Fight the Power

Liz Kendall is in fighting mood, and it’s no wonder. Fresh from her morning run along the banks of the Thames, she reveals the music of choice on her iPod: old-school, hardcore hip hop.

“I mostly listen to rap,” she explains. “I do listen to some Eminem, I listen to Dr Dre – my favourite – and loads of Jay-Z, but from the good old days of The Black Album. I listen to a bit of Public Enemy. It’s brilliant – particularly if I’m about to speak in the Chamber.”

Lean and keen, but with an added steel that belies her youth, the Shadow Health Minister likes to punch way above her weight on everything from the NHS and childcare to Trident and the future of the Labour party. And while hitting the streets is her favourite way to start the day, she’s also relishing the pavement-pounding of the general election, both in her Leicester West constituency and around the rest of the country.

As she explains her mission to reform public services, ‘Fight the Power’ sounds more like a personal political credo than a mere running rhythm. “There are real challenges for the main parties in trying to show people we are actually the insurgents,” she says, referring to surveys showing the Greens are now polling strongly among under-24s. “I feel insurgent. I don’t feel part of the status quo, I want to change things. I want to change what’s happening at home [in Leicester], I want to change things here [in Westminster], I want to change the economy and our public services. I feel insurgent. And that is what you need, young people want more of that, and a bit more honesty, that you can’t snap your fingers and change things overnight, but that you are hungry for change.”

And one area of public policy Kendall believes is desperately in need of some radical change – and a bit of power to the people – is health and social care. She recently visited Northamptonshire to see first-hand the success of the area’s pilot scheme in personal health budgets in mental health services, and describes the experience as “one of the two best days of my life since becoming an MP” (the other, she adds, was the day Islington’s Labour council introduced the London living wage for home care workers).

Kendall says she will never forget the stories of the people she met whose lives had been transformed by the scheme, particularly the cases of a woman called Mary, who had attempted suicide on dozens of occasions before she used her personal budget to purchase a more intensive course of talking therapies, and Alex, a military veteran who struggled with mental health issues following a stroke. “He became very depressed afterwards, for all sorts of reasons,” Kendall explains, visibly moved. “He found driving and remembering routes, for example to his GP, very difficult. He stopped going out and stayed at home, and felt his life was getting worse and worse. And then he got a personal budget for mental health and he bought a sat nav! He started going to his outpatient appointments. Then he decided he was going to go to a stroke support group, and that made him feel better. Then he started picking up other people and taking them there so they could help one another.

“He said he didn’t want to go on living before he got that budget. But it transformed his life, and it’s that kind of change we need. Because how can a clinical commissioning group – let alone a national government – know in detail what every single individual really needs for them? It’s about putting power and control back into people’s hands.”

While she admits the scheme “would not work for everybody in every circumstance...and if you really believe in giving people choice and control then it includes the choice not to have that”, she says if the right help and support is offered, the programme could be a success in other areas of healthcare too.

“We’d like to go much further in that. Ultimately if you believe that there shouldn’t be a divide between physical health, mental health and social care services in budgets at the council and NHS level, why wouldn’t you be putting them together at the personal level? The people who know best how to join up their service and support are patients, because they don’t see their needs through the prism of separate silos. The people who know best how to shift the focus of care towards prevention are patients, because they’re the ones who suffer if they don’t get services early on. And the people who know best how to root out inefficiency and waste are the people who use services, because they’re the ones who have to spend time talking to people time and time again, which isn’t good for them and is a waste of resources.”

Across the health service, from diabetes to social care for the elderly, Kendall says it’s increasingly clear that a focus on prevention and patient-led care packages is not only key to improving outcomes, but also to reducing costs and easing the financial pressures on the NHS. With the future of the health service proving a key election issue, Kendall argues that there is a natural temptation for politicians and the media to focus on headline-grabbing figures for extra funding – “is it £2.5bn, is it £8bn?” – rather than the more knotty issue of reform. “Everybody always jumps to the extra money,” she says, “but actually we very rarely focus on the long, difficult but vital issues. My personal mission is to make sure that we never take our eyes of those reforms. Because it’s not just about the money, it’s about different outcomes.”

