The NHS worked. Now it’s biggest threat is reform

Posted on

I don't always agree with Will Hutton. This morning I do. Writing in the Observer his article is entitled:

The NHS is loved and efficient, so why the obsession with reform?

Will and I obviously share something in common. Over the last six months he has seen more of chemotherapy suites than he would ever have wished to. Over the last year so did I. The cancers our family members have had to deal with are different and I now know that the prognosis for my family member is very good, but the stresses are probably not that dissimilar, and the admiration for the NHS and those who staff it are the same. I hope his family member's treatment is as successful as mine has been.

What this reinforces is what I have written this morning, which is that the state can be an extraordinarily efficient supplier of services. In the case of the NHS it has been.  It has been a world beater. But I write, with care, in the past tense. As a minister has admitted today, as a result of this government's reforms it has already lost control of the NHS. In that case there is, as such, no NHS left. There is just an unaccountable use of public funds that cannot in any way be guaranteed to deliver the care that is needed in a consistent, reliable or acceptable way.

This is because in the last year the NHS has met head on the one thing that can destroy it. That is competition. The whole logic of competition is predicated on failure. Without it competition cannot work, and yet failure is wholly unacceptable in the NHS. I know that supposedly regulation prevents such failure but that makes the competition pointless: it is not then competition at all but regulated monopoly that merely passes revenue to the private sector, which is what the Cowardly State promoted by George Osborne sets out to deliver.
And be under no illusions that the NHS is not under threat from that process. Osborne wants to cut the number of people employed by the state by 1 million. That is not possible unless large parts of the NHS are privatised. This will destroy it. The NHS exists for the common good and can only survive with its support. As Will Hutton concludes:
Anyone could find themselves stricken with leukaemia, even health secretaries and report writers. Their chance of a successful cure will depend on the rest of us resisting the "reforms" they so ardently advocate. We can own and we can pay for a great health system. It just takes the collective will.
That collective will is the antithesis of the competition that is being forcibly imposed on the NHS. The government wants to break the back of the great collective ideal. We know that. But I admit I still do not know where other major parties stand on the issue. After all, Labour began this process. Unless it says it has abandoned competition and marketisation in the NHS  what sort of an alternative is it? And that is an important question. One more parliament with this regime in place and there won't be anything left to fight about.