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The vision to lead the NHS



 

A vision

 

If you look at this person’s billboard, you’ll find a very short passage from Aneurin Bevan from 1942.

Aneurin Bevan had his critics too. Bevan would often comment that the Labour Party was not inherently socialist: citing that one in five members of Labour at the time were truly socialist.

Still, Bevan and Attlee carried on regardless. Here’s a comment from Bevan from 1946.

Second caption

Bevan left school at 13. He didn’t go to Charterhouse and Oxford.

The vision of the creation of the NHS is indeed one of the things which truly shocks critics of socialism. And for decades various Governments have been trying to undermine the National Health Service.

You can in fact tie yourself in knots over definitions of socialism, but certainly equality of opportunity for treatment and care (equitable access), solidarity, cooperation and collaboration might be strands. The idea of efficiently planning resources for the greater public good of the country might also be in the mix.

Lloyd George himself said it would be indecent for a democratic dictatorship to emerge from the National Government which had been put on a “war footing”.

Cameron and Clegg put us on a war footing, despite not having won the 2010 general election. But the war footing was to use the five years to extract as much money out of the public service and outsource it to the same bunch of people, as per outsourcing and privatisation of NHS, probation services, Olympics or workfare. These people are in the private sector.

Diverting resources from the public sector to the private sector is privatisation.

The result of this war footing for the NHS was an Act of parliament which did not have a single clause on patient safety, apart from the abolition of the National Patient Safety Agency; so it is rather ironic and foolhardy perhaps that Jeremy Hunt would wish to campaign  on this issue.

The 493 page Act of parliament has been used to spin a number of lies, such as GPs being in the ‘driving seat’. CCGs, or clinical commissioning groups, are simply insurance schemes which apportion risk to local populations, and work out how much money should be alloted to them for their future care or treatment (and how it should be spent.)

They are conceptually the same as the “health maintenance organizations” (sic), borrowed from the United States.

The absurdity of it is that the NHS was borne out of the failure of private insurance approaches before the War, so why should we wish to return to an inequitable fragmented country which the Attlee government had tried so hard to repair?

That war footing for the NHS was a convenient way to shoehorn in that famous section 75 and its Regulations which provided the jet engine for a market – competition. This market needed to be ‘regulated’ (in as much as the cost of living crisis has demonstrated the failure to regulate an oligopoly of companies which can legally collude in setting prices). And there needed to be a régime for fast managed decline of NHS trusts.

Private markets are fragmented, and always introduce “transaction costs” leading to waste and inefficiency. Directors of private limited companies have a primary duty to make a profit for their shareholders, and that’s the case even if you’re using the “NHS” as a logo or kitemark.

And you can take treatments out of scope. This is rationing. It happened under the previous Government, is happening under the current Government, and will happen under the next.

And it cost £3bn – money which could have been better spent elsewhere, such as on the frontline.

The myths keep on coming and coming and coming.

Who’s going to pay for the NHS going seven days a week? Are NHS Consultants simply going to accept a unilateral variation of contract with no mutual agreement? It might be a case of ‘see you in court’.

The next Labour government needs to set out a vision which can inspire the general public, and equally importantly inspire the staff of the NHS.

The staff of the NHS do not want to be told that ‘a culture of evil has become normal’ by the Secretary of State for Health. They want some dignity and respect too.

They don’t want a technocrat who can implement textbook ‘transformative’ leadership, such that they can turn their NHS Trust into the healthcare version of a motor car production plant.

They wish their views to be respected, and where they can speak out safely where something goes wrong.

Nobody’s ever dared to discuss with the public the effects of PFI on local economies, or the billions of efficiency savings, but, if indeed ‘transparency is the best disinfectant’, we need all major political parties to speak openly about this issue.

It might be that “clinical leaders” need to grow some balls where possible to neutralise some who are overly aggressive NHS management seeking to balance budgets and hit targets at all costs.

I’m sorry if this sounds like a rant more fitting for a left-wing version of Katie Hopkins (perish the thought).

But we need a vision.

 

 

That vision is the SHA.

  • Brian Cox

    Not a rant at all. I think this is spot on. We need lift the vision of the future for health care away from the short term operational issues and onto the bigger political and moral questions once again. I think you are absolutely right – we need to discover leadership of this kind. My feeling is that electorally this would be well received as people are unconvinced by the niceties of the technocratic debate that we sometimes get stuck in.

  • http://legal-aware.org/ Shibley

    Thanks Brian. Really appreciated.

  • http://twitter.com/mjh0421 Mervyn Hyde (@mjh0421)

    Another excellent article Shibley.

    One of the reasons I continually blab on about the fact that the deficit is a lie, and that we have the money to fund anything a government chooses to do, is because the politicians are lying to us.

    People believe these lying politicians because they do not understand how money is created, and falsely believe that a country operates like Thatcher’s version of a household budget.

    Japan has now been printing money, (unlimited Quantitative Easing) ever since the prime minister Shinso Abe came to power, and the economy is staggering back into health, after 20 years in depression; following this governments doctrine of Austerity.

    We have the money, all we need is to apply the resources, but the financial sector which is being supported by our taxes is dictating otherwise.

    This link reinforces what I say above: http://www.youtube.com/watch?v=i35uBVeNp6c

    We have the money what we need is a government willing to use it to fund our society properly.

  • http://legal-aware.org/ Shibley

    Thanks as ever, Mervyn. Will watch.

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