The list of vacuous phrases to do a critique of the NHS is getting ever longer.

It’s a list which has a semblance of ‘motherhood and apple pie’ or ‘chocolate and biscuits’, or whichever overworn bland meaningless soundbites you wish to put there.

The next election will require meaningful offerings from the main political parties.

There might be a temptation to implement ‘less is more’, and this is not altogether a foolish approach so as to allow greater definition to fall into place at a later date.

On the other hand, vacuous phrases run the danger of making Labour look as if it doesn’t know what it’s talking about, and, instead of talking in socialist language, is simply triangulating itself out of meaningful existence.

Here are some recent phrases which have been offered. They all sound perfectly sensible, and possibly are very attractive to those people who’ve not been following the detailed narrative of the NHS. But other parties are working on their offerings too.

 

1. “The private sector will only be allowed to offer patient services if the NHS cannot improve or they can show genuine innovation.”

It is hard to put down a definition of ‘innovation’, let alone how to measure the success of the application of innovation, commercial or otherwise. That said, the concept of who is better at competition, the private sector or the public sector, is an odd one, as current innovation theory converges on the need to collaborate beyond boundaries to generate innovative ideas.

 

2. “Whistleblowers will be protected.”

This is the ultimate motherhood and apple pie offering. For somebody who has just experienced a truly awful experience, such as Raj Mattu, this will mean very little.

Nobody can disagree with the statement. In fact, to suggest that ‘whistleblowers won’t be protected’ would be truly eyecatching. The real beef is how whistleblowers can be protected. It is extremely difficult to ‘legislate’ in response to a toxic culture, although it can be done.

Take for example, the Sarbanes-Oxley Act legislated in response to the financial misfeasance (understatement) in ENRON. But a good starting point perhaps would be repeal the Public Interest Disclosure Act (1998), enacted very early on in New Labour’s life, which virtually all people agree is not a statutory instrument which is fit for purpose.

 

3. “Intelligent targets will remain where appropriate.”

This is the ultimate in having your cake and eating it. This is Labour getting high on triangulation again – saying we believe in targets but not of the kind that may have contributed to Mid Staffs.

The idea that nobody can disagree with realistic aspirations on ‘waiting lists’ etc. but the phrase above fails the basic assessment device of legal drafting ‘who? what? when? where? how?’.

The extent to which you can encourage policy a certain way, or have to introduce incentives such as for collaborative behaviour, is an important one. More important than incentivising collaboration through financial incentives is getting rid of the effect of legislation which is unlawful due to a collaborative or anti-competitive effect.

Collaboration is not necessarily anti-competitive, hence the discussion of co-epetition, but this is an area which requires a lot of work (such as how to implement incentives which promote integrated care in general.)

 

4. “The NHS will no longer have either an internal nor external market. The NHS will be the preferred provider. Renegotiate PFIs where necessary.”

These statements are inherently internally contradictory. How is it possible to abolish the market and still have the NHS the ‘preferred provider’ simultaneously in a market? This simply does make sense.

This is clearly manna to Labour’s critics who argue that Labour doesn’t really mean it when it criticises the ‘tidal wave’ of marketisation.

The actual truth is that people in the City are currently trading on shares in PFI, and building up portfolios of shares. If you ‘renegotiate’ PFIs, this market for PFI shares will still exist. If you abolish PFI, it won’t.

A reluctance to abolish any PFI ultimately, ahead of payments coming to an end otherwise in the early 2020s, speaks volumes to many.

And this all feeds into the narrative that Labour has no sense of running the economy. For example, would you rather pay for your TV set over hire purchase for the next twenty years, or would you like to pay for it now if you could?

With interest rates set to go up from the Bank of England after the next election, as the recovery gathers speed in the UK, these are important questions, but the question over PFI arguably is as much for the Shadow Chancellor of Exchequer as much as the Shadow Secretary of State for Health.

 

 

 

So it is all very well to supply bland phrases.

Such phrases are either well meant and designed to say little to be non-committal, or are designed to be deceptive so that Labour can simply do ‘business as usual’.

A brief scan of Twitter any day will prove to anyone that business as usual from Labour for the NHS is no longer an option.