Early in 2010, the Financial Timesreported ‘a long-term friend’ ofthe Prime Minister, DavidCameron, saying that he is‘more right-wing than people

think – he’s more free market than peopleimagine’. Before the 2010 general election,the view seemed to be at odds withreceived opinion. Cameron won theleadership of the Conservative Party as amoderniser, who – to the chagrin ofThatcherite loyalists – wanted to governfrom the centre-ground.

A year into the Coalition, Cameron’sgovernment is proving to be further to theright than most people expected. Inparticular, Cameron is dogmaticallypromoting a form of economic liberalism,involving a smaller state and marketisedprovision of public services. In this article,I examine claims made before the electionthat Cameron was a moderniser who wouldmark a return to ‘One Nation’ Conservatism,with its support for an active state topromote social ends. I then examine howthis squares with the Coalition’s radicalreforms to the public services during its firstyear. I compare the Coalition’s approach topublic service reform with that pursued byNew Labour after 1997, and conclude by

briefly suggesting an alternative view of thestate, one that does not reject the argumentfor reform of public services but whichdraws more directly on empowerment ofcitizens, as an end.

Conservative modernisationThe radicalism of the Cameron governmenthas taken many by surprise, especially giventhe lack of electoral or popular mandate forits policies. Cameron was elected partyleader in 2005 as a ‘moderniser’ who wouldtake the Conservative Party back to thecentre ground. There had been earliermodernisers in the Party’s recent past –notably Michael Portillo (after something ofa reinvention in the late 1990s) – but it wasthe sustained electoral losses of 1997, 2001and 2005 that resulted in a modernisersucceeding as leader. From the moment heannounced his leadership bid in 2005,Cameron attempted to distance theConservatives from their image as the‘nasty’ party – or to ‘decontaminate’ thebrand, particularly from associations withthe more divisive aspects of the Thatcherand Major governments. He announced hiscandidature saying: ‘This Party has got tolook and feel and talk and sound like a ©

2011 T

he A

uth

or.

Pu

blic

Po

licy

Rese

arch

© 2

011 I

PP

R

public policy research – March–May 2011 23

Simon Griffiths reviews a year of public services under theCoalition and tries to square the radical programme ofreforms with the pre-election notion of Cameron as a ‘OneNation’ Conservative. If Labour is to effectively challengethe Coalition’s anti-state arguments, he says, it needs tofind a compelling narrative about the role of the publicservices and the place of the state in their provision.

The retreat of thestateConservative ‘modernisation’ and thepublic services

completely different organisation.’ In a 2006speech to the centre-left thinktank Demos,Cameron warned the Party that they ‘faceirrelevance, defeat and failure’, unless theyreclaim the centre ground. After Cameron’sfirst 100 days as leader, the politicalcommentator George Jones noted: ‘Rarely aweek goes by without Mr Cameron ditchinga piece of traditional Tory policy orshamelessly pinching an idea from NewLabour.’ Cameron worked hard to present anew image during his years in opposition.He was pictured, for example, pursuing aseries of ‘green’ activities – sledging withhuskies on a Norwegian glacier or cycling towork. Cameron, it seemed, represented areturn to a more ‘caring’ Conservatism, amodern version of the ‘One Nation’Conservatism associated in the post-warperiod with RA Butler, Harold Macmillanor the Tory ‘wets’, which accepted asignificant role for an active state inpromoting welfare and limiting inequality.

All this led to severe criticism from someon the right of the Conservative Party, suchas Norman Tebbit, who compared Cameronto Pol Pot for what he saw as Cameron’sneglect of Thatcher’s place in the Party’shistory. Former Daily Telegraph and EveningStandard editor Max Hastings wrote:

‘Plenty of party activists and MPs harbourprivate misgivings. They were appalled whenCameron publicly renounced school selection,appeared to rule out radical reform of the NHSand downgraded tax cutting as a priority . . .Nor do they much care for the idea that theparty’s Central Office will impose candidatequotas of women and gays’.

