The Guardian notes the governments plans for NHS returns today.
I admit I have not read these plans in as much detail as I would like. There is good reason for that. I have some fairly pressing commitments that are reducing time availability for very much else this week. But I still think some thoughts are appropriate.
First, I campaigned hard against the 2012 NHS reforms from Andrew Lansley and David Cameron. I recall it being suggested in an academic paper that I was the fourth most active person in social media to do so. Unsurprisingly I do, as a result welcome a move that reverses some of the damage those reforms delivered, including the denial of ministerial responsibility for the NHS implicit in them.
But, secondly, we are now in a very different place from 2012. That's partly because of Covid, of course. That alone suggests that the timing for this reform is wrong. A review into Covid and the issues it has raised for the NHS seems to be much more important than hasty reforms at this moment.
Third, a focus on wellbeing and not process might also be appropriate as the focus of reforms. 900 NHS staff have, I think, now died as a result of Covid. Almost none of them are ICU staff because they have enjoyed the protection that they have needed from this virus. Others have not. The lessons for an organisation that under current management so clearly fails to care for its staff also need to be learned before reform is considered. That, though, would require consideration of funding, and I rather suspect that is not on the agenda right now.
But talking of funding, there is a fourth concern, which also emphasises how much has changed since 2012. Then I assumed an NHS under ministerial control would be less exposed to risk of corruption and deliberate misallocation of resources than one under devolved, or private sector management. Since then though cronyism has become the modus operandi of government, with considerable effort being expended to keep it that way by, for example seeking to bankrupt challenges to this corruption from The Good Law Project. As a result I am no longer sure that ministerial control by a person who appears quite happy for his friends to secure lucrative NHS contracts without any apparent qualifications to do so is quite such a good idea. It is staggering how far we have fallen in such a short time that I have to now consider this.
So, fifth, the control mechanisms seeking to prevent abuse of one of the biggest budgets in government is critical to this reform programme.
Added together, I am concerned. But most of all, my concern is that I have lost faith in the good faith of ministers, from whom acceptable behaviour can no longer be assumed the norm. This government might has a consequence achieved its aim. It is destroying confidence in government itself. And that is shocking.
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Well here is a review: https://blogs.bmj.com/bmj/2021/02/11/a-new-bill-to-reform-the-nhs-in-england-the-wrong-proposals-at-the-wrong-time/
As expected, the media positive spin should be taken with a large pinch of salt. It looks like we should all be very concerned, and the timing in the middle of the pandemic is undoubtedly deliberate to ensure that these “reforms” will not get the proper scrutiny they should.
Thanks
Indeed, like Brexit, they seem to have more to do with handing control without scrutiny to ministers than with any public good.
Unfortunately I don’t really think it’s possible to disentangle politicians from healthcare. It now turns out, for example, that despite healthcare implementation being largely devolved to the private sector in the United States Donald Trump failed to arrange for that sector to order enough Covid vaccination shots, particularly the pharmaceutical chains where annual flu shots are usually given.
https://www.theguardian.com/us-news/2021/feb/11/us-covid-19-vaccine-doses-order-biden
This makes it all the more critical that voters make wise choices in the politicians they elect to office. When you have a mainstream media that is heavily slanted to representing the interests of a narrow super-rich elite this task becomes exceedingly difficult.
Helen Schofield
“This makes it all the more critical that voters make wise choices in the politicians they elect to office. When you have a mainstream media that is heavily slanted to representing the interests of a narrow super-rich elite this task becomes exceedingly difficult.”
And yet after years of austerity, deceit, corruption and manipulation, people still vote for the charlatans. Why?
Could it be because the whole country’s suffering from ADHD?
https://www.psychologytoday.com/us/blog/the-athletes-way/201603/how-does-anxiety-short-circuit-the-decision-making-process
Indeed, constant stress stops the brain’s frontal lobes from working properly thus adversely affecting decision making, endless poverty with its associated stress a potent weapon in the war of the haves against the have-nots. Those latter, constantly hounded by stressors, are greatly disadvanted when it comes to planning, say, how they might alleviate their problems by throwing off their financial oppressors. Convenient, isn’t it?
Oh dear yet another top down review. Sound only no real change other than possibly making it worse. 10 years in prison for those resisting reform.
