, isn’t it?

Lucy Fisher
Well, yes. I mean, yeah, yeah. That’s a stretch, the analogy. To use another, there may be blood on the wall by the end of the conference?

Robert Shrimsley
Yeah. I mean, it’s a sort of Britain’s Got Talent show, but not all of Britain and there’s not that much talent.

George Parker
No one’s watching.

Robert Shrimsley
No one’s watching. I mean, look, it’s a very, very strange Conservative party conference this year. The leader, Rishi Sunak, we’re told, is barely speaking at all. There’s none of the usual policy addresses I think, that’s right, from, you know, the main ministers or ex-ministers, former (inaudible) ministers. So what you’ve got . . . 

Lucy Fisher
Keir Starmer referring to them as ministers.

Robert Shrimsley
Absolutely, yes, and often compared to him, in fact. And, you know, so you’ve got the four candidates. They’re all gonna get a speech. And I think you were telling me earlier they might do a Q&A as well. So it’s gonna be the four of them trying out in front of the wider membership, which is interesting because that would obviously impact on the Conservative MPs who have the final say in whittling it down to the final two.

We’ll also have, I think, an absolute tonne of finger-pointing fringe meetings as everybody battles over the future direction of the party, tears their hair out over Nigel Farage’s Reform party and the threat that’s come from the right. That’s gonna be a pretty ugly conference.

But the only thing is whether they can emerge from it with the clear direction, the clear, clear frontrunner for the leadership. You know, the last time this happened, when David Cameron won the leadership in opposition, he won it on the basis of his conference speech. And he was not the favourite going into that conference. But he wowed the audience primarily through the trick of not having notes, which you wouldn’t have thought was the key issue.

So it’s gonna be quite, I think, quite a grim and a shell-shock on Conservatives who’s just not used to being this far from power and also not used to being irrelevant. And once this leadership conference is over, they’re gonna be struggling for relevance.

George Parker
It’s gonna be a completely weird event, isn’t it? The fact it’s a four-day event where, as Robert says, Rishi Sunak we’re told would turn up on Sunday and then disappear after having made a few remarks and then gone home to clear the way for this leadership contest, which is...

Robert Shrimsley
Four 20-minute speeches.

George Parker
Four 20-minute speeches. How is that gonna play out over four days? What are they gonna be doing apart from going through the postmortem on the Tory election defeat? I suspect it will also become quite nasty because in the absence of set-piece events, there’ll be a lot of space for back-stabbing and a negative briefing coming from the various camps against their rivals. And of course they’ve been told they’ll get a yellow card if they’re caught doing it. So when we get to the . . . 

Robert Shrimsley
They’ll try not to be caught.

George Parker
Well, exactly. When we get the negative briefings, as we all do, we always have to say they come from a rival camp rather than from identifying the camp from which these negative briefings are coming.

Robert Shrimsley
The other point is that the other thing about conferences, I mean, there’s almost no point to party conferences anymore. The one point they really have is to raise money for their parties. And what you’re gonna see obviously, the Labour party is gonna be completely flooded with every industry and business that wants to get ministers, whereas the Conservative party, all of a sudden you’re gonna see the exhibition area, all these stalls and it’s gonna be half-empty. People will not be paying to come unless they paid in advance because it was still . . . they thought it would still be in power.

Lucy Fisher
Even there, Jim and I have done a story on how some people who’ve bought tickets aren’t bothered about using them; just sunk cost now.

Robert Shrimsley
I think it’s gonna feel — I mean, all the things George said I completely agree with — it’s gonna feel a little bit like a ghost town.

George Parker
It will. And also, you really sense when this power shifts. And just one thing, ’cause I was at that conference when David Cameron made his no-note speech and beat David Davis unexpectedly. I thought what was interesting was that, yes, it was an impressive speech. But at the time, the Conservative party, they’d been through a series of leaders. And you could tell in the party a sense they now wanted to win again, and Cameron looked like a winner.