Yet, for all the talk, there remained a feelingthat this was conjecture, that Cameron’sideological beliefs were hard to make out.Prior to the general election, his team

remained purposefully vague on policydetails. His attempt to drag the Party to thecentre surprised many who noticed adisjuncture between Cameron’s early careerbehind the scenes for the Conservatives,where he was seen as being on the right, andhis more recent image. In an article entitled‘Mother’s Boy’, on the relationship betweenCameron and Thatcher, the academicStephen Evans asked whether Cameron’s‘inner Thatcherite’ would triumph over hisreforming self. As the political economistAndrew Gamble commented, ‘the realnature of Cameron’s Conservatism isunlikely to emerge until he is forced to defineit by the nature of the choices he makes inoffice’. Thatcherism, for example, did notemerge as a ‘public philosophy’ during herperiod in opposition from 1975–1979 – it tookthe privatisations of the early 1980s and theFalklands War before it became clear. NowCameron is in office, his ideological views arebecoming apparent.

The marketisation ofpublic servicesWhat is noticeable, when it comes to themain policies of Cameron’s government, is alack of faith in the ability of the state toachieve social ends. At one level this is seenin the Coalition’s stance on fiscal policy. Thecuts in government expenditure are severe.As Robert Chote, formerly Director of theInstitute for Fiscal Studies and nowchairman of the Office for BudgetResponsibility noted, the government’sresponse to the economic crisis means thatthe UK will undergo ‘the longest, deepestand most sustained period of cuts in publicservices spending at least since the SecondWorld War’. The Coalition has pledged toeliminate the bulk of the structural deficitover the course of this Parliament. This is farfaster than Labour and, until the election,the Liberal Democrats had proposed.

At another level, the retreat from the stateinvolves a rethinking of the role it plays inpromoting social ends. It is not the extent of thecuts in public services that was unexpected,but the radicalism of the pro-market reforms

public policy research – March–May 201124

© 2

011 T

he A

uth

or.

Pu

blic

Po

licy

Rese

arch

© 2

011 I

PP

R

Now Cameron is in officehis ideological views arebecoming apparent

now occurring. The state is beingwithdrawn from areas of public life itpreviously occupied. In theory, pro-marketreforms have two related elements: the firstis the devolution of power to service users,allowing their choices to shape services; thesecond is the creation of diversity of supply,so that organisations operate under marketor quasi-market conditions, creating moreefficient and responsive public services.

The delayed white paper, Open PublicServices (which appears to be undergoingsomething of a rewrite behind the scenesfrom its earlier, more radical incarnation), isstill likely to take market involvement in theprovision of public services further than everbefore. Trailing the paper earlier this year,Cameron argued that public services neededa complete transformation. Writing in theDaily Telegraph, he explained that the whitepaper would ‘put in place principles thatwill signal the decisive end of the old-fashioned, top-down, take-what-you’re-given model of public services’. Hecontinued that ‘the grip of state control willbe released and power will be placed inpeople’s hands’ and to achieve this ‘publicservices should be open to a range ofproviders competing to offer a betterservice ... [I]nstead of having to justify whyit makes sense to introduce competition insome public services – as we are now doingwith schools and in the NHS – the state willhave to justify why it should ever operate amonopoly.’ For critics, such as TUC generalsecretary Brendan Barber, the plan was a‘naked right-wing agenda that takes us rightback to the most divisive years of the 1980s ...[T]oday’s proposal to privatise everythingthat moves is exactly the kind of proposalthat voters would reject if put at an election.’

