From this morning’s Radio 4 ‘Today’ programme, an interview by Justin Webb of Andy Burnham MP Shadow Secretary State for Health.
This transcript is to the best of my ability, and is (c) of my blog and cannot be reproduced without my express permission. There are precise words here in this particular transcript.
Justin Webb
Labour’s view is clear. Mr Cameron himself must show leadership, grasp the nettle, and drop the Bill. The Bill being the Health and Social Care Bill, the hugely controversial reorganisation of the health service in England, and that Bill being back before the House of Lords today, with Labour hoping to damage it further by getting the government defeated on crucial provisions – including a new rule which would allow hospitals to raise up to 49% of their income from private patients, provided that money were ploughed back into NHS services. The Government says that Labour is launching an opportunistic attack, with no real sense of a properly thought-through alternative. The Shadow Health Secretary is Andy Burnham, and is on the line now. Good morning to you.
Andy Burnham
Good morning.
Justin Webb
Can we deal with that 49% thing first – what is it that you object to? You allowed, didn’t you, hospitals to make some money from private patients, but it was capped quite low. The Government simply wants to raise that cap.
Andy Burnham
We did Justin. We did Justin but it was carefully controlled, activity at the margins of the hospital. This Bill would take it up to a whole new level allowing the hospital to earn up to half of its income from treatment of private patients, so that’s 1/2 of appointments, theatre times, beds, car park spaces, devoted to the treatment of private patients.
Justin Webb
But no – they’d have to build extra to do it. They wouldn’t be taking existing NHS beds and turning them private?
Andy Burnham
That’s the point isn’t it? They wouldn’t have to. The effect could be that NHS waiting lists get longer, and people simply won’t accept that with hospitals built with taxpayers’ money which should be focused on treating NHS patients.
Justin Webb
Why would that be? They wouldn’t be focused on it, they’d be raising money from it which would be ploughed back into the NHS.
Andy Burnham
The Government’s Bill is producing a competitive market. They’re essentially saying to all hospitals that they’re on their own. You’ve got to find the money to survive. That’s a big break with NHS history. We’ve had a system which has been collaborative where systems support each other. They’re saying, with this Bill, to hospitals that they’re on their own – they’re saying to them that it’s a competitive market, you’re on your own, and you have to use these freedoms to protect your bottom line. My fear is that they would begin to devote more time for private patients squeezing NHS patients out, and that will be a return to the bad days of the NHS where people were told ‘wait longer, or go private’.
Justin Webb
But again, under Labour, independent sector treatment was introduced, wasn’t it? In NHS hospitals, treatment centres were introduced, run by private organisations, some would say they worked rather well, an element of private competition introduced by Labour and working?
Andy Burnham
That’s true we did, and that capacity allowed us to deliver lowest-ever waiting times in the National Health Service. The context was different, Justin. Let me explain that. We introduced those providers within the context of a planned collaborative system, so that the extra capacity was managed. And by the end of our time in government, around 2% of operations were conducted in the private sector. That gives you an idea of the type of scale we introduced.
Justin Webb
Yes, but that’s terribly important. You say collaborative, but it wasn’t entirely collaborative, in that there was an element of competition – which was terribly important wasn’t it? The point of doing it was to “gee-up” the NHS, in order, in this specific case … to get waiting lists down, which it did, didn’t it? It wasn’t entirely collaborative, in that there was an element of competition then that was terribly important.
Andy Burnham
Competition was with controls, that’s my point. The Bill takes the controls away – takes the brakes away off the system. This Bill would throw up the NHS to the full force of NHS competition law where every contract which takes place will be open to competitive tender. That is a huge change from the NHS we left behind – we had collaborative NHS with good standards of care. That’s the question that I keep on coming back to: why on earth are the Government turning it upside down? They inherited a self-confident NHS, and in just 18 months they’ve turned it into an organisation which is demoralised, destabilised and fearful of the future.
Justin Webb
Here might be why. While there was increasing spending and waiting lists came down, there’s no doubt that productivity reduced? It is actually inconceivable that the NHS can carry on in the future in the way that the NHS is organised currently. We won’t be able to afford it, and if we want to be able to provide the health for ourselves, run the health service for less than 10% of GDP which you do as much as the Government does, we have to find a way of delivering the service in a better way, and a more productive way?
Andy Burnham
I am afraid I don’t accept the premise of your question. NHS is one of the most efficient systems in the world. That’s what the independent experts tell us.
Justin Webb
The National Audit Office in 2010 said that taxpayers were getting poorer value for money than 10 years previously.
Andy Burnham
Well, the Independent Commonwealth Fund makes a comparative study of health systems around the world, and repeatedly tells us that the NHS is one of the most efficient systems in the world. We do spend less than 10% of GDP, but that’s not the case in other countries in France, the Netherlands, and certainly not in the United States. That’s why market-based systems tend to cost much more, A National Health Service gives you an ability to control costs. If you break that, the market runs riot. More broadly, you mention efficiency. It was a catastrophic mistake, in my view, that, when the NHS is facing such huge financial challenge, they’ve allowed existing systems to disintegrate.
Justin Webb
In a word, then, you think the Bill can now be defeated?
Andy Burnham
Yes I do. All around there is a consensus that it is better to work through existing systems than to carry forward this dangerous re-organisation. The Government has abjectly failed to build a professional consensus behind the Bill. My offer still stands, Justin. I have no objection to building GP-led commissioning. This Bill will damage the NHS at this particular time.
Justin Webb
You’ve already introduced that in the past, haven’t you?
Andy Burnham
Yes I have. This Bill will damage the NHS at this particular time.
Justin Webb
Andy, we’ve got to leave it there. Thanks.
