Tuesday, January 18, 2011

Reform or Reduction?

Andrew Lansley made his first appearance on Radio 4's PM programme yesterday afternoon, attempting to justify the radical restructuring that he is inflicting on the National Health Service - the jewel in the crown of the post-war welfare state and something that the Conservatives appear determined to rip from its setting and flog to the highest bidder.

Lansley said that he has learnt that 'he doesn't know best' - which raises the question of why he is introducing changes not mentioned in the Tory manifesto and not detailed in the coalition agreement. A restructuring so massive that it can 'be seen from space' according to one senior NHS manager and on a scale that has never been tried before. It is a shift that worries managers, medical staff and unions and one that is not demanded by patients - who are happier with the NHS now than they have ever been. Despite promising no more top-down restructuring, the Tories are going to waste £2-£3 billion on a process that will stifle progress for two or three years.

Of all the 'reforms' proposed by the Tories and abetted by their Liberal friends, this uncreative destruction has the potential to do the most damage to the future health of this country, for it heralds the end of the National Health Service as an entity, to be replaced by private consortia focussed on profit and ripe for a personal insurance system. I hope that people realise what is being done without a mandate - there is a reason that this wasn't exposed to any scrutiny prior to the election, as the Tories knew that talking about the NHS was dancing along beside the third rail.

Where's Claire Rayner when you need her?

We really aren't going to understand what we have here until the Tories have dismantled it. And don't think that it can be put back together again - it can't. Once this is gone, it is gone for good.

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