Back to Beveridge at Ballot Time

As the countdown to the General Election begins, people grow increasingly nervous. The spectres of triumph and disaster lurk hidden from view as we approach the electoral starting gate.

Some with long memories fear the false step – the promise to reverse Brexit without referendum, the trumpeted amnesty to illegal immigrants etc.

Some with equally long memories bemoan a lack of boldness and differentiation – where is the penny on income tax for education ?

Much my depend on your local political geography. In the leafier parts of the South saying ‘we are not the Tories’ may be sufficient.  In the Labour dominated north it’s certainly not.

This underlines the need to have a message that impacts in the North and does not startle the horses or the electors in the South.

There are such messages particularly in the field of health and education.

I think it is now accepted that the Coalition Health and Social Care Act 2012 was one of the most pointless, opportunity-squandering and ham-fisted pieces of legislation in modern times with most of its provisions (CCGs etc) now abandoned or reversed.

Parliamentarians persisted with it despite the concerns of nearly all health professionals, the Lib Dem conference, Baroness Williams and colleagues like Andrew George and other brave souls.

It was not a charter for privatisation but a definitive and conclusive expression of the market principle when applied to health which although rampant in the Blair years had to be toned down even then to get through the Commons. It proved unworkable in our NHS which still tries to cling to Beveridge principles.

What if though we were to revisit those principles and abandon the costly, bureaucratic internal market in the NHS – where the piled on overheads of administrators, defending as commissioners and providers their own silos, disappear ?  Arguably the necessary creation of the new Integrated Care Boards has already blurred the boundaries within the internal market. Commissioners and providers are now working together as the NHS to desperately husband scarce resources.

Such a move would enable us to re-allocate resources to the clinical services that need them, be popular, vote winning throughout the country, bold and differentiate us from Labour. ‘Back to Beveridge’ is not a romantic or nostalgic aspiration but has been argued in a hard headed, number crunching way in many places.

Most notably may I refer readers to a minority paper written by Dr Charles West and others during the passage of the Health and Social Care Act for the party’s public services working group. It can be found HERE . It called for the introduction of Local Health Boards which we now call Integrated Care Boards. The Lansley 2012 Act sought to abolish all strategic management of the local NHS.

History, I think, shows Dr.West to be more prescient than Lord Lansley.


* John Pugh was Liberal Democrat MP for Southport until 2017 and was elected as a Councillor for the Dukes ward of Sefton Borough Council on 2 November 2017.

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  • Jenny Barnes 6th Dec '23 - 4:44pm

    Maybe my memory is at fault, but I remember Baroness Williams speaking in favour of the Lansley reforms at conference. I think it was Glasgow, but I could be wrong on both counts.

  • @ Jenny Barnes. It was in Gateshead in 2012, Jenny.

    The Guardian, The Independent, Huffington Post all carried lengthy coverage of the debate, all still available now on line.

  • nigel hunter 6th Dec '23 - 11:40pm

    Winnigg policies have to be pushed ALL THE TIME.More publicity for them should be at the front of campaigning.

  • Jenny Barnes 7th Dec '23 - 10:38am

    Gateshead or sheffield? Anyway, my memory is obv. wrong, because I know I didn’t go to the 2012 spring conference. However, the substance was right, see this from LDV, esp the comments:

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