I’m not sure the Conservative party is in the mindset where it wants to win again. At the moment I think they’re still too ready to just be settling ideological scores and I think that’s what we’ll see in Birmingham in a couple of weeks’ time.

Lucy Fisher
I’m sure you’re right. And I’m particularly fascinated about one, to my mind, pretty madcap proposal to allow party members to speak from the main stage. I think, you know, the risk of someone with, you know, some pretty fruity views making headlines is . . . 

Robert Shrimsley
I don’t know, they’re allowing the four candidates. (Laughter)

Lucy Fisher
Robert, Lib Dems. There’s this weekend in Brighton before Labour and the Tories. We’ve spoken about this, you know, it’s a bit of an existential sort of situation for the Lib Dems now, isn’t it? Many people voted for them because they wanted to get rid of the Tories. Tories are now out of office. What is the point of the Lib Dems now?

Robert Shrimsley
That’s the key question. I mean, look, obviously this is gonna be a good conference for the Lib Dems. It’s their best parliamentary performance since before the war, certainly since the foundation of the party in its current form. And they’re gonna be feeling very chipper. They’ve got a lot of people who’ve been elected. They’re gonna want to do things, but they’ve got 70-plus MPs.

On another hand, that’s not that much against a majority the size of Labour’s. And so the question I think the Lib Dems got to grapple with a little bit is what do we need to be by the time of the next election? Because as you said, the party needs a specific purpose that gets people to vote for them. That specific purpose was get rid of the Conservatives. In a lot of seats, they were the vehicle for doing that.

Now, we don’t know where we’ll be in four-and-a-half, five years’ time, but if the country is souring on the Labour party, then “get rid of the Conservatives” is not gonna be the imperative they have. And that may be a weakness for the Liberal Democrats. So they need to have something. In the past it’s been, sometimes it’s been Europe, sometimes it’s been education, obviously opposition to the Iraq war. It doesn’t matter what it is necessarily, but they’ve got to have a unique and reasonably popular defining position that pulls people in, especially against increasingly insurgent, more populist parties, be it the Greens or the Reform party. So if you’re disaffected, you’ve got other options now and they’re a bit more strident.

George Parker
My experience, the Lib Dems when they’re up against a Labour government is that you sort of think, well, they’ve won seats off the Tories, therefore they need to tack to the right to appeal to keep Tory voters on board.

That in fact is not what happens. When the Labour party’s in office, what happens is the Liberal Democrats position themselves as the conscience of the Labour government. Now they would never put it like this because they would say we don’t recognise the sort of left/right spectrum in politics. But in crude terms what the Liberal Democrats I think will do, and I think they’re still, what Robert says, try to work out what they do. But I think what you’ll end up doing is find themselves in a whole load of positions where they’re to the left of the Labour party.

So you’re already starting to see a little bit of it on the NHS. We were talking about it earlier. Ed Davey in the House of Commons this week said, do you spend more money on the NHS? How are we gonna fund it? With a tax on bankers. You can always find a way of outflanking the Labour party to the left and still, I think, keep on board your soft Tory voters, because in the end they know the Lib Dems are not gonna be in government anyway.

Robert Shrimsley
But I think this misses the point. I think the point is that the fundamental leader of the Liberal Democrats is the leader of the Labour party because their popularity, their success depends upon voters being content with a Labour government. So being the extra conscience of the Labour party is fine as long as people are still prepared to see Labour in power. If that turns, that’s when the Lib Dems are in trouble.

George Parker
I totally agree. I totally agree with that. But I mean, the only way the Lib Dems come back in any way like the numbers they got in at on July the 4th is if the public still wants a Labour government in office. They don’t want the Tories back, but they’d like the Labour party to be a little bit more generous, tougher on the rich or whatever it is.

Lucy Fisher
Robert, quick word on Reform UK. I mean, they’ll be meeting in Birmingham just before Labour conference kicks off. What are you expecting out of that, if anything at all?

