Mark Pack yesterday noted Lib Dem health minister Paul Burstow’s hand at work in the NHS White Paper – it’s a theme also picked up today by the BBC’s political editor Nick Robinson, who comments on his blog:
The proposals for a re-organisation of the NHS included a fundamental and little-noticed change from those contained in either the Conservative manifesto or the coalition agreement. The government now plan to give councils a major new strategic health role, examining the purchasing decisions of GPs and fitting them together with their plans for public health and social care. For the Lib Dems, this represents an important injection of democracy into the new health market. For the Tories, it allows them to propose the abolition of primary care trusts altogether instead of, as originally discussed, having to hold elections to them.
He also notes the coalition process by which the reform plans were put together:
This was the result of the first negotiated departure from the coalition agreement. First the Tory Health Secretary, Andrew Lansley, and his Lib Dem deputy, Paul Burstow had to agree. Then they had to persuade the Tory Secretary of State for Communities and Local Government, Eric Pickles. Then the idea had to be taken to the cabinet home affairs committee chaired by the Lib Dem leader Nick Clegg. Finally, it had to be approved by the coalition committee which considers any major departures from the original agreement.
A reminder to LDV readers: Lib Dem MP John Pugh, Co-Chair of the party’s Backbench Health Committee, is actively seeking the views of party members. Click here for further details.
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12 Comments
I’m sure its lovely that the Lib Dems have had an impact on this policy but it doesn’t stop it from being utterly mad. Why have a massive (and expensive) reorganisation of the health service when we’re trying to SAVE money? Since when do LDs want a free market in the NHS? This policy (like Gove’s schools policy) MIGHT work if there was lots more money splashing around to pay for it but there isn’t. Why are we agreeing to this?? Its a massive gamble and is going to hurt the people who voted for us. Please get them to stop!!
“The government now plan to give councils a major new strategic health role, examining the purchasing decisions of GPs and fitting them together with their plans for public health and social care.”
Er… Councils and PCTs have been talking about integrating their organisations long before Lansley became SOS for Health. How are the Tories in Hammersmith and Fulham going to feel about Lansley’s proposals, considering they are the first LA to have a joint Chief Executive – soon to be half a Chief Executive?
Also, pre-Lansley, there was nothing to stop LA scrutiny panels examining the purchasing decisions of GPs (or anyone else in the NHS) if they so wished.
What these proposals are really about is the privatisation of the Health Service, and I am amazed and dumbfounded that Clegg has been taken in by it – or has he?
Wouldn’t “democracy” have been better served if one or both of the coalition parties had had the honesty to say this was what they intended to do before the election, or at the very least the honesty not to assure us that they weren’t going to do any such thing when they negotiated the coalition agreement only two months ago?
But we should be thankful to Nick Robinson for giving us some details of how this policy was cooked up, and what the procedure is for abandoning the provisions of the coalition agreement that the party approved. So nice to know that due process is being observed.
Hold on. Isn’t this fiddling while Rome burns?
It is mad, and against what was written in the Coalition agreement about stopping top-down reorganisations.
The coalition is two months into office, and has a tough job dealing with immediate economy issues. Now is just NOT the time to be rushing into a major reorganisation like this. It needs to be thought through and discussed carefully. Two months is certainly not enough time to do it. It’s a sort of thing associated with failing states – the people in government rush through their pet schemes without consultation or thought just because they can.
Yes, publish these ideas, ask people “What do you think of them?”, try a few project schemes, and get something more thorough implemented in a few years time if it seems people will like it and it will save money and/or improve the service. But “You’re going to have it because we say so, and we’re the masters now”? No.
But the Coalition agreement spoke about elected PCTs
what happened to that part of the agreement ??????
Also Councils already have NHS Overview and scrutiny role ??? what’s changed, what new sanctions
its not as if they can veto GPs commissioning
What stops local GPs falling out with local hospital and sending patients to another hospital ? closing the local hospital
Given that few GPs have commissioning skills, I have little doubt private health insurance companies will offer to commission for free (in return to access to potential private patients). Burstow has stated local authorities could commission. The Conservatives will ensure this never happens
This will be about GP rationing and privatising health care.
