Electoral Dysfunction: Royals’ cancer diagnoses put struggling NHS in the spotlight
There is an edict in our democracy that politics and royalty must not mix.
Sure, we live in a “constitutional monarchy” where King Charles is head of state, wading through government papers and meeting the prime minister weekly.
But when it comes to the task of setting the political direction and framing our nation’s political debate, the Royal Family has to zip it and remain entirely neutral.
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And just as the royals don’t stray into political territory, political editors like myself and politicians don’t talk much about the Royal Family.
In fact, politicians actively swerve any questions inviting them to comment on the latest tabloid drama around the royals.
But this week on Electoral Dysfunction, we’ve broken with our own conventions to discuss the Princess of Wales’s announcement that she has cancer, and ask whether this might be a moment when the cultural and social role the Royal Family play in our national life takes a more political tilt.
Because the princess’s diagnosis – on the heels of King Charles’s announcement he has cancer – has started a conversation about cancer that the British people are perhaps taking into the political dimension.
The realisation that anyone can find themselves in this position is throwing into sharp relief the state of our healthcare system.
In the same way some people might be asking, “could I have cancer?”, so too are we assessing what the prognosis is for a creaking NHS to treat us in a timely way.
This was the point made to us by listener Sophie, who emailed in to say that while she had “every sympathy” with the Princess of Wales and King Charles, “I wonder if it is now an appropriate time to start a discussion about the reality of cancer treatment for the majority of people in the UK?”
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Because while NHS waiting lists are at record high, the pandemic stalled so many patients presenting for cancer screening and testing.
NHS guidelines aim for 75% of patients with suspected cancer to receive a diagnosis within four weeks of a referral, while 85% should wait less than two months for their first treatment.
But the last time these targets were met was back in 2015.
In England and Wales, just over one in three people wait too long for treatment, while in Scotland – where targets are slightly different – a quarter wait more than two months to start treatment.
The public seem to have had enough, with The King’s Fund and Nuffield Trust think tanks’ annual report – out this week – finding that public confidence in the NHS is at its lowest level since polling began in 1983, with approval ratings dropping for almost all NHS services.
Long waits for a GP or a hospital appointment were cited by 71% of people as a key reason for their dissatisfaction.
Half of those surveyed supported rising taxes and spending more on the NHS, as we gear up for a general election in which the state of our health service will be the subject of very national debate.
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Satisfaction with NHS slumps
Labour MP Jess Phillips says “everybody feels nothing but sympathy” for Princess Catherine. But she also voices on our podcast perhaps what many of our listeners will be feeling if they are watching someone struggle with this awful disease and frustrated that treatment came too late.
“[The royals] are going to be treated a lot better in their cancer diagnosis than my family and my sister-in-law who is currently dying of cancer and has small children just like Catherine,” she said.
“The reality is that not everybody has vigilance on them [in screening and testing for cancer]. I’m not saying for a second that the Royal Family shouldn’t have vigilance and everybody in the country knows they will have more vigilance.”
But Jess also thinks that the royals should perhaps give “some nod of recognition to the fact its not as easy for others”.
She added: “I think that if they don’t address that particular issue, I just think that it’s dangerous and people like me who feel sympathy for them start to feel a bit hurt by it.”
Political territory that the Royal Family will be loath to touch, let alone try to traverse.
But as figureheads of the nation, their diagnoses, as well as opening up a well of sympathy, puts a struggling NHS into the national spotlight again.
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Rachel Reeves has told Sky News she is looking at both tax rises and spending cuts in the budget, in her first interview since being briefed on the scale of the fiscal black hole she faces.
“Of course, we’re looking at tax and spending as well,” the chancellor said when asked how she would deal with the country’s economic challenges in her 26 November statement.
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Ms Reeves was shown the first draft of the Office for Budget Responsibility’s (OBR) report, revealing the size of the black hole she must fill next month, on Friday 3 October.
She has never previously publicly confirmed tax rises are on the cards in the budget, going out of her way to avoid mentioning tax in interviews two weeks ago.
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Chancellor pledges not to raise VAT
Cabinet ministers had previously indicated they did not expect future spending cuts would be used to ensure the chancellor met her fiscal rules.
Ms Reeves also responded to questions about whether the economy was in a “doom loop” of annual tax rises to fill annual black holes. She appeared to concede she is trapped in such a loop.
Asked if she could promise she won’t allow the economy to get stuck in a doom loop cycle, Ms Reeves replied: “Nobody wants that cycle to end more than I do.”
She said that is why she is trying to grow the economy, and only when pushed a third time did she suggest she “would not use those (doom loop) words” because the UK had the strongest growing economy in the G7 in the first half of this year.
What’s facing Reeves?
Ms Reeves is expected to have to find up to £30bn at the budget to balance the books, after a U-turn on winter fuel and welfare reforms and a big productivity downgrade by the OBR, which means Britain is expected to earn less in future than previously predicted.
Yesterday, the IMF upgraded UK growth projections by 0.1 percentage points to 1.3% of GDP this year – but also trimmed its forecast by 0.1% next year, also putting it at 1.3%.
The UK growth prospects are 0.4 percentage points worse off than the IMF’s projects last autumn. The 1.3% GDP growth would be the second-fastest in the G7, behind the US.
Last night, the chancellor arrived in Washington for the annual IMF and World Bank conference.
Read more:
Jobs market continues to slow
Banks step up lobbying over threat of tax hikes
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The big issues facing the UK economy
‘I won’t duck challenges’
In her Sky News interview, Ms Reeves said multiple challenges meant there was a fresh need to balance the books.
“I was really clear during the general election campaign – and we discussed this many times – that I would always make sure the numbers add up,” she said.
“Challenges are being thrown our way – whether that is the geopolitical uncertainties, the conflicts around the world, the increased tariffs and barriers to trade. And now this (OBR) review is looking at how productive our economy has been in the past and then projecting that forward.”
She was clear that relaxing the fiscal rules (the main one being that from 2029-30, the government’s day-to-day spending needs to rely on taxation alone, not borrowing) was not an option, making tax rises all but inevitable.
“I won’t duck those challenges,” she said.
“Of course, we’re looking at tax and spending as well, but the numbers will always add up with me as chancellor because we saw just three years ago what happens when a government, where the Conservatives, lost control of the public finances: inflation and interest rates went through the roof.”
Pic: PA
Blame it on the B word?
Ms Reeves also lay responsibility for the scale of the black hole she’s facing at Brexit, along with austerity and the mini-budget.
This could risk a confrontation with the party’s own voters – one in five (19%) Leave voters backed Labour at the last election, playing a big role in assuring the party’s landslide victory.
The chancellor said: “Austerity, Brexit, and the ongoing impact of Liz Truss’s mini-budget, all of those things have weighed heavily on the UK economy.
“Already, people thought that the UK economy would be 4% smaller because of Brexit.
“Now, of course, we are undoing some of that damage by the deal that we did with the EU earlier this year on food and farming, goods moving between us and the continent, on energy and electricity trading, on an ambitious youth mobility scheme, but there is no doubting that the impact of Brexit is severe and long-lasting.”
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