Robert Shrimsley
I’m not particularly fussed about what they’re doing in their conference. I think Reform are interesting. I mean, they’ve got a new chairman. They’re really pulling in money, which is important. They’re very, very focused on next year’s local elections, the county council elections. I’ve talked to a couple of people, Conservative MPs, really worried what’s gonna happen in Essex council.

There are a couple of other councils where Reform will . . . And I think the key point about Farage parties is that they need election victories, a bit like the Liberal Democrats to some extent. They need election victories to maintain their momentum and their relevance. And so I think they’re gonna put all their focus on those next county councils, local elections next year. And if they do well in those, and it’s perfectly possible that they do, that’s gonna send a shiver up the spine of both the Conservative and the Labour parties. And I think that’s shrewd politics.

Lucy Fisher
Well, finally, let’s not forget the Greens who had their conference in Manchester last weekend. Our excellent producer Leah Quinn was there covering it. Now she’s popped into the studio to tell us more. Hi Leah.

Leah Quinn
Hi, Lucy. Thanks for having me.

Lucy Fisher
So what was the Greens’ message?

Leah Quinn
The Greens message, I think was, it was very hopeful. It was very buoyant, the mood at conference. Obviously, they’ve now got four MPs, which is the most they’ve ever had. So there was a lot of, we are the real hope, we are the real change. Labour have come into power and while there was a lot of sort of happiness over the Tories being out of government, they have basically just said that now Labour is in power that Labour are no better than the Tories and the Greens are positioning themselves as the only option for people who want to vote for a left party.

Lucy Fisher
They’ve got a bit of a schism, haven’t they? Interesting you point out the four MPs — two are in kind of Tory-facing seats, two are in Labour-facing seats — and they have co-leaders Adrian Ramsay and Carla Denyer in one of each. How’s that working, that kind of co-leader relationship?

Leah Quinn
So you’re right, obviously you’ve got the Brighton and the Bristol, which feels very like stereotypically left, very university town, very socially progressive. You’ve then got the North Herefordshire and Waveney Valley, which as you say is a lot more kind of market town, farmer, rural communities, very environmentalist. Carla seems to appeal more to the Brighton/Bristol groups. And then it’s probably safe to say that Adrian Ramsay appeals more to the market towns and to those rural communities.

But both Ramsay and Denyer were trying to suggest that there’s a lot more similarities between those communities than probably like I would suggest in my questioning and stuff like that. Like on environmentalism, on the fact that people want to keep the rivers clean there’s actually not as many schisms as we might assume. Whether or not you wanna believe that obviously is different.

George Parker
One thing I was wondering whether you picked up at all at the conference was this tension in the Green party where they’re very enthusiastic about having renewable energy and solar power and everything, but they’re not actually quite so keen on having those pylons running across their constituencies. Did that come up at all?

Leah Quinn
The Nimbyism critique definitely came up and it was something I put actually to Adrian Ramsay and to Ellie Chowns. We were talking mostly about kind of housing and things like that.

Robert Shrimsley
(Inaudible) Nimbys. (Laughter)

Leah Quinn
Yeah. What they would say like on the housing side of that is that they are in support of what they would say will be like affordable housing instead of luxury apartments and all that sort of thing. So while they have said previously that they’ve kind of rejected proposals for luxury apartment buildings and things like that they’re very much on the like, we want social housing, we want affordable housing.

George Parker
Can I ask one other question? We are used to going to other party conferences where we live off sausage rolls and pretty unhealthy stuff. Was there a higher quality of food at the Green party?

Leah Quinn
There was a lot of vegan foods. I think that yeah, the cliché on that front . . . 

Robert Shrimsley
Is that a yes or a no? (Laughter)

George Parker
I think yes, Robert.

Leah Quinn
Yeah. A lot of tote bags, a lot of vegan foods, a lot of Birkenstocks. I mean . . . 

