Sunday, 26 February 2012

NHS Reform

Why should the NHS be improved? Well nothing is perfect and some feel that competition improves business. It may be the case that competition within the NHS can be healthy (no pun intended) but competition brings its own layer of bureaucracy and inefficiency. There may also be improvements to be made with accountability in the NHS . I am old enough to remember community health councils and at that time I had access to local politicians who were part of the decision making process. I have not had that ability for many years so some parts of the latest bill may be good.

The Labour Party seems to have forgotten that they were pro-choice in the NHS and wanted private companies to tender for NHS work. Now they seem to be against it. Obviously they feel that the latest bill is a step too far but I just haven't heard any detail because Labour is too busy scoring points about David Cameron's "no top down reorganisation of the NHS".

Labour don't mind privatising parts of the NHS and this may be a vote winner for them but it is almost certainly a vote winner for the Tories. Both of these parties will tell us that the NHS is free at the point of access and safe in their hands but is it right that private companies can hive off one small section and work it for a profit? So if there are amendments that limit the break up of the NHS workforce I think it is fair to say that they come from the Liberal Democrats. The problem is that this message is not clear. We can only assume that Liberal Democrats are making these amendments because ministers bear collective responsibility and they can’t tell us which bits they don’t like.

It is nice to hear politicians from all parties telling us that the NHS is safe. The trouble is that NHS morale is low and the service cannot be as safe as it was on these grounds alone. Whether the details of the bill are good or not sounds like the basis for a thesis but headlines are made by the general acceptance or rejection by the professional bodies and they are rejecting it.

David Cameron is certainly wrong about the importance of choice within the NHS. He is right about choice if this means that those who can afford it get private treatment but those who seek care within the NHS don't want choice. They want a good local service. They don’t care if the ambulance is private or public. They don’t want to choose between a doctor in the local hospital or one who does a similar job twenty miles away.

You may not be able to tell where Liberal Democrats are able to amend the bill but they were doing the same job in opposition when Labour were busy doing their bit setting up private organisations e.g. the privatisation of the out of hours service for GPs which has been a disaster. The current bill is significantly different from that which was originally proposed, and which would have been a Conservative disaster if the Conservatives had been able to do just whatever they wanted.

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