The vast majority of Gps, medical staff and nurses want to be advocates NOT commissioners
GP commissioning groups will become US style health maintenance organization (HMO)
Lib Dems really need to get hold on the detail on this or the agenda will be simply wholesale privatisation at the cost of patient care, with little or no accountability to patients or population
“… we’re the masters now …”
Oddly enough, precisely that phrase came into my head when I was thinking about the government yesterday.
Nick Robinson. – would that be the former chairman of his Uni’s Conservative association & Chairman of the Young Conservative? The same one who was almost wetting himself on TV when his mate Dave got in?
I am so glad you have pointed out such independent analysis.
Is it so surprising that the Lib Dems are aiding and abetting the Tories’ back door privatisation of the NHS? History
has shown us that when it comes to the conflict between capital and labour the Liberals will always shore up the Conservatives. I always thought your proposals to make PCTs more democratic was a good thing. Likewise your proposals to get the PCTs to act as the champions of patients. I should have learned: whenever your party produces a policy I can support (such as the amnesty for illegal immigrants) it is abandoned by the Orange Tories within weeks. That’s why I refer to Clegg as Mr 180 degrees. I suggest that many GPs are small businessmen who loathe the PCTs because they make them work harder for the huge amounts of money Labour gave the GPs in return for very little extra productivity. Even now, my GP’s surgery does not open at weekends or in the evenings. And now these people are to be given more autonomy.
I thought that the Lib Dems had sold out over the VAT rise and the welfare cuts. Now, watching them support the privatisation of the NHS by the front door, led by Lansley who is in the pay of a private health company, I realise that the VAT rise and the welfare cuts were small beer compared to this.
What mandate was there for this?
This is an utter disgrace.
I hope you’re proud of yourselves. I’m utterly ashamed that my vote for my local Lib Dem MP contributed to this.
Expensive ideological reorganisation (see also Education, fixing outstanding schools, which by definition, ain’t broken) at a time of crisis retrenchment would seem to indicate that many in the Government do not believe that the crisis is as bad as all that.
I conclude that the retrenchment is also ideologically driven.
I was one of the ‘North Koreans for the day’ who voted massively in favour of the coalition agreement in Birmingham. I also stood as a candidate in May.
I have seen no public statement from the party re the announcement of the health white paper. One of the reasons I was so supportive of the coalition was that the Health section had clearly adopted much of what we were saying in our manifesto. And yet it has been cast aside with nary a nod in the direction of the wider party. I only know that it was even discussed by the coalition committee as a result of this LDV article. It is good to know that John Pugh is now seeking opinion – I am sure he will get it too! – but surely now is TOO LATE! Our leadership has caved in on one of the most stupid pieces of policy I have seen, and that includes Gove’s fantasy ideas that will further ruin our education system. for all but the well off.
For the record, here are the three main bullet points that have been abandoned:
• We will stop the top-down reorganisations of the NHS that have got in the way of patient care.
• We will ensure that there is a stronger voice for patients locally through directly elected individuals on the boards of their local primary care trust (PCT). The remainder of the PCT’s board will be appointed by the relevant local authority or authorities, and the Chief Executive and principal officers will be appointed by the Secretary of State on the advice of the new independent NHS board.
• The local PCT will act as a champion for patients and commission those residual services that are best undertaken at a wider level, rather than directly by GPs. It will also take responsibility for improving public health for people in their area, working closely with the local authority and other local organisations.
What Lansley (and apparently our leadership) are now proposing is a recipe for further wasteful reorganisation, the emergence of private health companies – which we warned about in our campaign literature, especially in the East of England, and Tory links to these.
We have lost the plot on education, we have lost the plot on health, and all we can hold onto is a referendum on a system of electoral reform that nobody wants (apart from Labour, well, parts of it, and only if it isn’t our idea). There is no commitment to PR at local level, the house of lords reforms are being kicked into the long grass, just why exactly are we still supporting the coalition?