Lucy Fisher
Socks with the Birkenstocks?

Leah Quinn
Yep, a lot of that as well, hiking gear as casual clothing. Yeah, take that as you will.

George Parker
It’s like the Lib Dems in exile.

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Lucy Fisher
We’ve just got time left for Political Fix stock picks. Leah, who are you buying or selling this week?

Leah Quinn
I am actually buying a London Assembly member of the Greens, Zoë Garbett, who was the Green candidate for London mayor, because I spoke with her at conference and I actually thought she was very eloquent and actually really impressive in the way that she communicated a lot of her views. She’s very passionate about drug legalisation and regulation. She’s a councillor in Hackney where she’s worked a lot with young men of colour around being criminalised, basically for carrying small amounts of marijuana.

Lucy Fisher
George, how about you?

George Parker
Well, going back to our discussion on the Tory conference, I think I’m gonna sell Tom Tugendhat, one of the four surviving leadership contenders. Now, he saw off Mel Stride this week, but it just doesn’t, I don’t know what you think, Lucy, it doesn’t seem to be quite happening for him at the moment. And the fact that Vicky Atkins, former minister, one of his One Nation mates, very . . . In a very high profile way, went across the Robert Jenrick camp this week, I thought it was fairly ominous for Tom Tugendhat. So he’ll really need to pull out of the fire at the Tory conference if he’s gonna make it through the last two.

Lucy Fisher
Robert.

Robert Shrimsley
Yeah, I’m gonna get one I would never previously once upon a time I would never have expected myself to tip them. I’m gonna tip Sir Geoffrey Clifton-Brown, who is a very, very long-serving Tory backbencher who people won’t, unless they’re really paying attention to politics, will not know very well. He’s been around a very long time, officer of the 1922 backbench committee. But this week he was made chairman of the public accounts committee, which is one of the select committees that has the most clout and makes the most noise in Westminster. It has big support from the National Audit Office, and it looks into wasteful government spending.

And the chair of this committee can be a very powerful and vocal figure in making the argument where the government misspends, which all governments do. And so I think actually, while his Conservative colleagues with front bench posts are struggling to cut through, I think we’re probably gonna hear quite a lot from Geoffrey Clifton-Brown making the case against wasteful Labour spending. So I think he can be quite explosive if he feels like it. What about you, Lucy?

Lucy Fisher
I’m buying David Lammy. I think he’s had a good week standing side by side with Antony Blinken, the US secretary of state. He’s been tasked by Keir Starmer with going to Ukraine to hear directly from President Zelenskyy about Ukraine’s war needs before both Blinken and Lammy report back to Starmer and Biden as Starmer heads off to the White House on Friday for a crunch meeting where, yes, they’ll be discussing Gaza and the Middle East. But the real meat of their talks will be on Ukraine and whether to lift restrictions on long-range missiles for use by Ukraine into Russia, which will be a really key turning point in this war, key milestone if so. But I’m sure we will be discussing that in weeks to come.

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But for now, my thanks to Robert, George and Leah for joining.

George Parker
Pleasure.

Robert Shrimsley
Cheers, Lucy.

Leah Quinn
Thanks, Lucy.

Lucy Fisher
See you next week. And that’s it for this episode of the FT’s Political Fix. I’ve put links to subjects discussed in this episode in the show notes. Do check them out. They’re articles we’ve made free for Political Fix listeners. There’s also a link there to Stephen’s award-winning Inside Politics newsletter. You’ll get 30 days free. And don’t forget to subscribe to the show. Plus, do leave a review or a star rating if you have time. It really helps spread the word.

Political Fix was presented by me, Lucy Fisher, and produced by Clare Williamson. Manuela Saragosa is the executive producer. Original music and sound engineering by Breen Turner. Jean-Marc Eck is sound engineer. Andrew Georgiades and Petros Gioumpasis were the broadcast engineers. Cheryl Brumley is the FT’s global head of audio.

We’ll meet again here next week.

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