The Open Public Services white paper wouldbuild on a radical marketisation of publicservices already underway. In health, theCoalition’s proposals have been described inThe Lancet as ‘the biggest changes in theNational Health Service (NHS) in Englandsince the service began in 1948’. The Healthwhite paper, subtitled ‘Liberating the NHS’(presumably from the state) sets out plans togive patients ‘choice of any provider, choiceof consultant-led team, choice of GP practiceand choice of treatment’ as well as extended‘choice in maternity through new maternitynetworks’. The resulting Health and SocialCare Bill currently going through Parliamentaims, among other things, to give newconsortiums of GPs across England the taskof commissioning the healthcare they deemappropriate for their patients and controlover the budget to pay for it; to abolish the150 or so primary care trusts and 10 strategichealth authorities which previously hadcommissioning roles; and to compel allhospitals in England to become foundationtrusts, semi-independent of Whitehallcontrol with, for example, the freedom toearn money by treating certain numbers ofprivate patients (currently around half ofhospitals already have that status).

Yet the government has failed to convincethe vast majority of professionals working inthe health service of the merits of the reforms.Again, the reason often expressed is a concernthat the proposals are driven by a desire tomarketise public services, without recourse toevidence about whether policies will drive upstandards for users. Writing in The Lancet,Margaret Whitehead, Barbara Hanratty andJennie Popay argue that:

‘The [Health] White Paper’s proposals are ideo-logical with little evidential foundation. Theyrepresent a decisive step towards privatisationthat risks undermining the fundamental equityand efficiency objectives of the NHS. Ratherthan ‘liberating the NHS’, these proposalsseem to be an exercise in liberating the NHS’£100 billion budget to commercial enterprises.’

The way education is provided is also beingdiversified. The Academies Act (2010), one

public policy research – March–May 2011 25

© 2

011 T

he A

uth

or.

Pu

blic

Po

licy

Rese

arch

© 2

011 I

PP

R

It is not the extent of the cutsin public services that wasunexpected but the radicalismof the pro-market reformsnow occurring

of the first pieces of legislation to be passedby the Coalition, aims to make it possiblefor all state schools in England to becomeacademies. In May 2010, the Secretary ofState, Michael Gove, wrote to every headteacher in England to encourage them toapply for academy status. Academies arelargely publicly funded independentschools free from state control, mainly atsecondary level. They can set their ownpay and conditions for staff, deliver theirown curriculum and change the length oftheir terms and school days. Low-performing schools becoming an academyare required to have a sponsor, generallyfrom the private sector.

The Academies Act also made possiblethe introduction of ‘additional schools’ –more commonly known as ‘free schools’. Thiswas a part of the Coalition Agreement, whichagreed to ‘promote the reform of schools inorder to ensure that new providers can enterthe state school system in response to parentaldemand’. Derived from charter schools in theUnited States and free schools in Sweden,English free schools are all-ability, state-funded schools, free of local authority control.Under the new plans it will become mucheasier for charities, religious or educationalgroups, teachers or parents to set up newschools. Critics of the model have, amongother things, attacked the freedoms these newschools have – described by Mary Bousted ofthe education union ATL as the freedom toteach ‘creationism instead of literacy’ – theeffect that these schools could have inincreasing segregation, and the lack ofdemand for them among parents.

In higher education (HE), thegovernment has also pursued a marketisingapproach. The Browne Review, which waslargely adopted by the government,provides an example of the reprioritisationof HE around the choices of students andthe diversification of supply. Browne arguedthat there should be no limit on feescharged by universities (a proposal rejectedby the government) and that new providersshould be allowed to enter the HE market.While the Browne Review must be seen aspart of a longer-term move to a moremarket-based system, the radicalism of itsproposals was much commented upon.John Thompson and Bahram Bekhradniahave noted that:

‘The idea of the withdrawal of the state fromthe direct funding of universities is deeplyideological ... It is instead driven by the beliefthat the market – and in particular studentchoice as the manifestation of the market atwork – is the best way of ordering things, andto the extent that government funding is to beprovided it should be provided in such a wayas to increase student choice.’