The left in particular, she says, has a responsibility to show that “social justice” and fairness in public services can be delivered at a time “when there is less money around”. “There’s nothing socially progressive about wasting money on services which aren’t achieving outcomes for people. As Bill Clinton said, it’s down to the people who believe in the power of the state to improve people’s lives; the onus is on us more than anyone to be pro-reform, because it is the people without power, wealth and opportunity who suffer when public services fail.”

The political row over the NHS has become increasingly fraught in recent weeks, with Ed Miliband making the A&E crisis the centrepiece of his attacks on David Cameron at PMQs. But the Labour leader has himself faced criticism over allegations he told senior BBC figures that he planned to ‘weaponise’ the health service. Asked if she has personally heard anyone in the party use the damaging phrase, Kendall emphatically insists she has “never, ever” come across it “from any person I’ve had a conversation with in the Labour party or the labour movement”.

In fact, she accuses Cameron himself of seeking to “play the political card on the NHS when it suits him”, whether over the record of the Labour administration in Wales or the Mid Staffs scandal. “I think one of the most disappointing things about Cameron, and Jeremy Hunt, is the NHS is all about politics for them,” she says. “But actually what you need is a man with the plan, and the men – and woman – with the plan are Ed Miliband, Andy Burnham and myself.”

Next Tuesday, Labour will outline its 10-year vision for the future of health and care, a plan Kendall says represents the clearest analysis of the problems facing the NHS in a generation. “If you think about the three previous prime ministers and their health policy, whether it’s Tony Blair, Gordon Brown or David Cameron, they had nowhere near as clear analysis of the problems and the solutions as we now have,” she says. “Successive governments have continually reorganised the backroom structures of the NHS, and it’s rarely if ever achieved the savings or the outcomes people want. We have learnt about what works and what doesn’t work in driving change.”

On private sector involvement in the NHS, she insists there “will remain a role” for private and voluntary firms “where they can add extra capacity to the NHS or challenge to the system”. “I’ve always believed what matters is what works,” she adds, citing the positive contribution independent sector treatment centres (ISTCs) have made in reducing waiting times. “I remember when I worked in the Department of Health a very senior clinician saying ‘you’ve got one of these ISTCs down the road now so I’m going to have to talk to some of my GP colleagues about getting my waits down and stop doing so much private practice’. So it did bring challenge to the system. It was the NHS – and the increased investment we put in the NHS – that delivered the vast majority of the reductions in the waits. But some challenge in the system was crucial to that.”

But she warns against a tendency to see the issue of NHS reform as simply about more private sector involvement. “I think people do worry that there is a kind of ‘reform’ which is to just ‘put it out to the private sector’, when actually what you want is to reshape services locally and, I would argue, nationally too,” she says. “Salami-slicing cuts and simply putting things out to tender isn’t what I call real reform. That isn’t to say that there isn’t an important role for the independent and private sectors. But real reform is more difficult than that.”

Kendall is certainly nothing if not a moderniser. Her career reads like the perfect CV for a health minister: a former special adviser to Patricia Hewitt, King’s Fund researcher, policy wonk at the IPPR and erstwhile director of the Maternity Alliance charity for new parents. She knows health, childcare and social care policy intimately. 

She stresses how the NHS has to learn from new technology to cut costs, while delivering better consumer satisfaction and more joined up care.

“It is a disgrace how little we have used technology to transform people’s experience. This [she points to her iPhone] is part of my life now and that is how people increasingly expect to interact with the NHS.” But she’s not just in favour of more medical consultations by Skype or phone.

