To those of us with some knowledge of the founding, funding and growth of the NHS, it is a source of wonder to see the Tory conversion from outright opposition to apparent support. Now, we are told, it is the Tory ambition to produce an NHS second to none in Europe. And all this by spending less money and sweeping away an unloved bureaucracy. I rely in my continuing disbelief in a Freudian slip. Yesterday David Cameron told us that a failure to reform the NHS along the lines the Coalition now proposes would make the NHS unaffordable and the agreed NHS objective of ‘free at the point of need’ would become unsustainable. Where and when have we heard this before? I rely on my readers to tell me. But am I not right to say that we heard in 1948 when the NHS was formed, and was rammed down our throats my the Blessed Margaret Thatcher in thirteen long years of starving the NHS of capital and finance. Under the Tories we can never afford it.
Is it possible to build a world class NHS without spending more and more money and increasing the proportion of GDP spent on the NHS. I suggest not. The NHS was firmly rooted at the bottom of most EU Health league tables when Margaret bowed out unwillingly from power. It required massive capital and revenue expenditure under Labour administrations to lift it to mid-table performance.
It has always seemed to the Tories that this expenditure was avoidable if the private sector was permitted to play a larger role in health provision. In recent years the private sector has played a significant role but always under the protection of a benificent state. Is there, just possibly is there, a way of surrendering to private interests, saving administrative costs while preserving the mantra of ‘free at the point of sale (sorry, need).’
And the solution, ‘Give the money to GPs’. Or as it was said in the distant days of ITMA and Tommy Handley, ‘Give them the money Barney.’ It never dawned on David Cameron in all this bravura that perhaps the GPs did not want this money. Nor that any responsible professional health organisations agreed with his proposed reforms. This is not his style. ‘You disagree with me. That’s a pity. But that is not going to stop me pressing ahead. So it may not work out but I believe it will.’ You learn this sort of thing on the playing fields of Eton.
‘Oh well clever dick, what reforms do you support to get this massive and growing health care under control.’ Well, first I believe in evolutionary not radical change in the NHS. I am not against givng GPs control over their budgets where they wish to operate this way or to making compensatory reductions in central bureaucracy. I am in favour of compensatory savings in central bureaucracy if we proceed this way and not at the expense of the necessary protection NHS services enjoy and need. This is the not the Tory way. You do not learn this approach on the playing fields of Eton. ‘What a cissy. Press on lads.’