Since the general election, it is clear thatCameron’s modernisation of theConservative Party does not mark a returnto One Nation Conservatism, with itsacceptance of an active and involved state.It is presentational. As with Labour sinceKinnock, modernisation was a way ofdisassociating the Party from unpopularelements in its immediate past. In contrastto Labour, however, Conservativemodernisation has not meant substantiveideological changes. Cameron worked hardto project a different image of theConservatives and shifted debate away fromthe economy, particularly prior to theeconomic crisis in 2008, and from Europe.Negative associations with the divisivenessof Thatcher’s government and the crises-riven Major years were broken. Yet, a yearinto government, there is growing gapbetween Cameron’s presentation as acentrist politician and the radical ideologypursued by his government.

public policy research – March–May 201126

© 2

011 T

he A

uth

or.

Pu

blic

Po

licy

Rese

arch

© 2

011 I

PP

R

It is clear that Cameron’smodernisation of theConservative Party does notmark a return to One NationConservatism, with itsacceptance of an active andinvolved state

© 2

011 T

he A

uth

or.

Pu

blic

Po

licy

Rese

arch

© 2

011 I

PP

R

public policy research – March–May 2011 27

New Labour and theCoalitionThe use of market systems in the publicservices is, of course, not unique to theConservatives. The previous Labouradministration introduced significantincreases in the use of ‘choice’ for serviceusers, particularly in the health service.For example, patients were theoreticallygiven the right to choose betweenhospitals if they were moving fromprimary to secondary care. As with theplans put forward by the Coalition, choicewas made meaningful through adiversification of providers: for example,through the introduction of IndependentSector Treatment Centres (which useprivate health organisations to deliverNHS care) and foundation hospitals (inwhich NHS hospitals are given moreautonomy over management). It could beargued that the Coalition policies aresimply a continuation of thoseimplemented by New Labour.

Yet, there are significant differencesbetween the Coalition’s reforms and thosecarried out under the last Labourgovernment. First, Labour’s reform ofpublic services – including the use ofmarket mechanisms – was tied tosubstantial investment. For example,between 1997 and 2006, public spendingon health increased from 5.4 per cent toaround 7.3 per cent of GDP. In 2007/08,spending on the NHS was approximately£92 billion, compared with £33 billion in1996/97. Between 1997 and 2006,government spending on education rosefrom 4.5 per cent of GDP to roughly5.5 per cent of GDP. Under the Coalition,by contrast, marketisation is seen as a way

of reducing costs and is coupled with cutsto spending on services.

A second difference is over the extent towhich user choice can be introduced intothe public services: for example, whetherthere is choice between public and privateproviders or just within the public sector,what additional support is needed to assistservice users in making choices, andwhere the limits of user choice lie whenthey run up against expert advice. UnderGordon Brown’s premiership, seniorConservatives attempted to claim themantle of the ‘choice agenda’, arguing thatBrown was either a sceptic or that he didnot have the support in the Labour Partyto carry on with Blair’s choice-basedpublic service reforms. Pursuing this tactic,George Osborne risked alienating theright of the party by declaring in 2007that David Cameron was the true heir toTony Blair, while Brown was ‘OldLabour’. The tactic has some purchase, asthere remains a highly sceptical strand onthe left, active in both the Labour and theLiberal Democratic parties, aboutelements of the choice agenda and the useof non-public sector provision in somepublic services.

A third difference between Labour andthe current Coalition concerns the role ofthe state. For critics of New Labour, theParty’s attempts to deliver choice in thepublic services were flawed because theywere dominated by a statist approach. Thiscriticism is often couched in terms of arejection of post-war Labour ministerDouglas Jay’s claim that ‘in the case ofnutrition and health, just as in the case ofeducation, the gentleman in Whitehallreally does know better what is good forpeople than the people know themselves.’Speaking during Brown’s 2007 leadershipelection, Osborne argued:

‘Each public service is different. Each personwho uses that service is different too. Howcan the gentleman in Whitehall know whatis best for them? How can personalisation ofpublic services mean anything if you take the‘personal’ out of them? Yet that is the route

It is true that the Labour Partyas a whole would still envisagea more extensive role for thestate in the public servicesthan do Conservatives

public policy research – March–May 201128

© 2

011 T

he A

uth

or.