What I think covid has shown is that the NHS is not, to coin a phrase, fit for purpose. This is not the fault of the NHS or those working in it who have done an incredible job under extreme circumstances and will be required to do so for some time to come. The blame rests with Government, which in the last 40 odd years have mostly been Tory, who have underfunded it and played political games with it. The cronyism is the icing on the cake for the Tories.
The NHS waiting list now stands at an incredible 4.5 million, with covid far from finished, we have to assume it can only get worse. Many of these people will never get treatment, they will die first. It’s a national scandal, but where are the opposition when you need them?
Yet, despite all this the Tories still lead or hold steady in the polls. I’m not sure what to make of those who say they would still vote Tory, apart from the 20-25% hardcore, many of which would idolize Farage as leader given half a chance. It’s as much a failure of the opposition in showing a different way forward. If they can’t do that after what has happened with Brexit and covid they might as well give up.
@ MarP
Well I think most of us on this blog know how the exchange scenario will run under the current Starmer Labour leadership or indeed Corbyn led one:-
Starmer –
“This Conservative led government ought to be spending more money on the NHS!”
Johnson –
“But the government’s maxed out its credit card!”
Starmer –
“Oh OK then.”
(Starmer muttering under breath “Now what did I do with my expenses claim form?”)
I agree but see it as on a continuum since Thatcher herself – Thatcherism is reaching its logical conclusion. That is what is happening.
The only thing that has surprised me is how bare faced they are about it now.
But then again, they’ve had nearly 50 years to condition the public to accept it. There has – whether you like to accept or not – been a deliberate ‘project’ to get us to this point.
“The Road from Mont Pelerin: The Making of the Neoliberal Thought Collective”
Philip Mirowski. 2009
It’s a shocking read
I totally agree with you there PSR, and I’m the same with my surprise that we don’t even get the shiny veneer of pretend-democracy anymore. It’s getting like we live in a double country now – one with the elite, one with the plebs, and all plebland get to do is export to elite-land. Nothing ever seems to flow back in.
So glad you are highlighting this latest grab for more power by the government . I too campaigned against the 2012 act as I could see at the time the gross consequences . I do remember those in the Labour Party who refused to support it and what a surprise Corbyn was one of them. He went on to tirelessly campaign for the NHS and for better Social Care. That was why he was pushed forward to be leader of the opposition as he was the only one at the time who was standing up for the people and public services I have worked with the NHS over the years as well as originally starting my professional life as a nurse. The rant should have been anyone but the Tories . If there had been PR back in 2017 we would have had at least 3 years of reversing the damage done by the stories over the years Also we would not have the likes of Serco Deloittes Capita running our NHS and Social Care . No one can say it would not have happened any more than I have to admit this is my opinion and that of thousands of other socialists. It happened back on 1948 when the Tories said it was impossible. We will never know and now we have no
Opposition. The powers that be have won that one too
Keep our NHS Public (KONP) have concluded that, far from heralding the end of NHS privatisation, the plan is to actually make it easier for private firms, including US corporations, to take over the running of individual NHS “footprints” – there will be 48 in England. It will avoid the tiresome business of having to have competition when companies wish to take over services, something which the Johnson government clearly doesn’t consider necessary. https://keepournhspublic.com/government-used-crisis-to-increase-privatisation-nhs-white-paper-will-endorse/
The 2015 model then…..simply legitimised
In a speech to Parliament in November 1995, the late Tony Benn spoke about a fictitious boat race between the NHS and a Japanese crew. He said: “Both sides tried hard to do well, but the Japanese won by a mile. The NHS was very discouraged and set up a consultancy. The consultancy came to the conclusion that the Japanese had eight people rowing and one steering, whereas the NHS had eight people steering and one rowing. The NHS appointed people to look at the problem and decided to reorganise the structure of the team so that there were three steering managers, three assistant steering managers and a director of steering services, and an incentive was offered to the rower to row harder. When the NHS lost a second race, it laid off the rower for poor performance and sold the boat. It gave the money it got from selling the boat to provide higher than average pay awards for the director of steering services.”
This however was pirated from a similar tale from1982 and the time of the NHS Trusts
Then it was a fictional annual regatta involving Health Boards from all over Europe.
Every year the National Health Service romped home as easy winners until the formation of Trusts changed the picture completely and the Norwegian boat won for the first time.
The rest is as above.