The Secret Revolution: Tory plans for the NHS

Posted on January 23, 2011


I tuned in to Thursday njght’s Question Time for additional reasons to usual last week, with Burnley FC defender and Professional Footballer’s Association chairman Clarke Carlisle amongst the panellists. Carlisle’s performance was assured if unremarkable on the show, where most heated debate amongst audience and panellists was over the Con-Dem government’s recently announced NHS reforms.

Few things unite George Galloway and Alistair Campbell, but in this instance they added their voices to the criticism of Health Secretary Andrew Lansley’s reforms. Under the new rules, Primary Care Trusts are to be abolished and replaced by consortiums of GPs. The reforms were not mentioned in the coalition agreement or the Conservative manifesto. Indeed, as Campbell pointed out on Thursday, the coalition agreement expressly states that no “top down reorganisation” of the NHS would take place during this parliament. Criticism has come from all angles, most pointedly from the Royal College of Nursing and the British Medical Association. The House of Commons health select committee has also gone on the record with concerns. There is no suggestion that GPs are in any great rush to take on the types of responsibilities, or that the public want their GPs spending their time on management responsibilities. I have my own doubts about whether the move is a good idea. For every GP that would thrive in such a role, there must be many who are not cut out for such an extension to their responsibilities. It seems to be forgotten that GP commissioning was adopted as a policy by John Major in the 1990s, yet scrapped by New Labour because it didn’t work. There is no reason why it should now. As Galloway pleaded on Thursday night: “Let GPs be GPs”.

The fact that GPs will be trusted with added responsibilities is not the major problem with the reforms, however. In spite of his pledges during the election campaign to protect the NHS and his swift slapping down of Tory MEP Daniel Hannan when he criticised the service back in 2009, it seems Cameron is no fan of the NHS or what it stands for. Indeed, just as his party are using “deficit reduction” as a smokescreen for the zealous cuts the likes of Cameron and Osborne secretly crave, the term “NHS reform” merely disguises what is in fact the first phase of NHS privatisation. As Polly Toynbee says, “GPs are camouflage for the true Cameron revolution”. Though he denies it, one gets the feeling that Cameron does believe the NHS is “second rate” and that opening it to market forces is the only way forward. Indeed, these reforms signal the start of a creeping privatisation that will not work in the favour of patients, but the private companies that stand to benefit from the new rules.

Diane Abbott points out that patient satisfaction with the NHS is at a record high. It does not seem that Cameron and Lansley are listening to patients and NHS staff at all, but merely pushing ahead with a marketisation agenda of the sort they previously insisted would never be implemented. Cameron is partly correct when he argues that he is merely ppicking up where Tony Blair left off in terms of “modernising” the service, but Blair would never have gone so far. Neither, in all honesty, would Margaret Thatcher, a political inspiration to both Blair and Cameron. And that is because both patients and staff are against opening the NHS up to the market. For that is what these reforms will do. GPs will inevitably hire private companies to help. Competition is at the heart of the proposals. And though Lansley claims providers must compete on quality rather than price, it will only be a matter of time before the NHS is fully at ther mercy of the rules of the market.

The reforms have the potential to be disastrous for the NHS, as numerous commentators have pointed out. Behind the scenes, they are driven by a Conservative agenda to break up the NHS and distribute health provision amongst private companies. The British people don’t want it; NHS staff don’t want it, but Andrew Lansley’s NHS reforms set the NHS on a road that will inevitably result in market forces deciding whether patients live or die. And that is a crime.

Posted in: Politics