Tuesday, 5 April 2011

Shedding light on NHS policy

When the Liberal Democrat Spring Conference voted overwhelmingly against Tory-led plans for NHS reform, it seemed to many that this would introduce friction into the workings of the coalition. Now, however, David Cameron has been forced to rein back the ambitious plans following criticism from all sides. When Norman Tebbit and Shirley Williams are both strongly critical of the same policy, and for the same reasons, you know that there's something wrong with it.

Both coalition parties agree on the need for NHS reform, but the Liberal Democrats approach is that patients come first. This means having elected health boards. The Conservative plans involve giving control of 80 percent of the NHS budget to GP consortiums. Now, GPs certainly ought to have a say in how the NHS operates, because they see it at close hand and can be expected to have a good idea of what patients want and need. However, taking doctors who are skilled in the treatment of patients and making them into administrators is perhaps not the best use of resources.

The other thing is that Liberal Democrats say it is alright for the government to pay for private treatment if for any reason the NHS is unable to provide it on time. We should obviously work to close the gap, so that the same situation doesn't arise again later on, but when lives and health are at stake that's no time to go all ideological. The Conservative-led proposals though would have patients referred for private treatment even if the NHS was fully capable of providing it. It would have had NHS and private contractors competing on a supposedly equal footing - except the NHS doesn't have a vast marketing department dedicated to persuading GPs to use its services.

So, how did we get to this point? These plans weren't in the coalition agreement hammered out after the last general election. They weren't in any manifesto. They probably surprised David Cameron as much as anybody - he is on record as having said repeatedly that the NHS would be safe in his hands, and that there would be "no more pointless and disruptive reorganisations".

The whole thing seems to be the brainchild of Health Secretary Andrew Lansley. And while it seems likely that similar plans would have sped through unopposed in a purely Conservative government, the Liberal Democrats have shed just enough light on them to ensure that even the Conservatives can see the problem with them. That has to be a good thing.

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