Pu

blic

Po

licy

Rese

arch

© 2

011 I

PP

R

Gordon Brown appears to be about toembark on. Public services that are only provided by the state.’

The Conservatives are keen to depictLabour – particularly Brown and now EdMiliband – as statist socialists in theFabian mould, who equate the publicservices with the public sector. Althoughthis is far from the case, it is true that theLabour Party as a whole would stillenvisage a more extensive role for thestate in the public services than doConservatives.

Over the last 30 or so years, the state hasgradually fallen from favour. At times, thishas resulted in a more responsive, user-centred approach to public serviceprovision. Yet the Coalition’s reforms markan historic and dogmatic rejection of theuse of the state to promote social ends.Cameron is clear on the state’s limits,writing in the Daily Telegraph that under thenew proposals on public services, ‘the statewill still have a crucial role to play’, but thenlisting a brief set of criteria limited to areassuch as fair funding, competition and access.He argues that ‘[t]hese importantresponsibilities for central government mustnever become an automatic excuse forreturning to central control.’

ConclusionsWhen David Cameron commented in 2005that the Conservatives have ‘got to look andfeel and talk and sound like a completelydifferent organisation’ many commentatorsassumed a rejection of the Thatcheriteinheritance and a return to a centrist formof One Nation Conservatism. Yet, looking,

feeling, talking and sounding different canbe carried out with little significant changeto one’s underlying beliefs. In government,the radical nature of Cameron’s economicliberalism – and what it means for the state– has become clear.

If Labour is to challenge effectively theresurgence of anti-statist arguments underCameron it needs to find a compellingnarrative about the role of the publicservices and the place of the state in theirprovision. There is scope for a plurality ofprovision in the public services. Yet themarketisation of public services on the scalecurrently being carried out is dogmatic. Attheir best, pro-market policies haveempowered service users and providedthem with greater choice (such as theintroduction of individual budgets insocial care), but the introduction ofmarkets must be on a case-by-case basis.The introduction of the market is not anend but a means, and as a means it may ormay not be effective. When operatingunder a framework regulated by the state itcan help provide efficient services focusedon the user.

During the 20th century, much of theLabour Party relied on a largely Fabianconception of the ‘all-knowing’ state asthe vehicle for a good society. Thisconviction meant that Labour was, by thelate 1970s, vulnerable to the argumentsput forward by the right that the stateconstituted a major constraint onindividual freedom: that it was, inHayek’s phrase, linked to serfdom whilethe market was linked to liberty. Suchneo-liberal language is now found in theCoalition’s white paper on ‘Liberating theNHS’ and elsewhere.

Rather than accept the right’sassociation of the state with serfdom andthe market with liberty, Labour can drawon those aspects of its revisionist socialdemocratic and new liberal heritage todefine the role of the state. A focus onempowering citizens, as an end, wouldcreate a clearer narrative. An account ofempowerment lies largely outside thescope of this paper. However, it is found in

Labour can draw on thoseaspects of its revisionist socialdemocratic and new liberalheritage to define the role ofthe state

a line of thinking that goes back toliberals, such as Hobhouse and JohnMaynard Keynes, and social democrats,such as Raymond Plant and Amartya Sen.In the public services, the question is whatmeans will best empower users? Labourneeds to make the case that in the publicservices the means to empower citizens

may be pluralist, but that end will not beachieved by the dogmatically drivenretreat of the state.

Dr Simon Griffiths is a lecturer in politics atGoldsmiths, University of London and a visitingresearch fellow at the Centre for Political Ideologiesin Oxford.

© 2

011 T

he A

uth

or.

Pu

blic

Po

licy

Rese

arch

© 2

011 I

PP

R

public policy research – March–May 2011 29