As a health policy researcher and campaigner for a better NHS, I have been following with interest Labour MP Clive Efford’s attempt to reverse some of the current government’s most controversial health policies. His private members bill, although unlikely to succeed, signals Labour’s priorities in heath.
There is no question but that the Coalition’s top-down reorganisation of the NHS needs to be overturned. It extends the use of market forces on a compulsory basis enforcing rules of competition which set the NHS towards increasing privatization. Alongside this, the Coalition removed the Secretary of State’s legal duty to provide health services in England, a duty she or he had had since the creation of the NHS but which was repealed in the 2012 Act.
Efford’s bill takes us part way down the road to removing some of the worst excesses of the Coalition’s reforms. It removes the economic regulator’s duty to promote competition and attempts to protect the NHS from ‘TTIP’ – the US-EU trading treaty currently under negotiation widely believed, if agreed, to make NHS privatization effectively irreversible.
However there are some important omissions in the bill. Somewhat bizarrely given its promise to do so, it does not in fact restore the Secretary of State’s legal duty to provide national health services in England. It also leaves intact the market structure in the health service – that is, with separate commissioning organisations and providing organisations relating to each other through contracts in some kind of competitive context. This is despite the fact that running a health system as a competitive market has been estimated by at least one expert to be costing the country £5bn every year – that’s £5bn which could instead have been spent on giving patients care.
For those who think market competition will lead to a better and more efficient service, it is worth checking out the state of social care where the combination of market forces plus funding constraints has conspired to reduce quality despite the best efforts of the under- paid and under-valued care workforce. It looks as if this could be precisely the scenario facing the NHS.
The fact is that to restore the NHS as a public organisation devoted to public service rather than market dogma and protected from the predatory intentions of big business, we would have to go beyond undoing the 2012 Act. A real restoration of the NHS requires that many of New Labour’s NHS policies also be reversed. They include the market system itself and their growing use of private companies to provide core services. Indeed many of the instances of privatization in the NHS we currently see around the country result from Labour rather than Coalition policy. Labour will need to go further if it is to show it is truly committed to saving the NHS.
Campaign Against NHS Privatization, Leicester