The NHS is once again in the news and not in a good way. It is fast becoming a basket case with ambulances unable to deliver critically ill patients to hospital in anything like acceptable times, operations often delayed with unacceptable waiting times, people unable to make GP appointments and now a series of strikes because the Tory Government cries crocodile tears instead of funding the NHS and its staff properly.
There is a dangerous myth that has been around in our politics for far too long that the public sector is inefficient and that as much of it as possible should be in the private sector. This has permeated our party as well with lots of seemingly intelligent people believing the tales spread by the Tory Party and their business backers about the terrible inefficiency of nationalised industry. In government we actually supported this nonsense with the part privatisation of Royal Mail and what a success that has been, not.
The NHS, once our pride and joy has seen endless moves under both Labour and the Conservatives to hive off large chunks of it to the private sector. (Doubters should read NHS plc by Professor Allyson Pollack or Betraying the NHS: Health Abandoned by Michael Mandelstam to see how complicit Labour is in destroying the NHS). Now Labour’s Wes Streeting is talking about using the private sector to tackle the obvious problems that decades of underfunding have caused, completely dismissing the evidence that the moves to privatise the NHS have been the cause of many of the problems. He is ignoring the multiple reorganisations that have been foisted upon the NHS over the past 30-40 years, including the Lansley reforms that our party stupidly supported in government. The splitting up of our NHS, into hospital trusts, mental health trusts, primary care trusts, ambulances trusts and many other trusts, coupled with the so-called internal market that people foolishly believe will create efficiency, have left the NHS spending far too much time and money on bureaucracy rather than patient care. Hospital building mostly done through the hopelessly inefficient and sometimes corrupt PFI process has stalled and GPs face mountains of paperwork that stops them giving proper care.
Our party must now stand up and state very clearly that we support an integrated NHS, running all its own services and employing its own staff and we must state very clearly that we will fund it properly out of national taxation. We must make it clear that privatisation is off the table and that we will reverse that which has already taken place. We know that voters care about the NHS and this is an open goal if we are only prepared to take a stand.
What is the point of a Liberal Democrat Party whose forebears laid the ground for the ‘cradle to grave’ welfare state if we now continue to try and save the NHS with the very policies that have caused its problems. In addition, our country now needs a massive training programme to make sure that the NHS gets all the doctors, nurses and other staff that it needs and those staff should be properly rewarded and so that we can stop depriving many poorer countries of the medical staff they so desperately need by poaching them to prop up the NHS .
With both the other parties offering no real solutions to the myriad problems of the NHS, it is surely time for us to offer a radical alternative to recreate an NHS we can all be proud of.
What have we got to lose?
* Dr Michael Taylor has been a party member since 1964. He is currently living in Greece.
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15 Comments
Thank you for an important article!
Might the current leadership style of our party be described as, “The bland leading the bland”?
Yes, the years from 2010 to 2015 were not good for the NHS for which, sadly, the Liberal Democrats must take full responsibility. (It is no good us blaming the ‘evil Tories’ as we were the ones who enabled them to be the government.) The issue is how the party regains credibility just 8 years after backing the Tories in government. My suggestion is to take a leaf from the Labour Party under Tony Blair…perhaps we need our leadership to speak about us being the ‘new Liberal Democrats’, having learned from our mistake in joining the Tories in coalition and making clear that we rule out that possibility ever happening again. Maybe then we will be listened to when outlining a vision for the NHS that is different from that promoted by the Tories.
It is not entirely a myth that the public sector is inefficient. The belief on the right that it can never be efficient and that on the left that it already is have contributed to its inefficiency.
One area that the public sector necessarily does less inefficiently than the private sector is outsourcing. The cozy trust relationships between private sector suppliers and clients would be deemed corrupt between private and public sectors.
The NHS is a key Policy battle and it does seem that Labour are on the same line as the Conservatives at least they are in the battle for votes at the next election! Will they change their minds after the election?
Whoever has the best policy in the minds of the voters out of the LD’s and labour stands the better chance of taking consrvative held seats.
The Conservatives will major on where is the money coming from for any policy that does not involve further privatisation and that answer needs to be ready, strong and clear. In my mind (no detailed knowledge) is that it can come from a taking back of work from the private sector, but does need a poositive focus on improved management of the NHS along side it.
There has long been something fundamentally wrong when quite often people who access private health care get treated much more quickly than via the NHS. Surely that is an indication of lack of capacity in the NHS that has been going on for at least 12 years, hence the need for better funding.
There is also a need for review of its organisation and management which is perhaps too centralised and with too many short-term interventions by government, rather than long term planning. Experts have reminded us this week that the current crisis has been frequently predicted for several years.
There is still (in spite of the report of the Stafford Hospital problem) inability to listen to frontline staff; bullying of staff who complain to their bosses about what they think is wrong happens too often and not only at Birmingham Hospital (currently in the news).
Currently the other needs are more staff, better social care (for children as well as adults) better local public health schemes and better housing, for the prevention of ill-health and for developing people’s ability to deal with minor ill-health without having to go to hospital.
A regressive piece, rather poorly argued, not liberal or Liberal.