“Some people think ‘oh it’s just some pushy middle class people wanting to get things from their doctor when and where they want. I don’t think there’s anything wrong with making sure that our NHS needs to meet the needs and demands of middle class people or anybody else. But actually technology is about something much more powerful than that. It’s about allowing people to manage their condition.”

Kendall cites the example of an arthritis club in her constituency that helps sufferers share information on social media. Another scheme helps pensioners with breathing difficulties by letting them take their own oxygen and blood readings at home, relaying them electronically to a nurse.

“I went to the States to look at what they are doing there and it’s very interesting that one of the fastest areas for venture capitalists to be investing their money is health and IT. One half was in medical records, the other half was in health apps. Follow the money.”

She’s as keen on reforms highlighted by NHS chief executive Simon Stevens (a fellow former Blairite special adviser), to get different services working from ‘multi-use’ facilities. “We’ve got to get the best out of all our assets,” Kendall says. “If I look back to my greatest passion in life, which is about giving kids the best start in life: we need to make sure that our health visitors, midwives, Surestart and schools are all joined up. If we want to get parents understanding that the way they interact, talk with and play with their baby can have a huge impact on their later life chances, why couldn’t your first midwife appointment be at your SureStart or your local school? It’s about joining all that up to get the best outcomes for people.”

In public services, as with personal health budgets, “people want a sense of control over their lives”, she says. “Money gets you choices and chances and opportunities, a cushion and networks and contacts, I want to see those available to everybody.”

Another Blairite characteristic that Kendall is unafraid to display is her hawkishness on defence and foreign affairs. Asked if she now regrets voting with the leadership on Syria in 2013, she replies: “No. I don’t, but I think it is really important that we make a strong case for Britain’s role in the world, and that it is in our national interest to do so. Many would wish we could put up the drawbridge and hope the rest of the world goes away. Labour must and will remain firm in our belief that we do have an active role to play in the world along with others.”

So, it is time for the party to move on from its Iraq hangover? “We need a new generation of people to make a case for Britain to play an active role in the world along with our international partners. Politics in the end is always the route to solving some of the big challenges we face – but the ability for our military to act must always remain part of the range of tools that we use. It’s really important, when we see what’s happening with ISIL in Syria and Iraq.”

And to those who say the Syria crisis could have been curbed if the Commons had voted for military action two years ago? “I think Ed was right to say there were a series of important criteria that need to be met. And he’s also right to support the action the Government has taken in Iraq.”

Even Blair’s severest critics accept that his forte was winning general elections. With the 2015 campaign well underway, Kendall is already enjoying the race. Yet with Labour appearing to flatline at 30-32% in the polls, isn’t it true that the message isn’t cutting through on the doorstep?

“When you are able to talk to people face to face rather than through anybody else’s prism it’s always much better,” she says. “But I think it will be incredibly close, it’s all to play for there are still a lot of people still undecided. The challenge and the prize is to set out a credible message of hope that things can be better for you and your family and this area. It’s about credible hope. The party that nails that message I think will be the one that comes through. You can have easy headlines like UKIP or the SNP make, it’s always somebody else’s problem, it’s Europe’s problem or all the problems in Scotland are down to Westminster. Or the Greens who say it’s all this awful globalisation. Easy answers to very tricky problems.

“I think people understand that if we are straight and honest with them we can make a big difference, if we work together. Not simply thinking that somebody else is always to blame. For me this is the big choice.”

And she reveals she’s even had to rehearse her Labour doorstep pitch with her own parents, both of whom take a keen interest in politics. “A lot of my election campaign is spent dealing with texts from my parents,” she says. “With comments on everything from ‘it was a disgrace on PMQs today, what are you going to do about it?’ to ‘nobody’s talking about old people’, ‘what are you doing for my brother?’, ‘what are Labour saying about schools and families and kids?’

But does she get the same reaction as some colleagues when they canvass ‘soft Labour’ supporters:  that they can’t vote for Ed Miliband? “I don’t get that, that’s not what I get. I get ‘What are you going to do about it? None of you make any difference.’ That’s what I get. Less so on my own patch…although you still get it.”

