February 22, 2012
The former Tory Chancellor of the Exchequer, Nigel Lawson, famously called the NHS “the closest thing the English have to a religion.” This oft-quoted truism is once again doing the rounds as the furore over the Health and Social Care Bill boils on despite continuous opposition from almost everyone in the profession and large swathes of the public. Ed Miliband even had a good soundbite in PMQs when, citing supposed (and since refuted) opposition to the reforms from the Tory Reform Group, he hit Cameron with the line that ‘Even the Tories don’t trust the Tories on the NHS.’ Lawson’s judgement remains an apt assessment of how important the NHS is to the British people and the corresponding distrust of creeping privatization into this most popular institution of the welfare state. For an example of this instinctive distrust of marketisation of the NHS, last week’s Question Time saw the American business woman, Julie Meyer, jeered by the audience when she suggested that we should turn it into a ‘trillion pound British healthcare industry.’ Perhaps this response was unsurprising given how America somehow squanders away 16.2% of its GDP on healthcare (as opposed to 9.3% for the UK) and yet leaves around 50 million people, or approximately 16% of its population, without healthcare. However, I want to focus on the bad politics surrounding this bill. I lack sufficient expertise and willpower to dissect or examine the 367 page bill itself.
Firstly, this bill was not democratically mandated. The much cited Coalition agreement set out that the government would ‘stop the top-down reorganisations of the NHS that have got in the way of patient care.’ Further to this, the Tory 2010 manifesto stated that ‘more than three years ago, David Cameron spelled out his priorities in three letters – NHS. Since then, we have consistently fought to protect the values the NHS stands for and have campaigned to defend the NHS from Labour’s cuts and reorganisations.’ Occasionally there has been an attempt by the government to claim it is not top-down but bottom-up change. However, one Tory MP argued that ‘stripping out primary care trusts (PCTs) and strategic health authorities is as top down as it comes.’ Even if certain clauses in manifestos gave hints of coming organizational changes, no radical transformation was openly offered up at the last election by either the Tories or the Lib Dems. Instead, the government is open to accusations of dishonesty and hypocrisy given the record of both the Tories and Lib Dems in critiquing overly zealous top down New Labour reforms of the NHS.