To utilise the capacity in the private sector , as Wes Streeting, us as a govt party, the Tories as well, argue, is akin to a form of nationalisation. It is not privatisation. There is the latter, such as selling off a building or a contract. But to argue for integration, as does this article, when that is precisely what Wes Streeting et al are for, is absurd, when saying, no to use of the private sector.
The NHS has not been an envy of the world. France has, and Germany, and many, all share one thing. They use public money and systematic organisation, to integrate and utilise privately run facilities. They offer real choices which the patient has as an individual. If this piece wants this party to return to its anti choice left wing one size fits all socialist and corporatist, monopolist, statist, policies, forget it, been greatly tried and found to be wrong. In an era of choices of everythging, to have no choice in healthcare is terrible, and not liberal.
It was a speech by Wes Streeting as Keir Starmer making comments, that showed how politics in the UK makes no impact as it is all a mess.
Those on the centre ground terain, Streeting and Starmer, included, are akin to the very Liberals referred to in this article, old Liberals, pre modern era. Grimond argued for using the private sector, as well as for choice, in the years all through his tenure as being at the top of Party , in every sense.
To have a free hip or knee replacement, paid by the NHS, in a small private cttage hospital, is good policy and works in practice.
To be ideological on provision, based on what sector it is providing it, is for Corbyn and Momentum.
Read Wes Streeting on this. He says it, its conservbative to look back at what never was as described. Nostalgia is fine for personal tastes. It is not good for political choices.
I was disappointed in Lorenzo Cherin’s intervention.
As I argued in my piece, the part privatisation and the myriad of reorganisations plus the splitting up of the NHS into a vaguely connected series of trusts as well as farming out some operations to the private sector is exactly what has caused the problems along with starving the NHS and its workers of cash.
I would strongly urge Mr Cherin to read NHS plc and Betraying the NHS: Health abandoned, because they will disabuse him of his fascination with the ability of the private sector to solve the NHS’s problems.
You only have to look at the services that have been contracted out like cleaning, cataract surgery, simple hip and knee surgery to see that the NHS and its patients have suffered as a result.
I am not a public sector fanatic, but I am firmly of the belief that the NHS will work much better as a fully integrated service with control over all its functions, rather than the half privatised and underfunded organisation it has become.
Sometimes politicians have to recognise that their direction of travel is wrong. It is time for the LibDems to end their love affair with mucking about with the NHS and take radical action to restore it to the great services it once was.
Mick, I have not a jot of fandom for any aspect of any sector in general. I have experience a knbowledge of the facts as I and others experience it. This too, added to with years of effort and research.
My wife and I have disability issues. Hers as a result of a car accident years ago. Her treatment, lack of it, by the NHS, has now, let me be careful I am moderate in description, been, awful.
I have known two elderly friends a generation older than us. One, told on thew NHS, she would wait three years for cataract operation. No private sector opffered, she went private, sorted.
And my other friend, given a hip replacement free by the private sector under an integrated contract with her East Midlands NHs.
None of the problems are Private vs public only. They are due to appalling ideology and starving the service of, money, choice, freedom, variety.
Greece where you are Mick , nor any country you name, has our system. French, German, Sociaslists, think nothing of the divide, they see, only who pays, who gains.
You and any who want one size fits all, are not Liberal in approach. Abolish small private innovation and you destroy progress. Liberalism is flexible non ideological on provider, or it is authoritarian statist belief.
Another thing Mick is why can you not realise integration is what I advocate. I want to integrate the private sector. That means every provision, in every area, under an NHS flexible arrangement. The patient in charge. Of course some of the actual privatisation, farming of admin to Virgin, is not the same. To utilise BUPA or Nuffield facilities, is integrating them into the NHs. This is not the same as privatisation. To put a private company in charge of a hospital, though often not warranted, is also not privatisation. That is because the service is accountable to the Health funders, authorities. In every EU area, there is only integrated provision with total or partial choice of provision. Only the UK offers a different way, that failed and does fail.
I have no ideological preference for one sector, only a liking for the truth.
The French health system has its problems too!
https://www.rfi.fr/en/france/20230106-macron-offers-solutions-but-no-magic-cure-for-france-s-stricken-health-system
I agree with Lorenzo. Labour and Wes Streeting are getting it absolutely right on the NHS. The purpose of NHS reforms from the centre left are to save the cherished principle of free healthcare at the point of use, not to dismantle it. The socialist view that the service should be 100% public is wrong headed.
Are the LibDem MPs asking why Rishi’s previous commitment to convert the 2022/23 increase in NI into a separate NHS levy for the 23/24 tax year hasn’t been reinstated?
Sorry Lorenzo but if you think that farming work out to the private sector is co-opting the private sector into the public sector you live in a different world to me. Labour and the Tories have been giving off vital parts if the NHS to enrich the private sector, not to improve health care and to try and save money. Anyone who has studied the situation knows that health care has suffered as a result. You and your wife’s problems will not be solved by further outsourcing, but by a fully integrated and properly funded NHS. Clearly, we’re not going to agree on this, so I shan’t respond further.
Marco, I thankfully reading your comments see that we have some Liberalism, social indeed, to add to the social democratic ideas of current Labour.
Mick, sorry, you ought to respect individuals and what they have gone through and why therefore they know what is right based on this.
I want to integrate not “farm off!!!!!”