And she has a broader point about the need for Labour not to been seen as negative. “You can’t be the moaning man in the pub. Actually the moaning man in the pub often has a real point underneath it all. But mostly you end up not listening,” she says. “People want us to hold the government to account but they want a credible solution. And I think many people understand that on most of the big changes we need to say people will have to play a role themselves, it’s not just something you can just click your fingers from here [Westminster]. We can’t really turbo-charge our economy unless we also change what’s happening in the European economy. We can’t really transform our kids’ life chances unless we work with parents to give their kids a start in life, we can’t improve our health unless we all take on more of a role. That’s where we started as a party.”

As for Blair or even David Miliband possibly appearing again on the campaign trail, Kendall says it’s up to “this generation of Labour MPs and shadow ministers to be leading the campaign”. “People want to feel and see something different. If there’s one thing that Tony rightly taught us all, it is that our values stay the same but the policies that we need change as circumstances change around us. It’s down to Ed and the Shadow Cabinet to lead this now.”

Some in the party say privately that Kendall herself has the passion and brains to make a future Labour leader. Does she rule out the leadership? “If anyone says anything nice about me it’s incredibly flattering,” she says, before adding firmly: “All I care about is winning on 7 May. All I care about is getting Ed into Downing Street, full stop. That’s it.”

In the meantime, Kendall’s morning runs, 5 or 6 times a week, despite freezing cold or driving rain, are her own way of keeping it together amid her hectic schedule. “I run from near Vauxhall Bridge to the Millennium Bridge and St Paul’s – ah, it was lovely this morning – and back round for Westminster. I do the Great Central Way when I’m at home and the big difference is you smell stuff in Leicester. You can smell grass and flowers and damp. You don’t smell anything in London,” she says.

“I love it. I run for myself not as competition against anybody else. Haruki Murakami in 
What I Talk About When I Talk About Running, he’s the only person who’s ever described it well. You don’t think about all the separate things in your professional life and your personal life and focus on them, they just kind of percolate around in your head and afterwards you feel a bit more sorted. You feel great.”

But even at the tender age of 43, her body is beginning to feel wear and tear, she says. “I’m properly addicted to running, but I have to find something else because I can hear my knees. Yes, I can hear my knees. It’s a disaster. It’s not good.”

How about taking up cycling? “I would worry that I would get road rage,” she laughs, imagining the run-ins with cabbies and bus drivers. “I can’t do that, an MP shouting abuse! And I would, I know I would.”

So for now, she’s sticking to the pavements and footbridges of the capital and Leicester. Few MPs have an interest in both hip-op and hip-ops. But running against the forces of conservatism, in music and in politics, seems to be the activity Elizabeth Louise Kendall likes most of all.

KENDALL ON…PRIVATE HEALTH INSURERS

“I have been spammed by private insurers increasingly over the last year or so. People’s worries are increasing as [treatment] waits go back up.”

KENDALL ON…HOW LABOUR CAN WIN

“It’s about the degree to which we are simple and straightforward with people about the really big challenges and don’t provide false promises but something credible.”

KENDALL ON…THE TORIES’ EUROPE POLICY

“It’s not to work with our partners to reform Europe so that it’s a stronger growing economy that we can export into. It’s to have some sort of individual little repatriation of powers.”

KENDALL ON…TRIDENT RENEWAL

“It’s been agreed by our national policy forum. We have to remain very, very firm on that in a very dangerous world.”

KENDALL ON….CHILD ABUSE INQUIRIES AND WESTMINSTER

“Absolutely no stone should be left unturned…whether it’s any part of the Establishment, that has to be looked into.”

KENDALL ON…HER 2010 TWITTER REPRIMAND

“It’s ridiculous, the [State Opening] is broadcast. I’m all for obeying rules when I think they have a point, but I didn’t really understand that so I wasn’t mortified at all.”