Labour must bear the blame for the shameful decline of the NHS The problem with establishing who knew what, and when, is that the public-sector machine will close ranks against any attempt to shine a light into its murky world. The recent Francis Report on the deaths at Stafford Hospital is a prime example. This was a whitewash, blaming generalities such as the health service's "culture," rather than ministers and their policies. I have worked in government, and know how the information channels work, including those that reach Downing Street, and I find it inconceivable that ministers did not know what was going on. It is, of course, perfectly possible that Andy Burnham and his predecessors were kept in the dark, or actively lied to, but we need a rigorous inquiry to establish that - one covering not just Mid Staffs, but going into the advice ministers received about other hospitals on today's shameful list. It is not just in Westminster where there was, and still is, a problem. One central reason why Labour has been allowed to get away with the idea that it is the "party of the NHS," while presiding over such a shameful record, is that it benefits from the axis within the public services that tirelessly attacks those who dare to suggest that the health service might need to change. Most notorious is the treatment of Julie Bailey, the ex-nurse whose mother was killed by neglect at Mid Staffs, who has been the targeted of venomous abuse for speaking out about it. In 2011, union activists posted an internet video which stated they hoped she would die; she has since been subjected to a campaign of nuisance calls, threats and online vitriol; has been hounded from her business and her home and even seen her mother's grave desecrated. While there is no suggestion that the Labour Party in Westminster put anyone up to this, it must recognise that there are elements in its movement so determined to maintain state control of public services that they resort to smears and abuse. One party activist, Diane Smith, even claimed that Bailey was campaigning to close Stafford Hospital and sack local staff; allegations which she then had to withdraw. When I wrote in this newspaper about the need to bring transparency and competition into public services, a trade union activist used official Barnet council resources to send me a profanity- and abuse-laden tirade. The easy option for Andy Burnham and Ed Miliband would be to continue to deny all culpability for the NHS's failings, and to turn a blind eye to the local zealots who speak in their name. Or - as over party funding and candidate selection - they could unequivocally distance themselves from the union extremists, and show that they recognise where they have gone wrong. In doing so, their best approach would be to drop the ideological baggage and agree to some simple, tough decisions about how to prevent a repetition of the scandals that occurred on their watch. For instance, while they may never agree with the Government on allowing competition in the NHS, there is a clear case for urgent action over our worst hospitals. Of today's 14, there are at least six that cannot be turned around with their current management in place. So why not support an open competition for new providers, including private-sector ones if necessary, to take them over and turn them around on a payment-by-results basis? Next, there should be more transparency in the NHS - and we need to go much further than the present Government's introduction of an online rating system of hospitals. The Care Quality Commission, which Labour established, has recently been exposed for covering up abuse. It should not only be overhauled, but forced to produce simple, trusted league tables advising people about hospital safety and standards, much like Ofsted does for schools. Such ideas, however, are vehemently opposed by the trade unions - meaning there is little hope of Miliband being able to change Labour's current policy of taking the NHS back to a state-only system of "preferred providers" to deliver hospital care. But the voters are wising up: not only to Labour's past mistakes, but its lack of new ideas on how to fix things. For that reason, today may well be the beginning of the end for Labour's comfortable monopoly on being trusted to run our most valued public service. Sean Worth is a former No 10 special adviser