The narrative goes something like this.
Personal health budgets are the stepping stone to private health insurance. You’re given a fixed amount of money, which, as time goes on, is not nearly enough to pay for your health and social care needs. But not to worry, you can top up the budget, like you top up your pay-as-you-go phone account. And if you don’t want to spend your budget in the NHS, you can transfer to private insurance firms like a voucher.
The typical media question, in fact used by Robert Peston last week on Newsnight on Andy Burnham last week, is: “Do you have any fundamental objection to healthcare, as long as its cost-effective and of high quality, being provided by the public sector?”
An answer to this normally involves an answer which revolves around transfer of resources from the public sector to the private sector, or a bit of a fudge saying there’s no ideological objection to private providers, so long as there’s a NHS “preferred provider”.
Labour is obsessed about one thing: the deficit. From this, Labour is prepared to swallow all unpopularity, such as not spending money on pay increases in the public sector, or spending money on benefits (even if the benefits are totally legitimate).
When Ed Miliband was asked later in the week about the “funding gap” on LBC, Ed Miliband gave an answer in the style of ‘some of my best friends are midwives’, and then gave the customary fudge-answer on how he would like the NHS to make better use of the money it’s got.
Except, this won’t wash. There are currently more papers in the business management press along the lines of ‘why belt tightening still won’t make you fit in your trousers’ than Ed Miliband’s been to friends’ bar mitzvahs.
And yet the more blunt way of saying we will preserve the NHS is to go out for an all out attack on the City or private insurance. Labour supporters have to ask why he won’t do this. Is it because Ed Miliband does not wish to be seen to be anti-aspiration? To give you some context, Labour is planning to give hedge fund boss, Michael Farmer, a top honour.
Labour, in saying it does not wish to promote private insurance, does not spend any money. It might though nark off previous Secretaries for State for Health in the Labour Party who work for private healthcare funds.
People pay into the National Health Service, knowing that it is there for them. There is a genuine sense of solidarity and pooling of risk, and equity: free at the point of need. It’s a moot point whether the service is as comprehensive as it could or should be.
But Simon Stevens in bigging up personalised medicine has nailed his colours to the mast without saying so.
Many have alluded to, as indeed the previous CEO of NHS England – Sir David Nicholson has, the fact that knowing the precise risk of a condition with a strong genetic contribution, such as in rare causes of dementia, would mean that that person and their family would end up paying much higher premiums than in the National Health Service.
Ultimately it seems voters want to go for the least costly option – which is why Ed Balls and Ed Miliband would rather wire themselves up to the National Grid than to discuss with Andy Burnham how social care is going to be funded comfortably.
So if Labour tells voters in an all out private insurance system some people will be paying through the roof, and the NHS will go to pot, this will play very nicely to those people who are dead against private insurance in the country’s healthcare.
It will play nicely: if Labour actually mean it.
