What's next for the NHS?

Publisher Website
Google Scholar
Abstract
Telltale signsHence, of course, the question: “What will his arrival mean for NHS policy?” The absence of evidence, and a brooding silence from Mr Brown, has led to fevered speculation and much reading of runes and tealeaves. The answers from the oracle at Delphi were clearer than the outcome from these exercises.But for what it is worth, here is the evidence. The joint document that Blair and Brown issued in March on the future of public services endorsed the Blair approach of competition, choice, and use of the private sector, but contained a bunch of Treasury-style qualifications such as “where appropriate.” Pro-choice civil servants in the Department of Health were excited when a draft of the document came back with a big red circle around the word “choice” in Mr Brown's handwriting with a comment along the lines of “we must pursue this.” The more sceptical, however, noted that, at least in theory, it is possible to pursue a policy of choice entirely within a publicly owned system. No room, necessarily, for an enhanced role for the private sector there.The next big piece of evidence was a leaked letter in late May from Mr Brown to the Confederation of British Industry in response to one of its policy documents. It declared that a reform agenda of “choice” and “the use of competition and greater contestability,” one involving the independent sector, “must be driven forward” for the public services. In other words, the Blair agenda, this time shorn of the weasel words such as “where appropriate” that the Treasury inserted into the earlier document.Blairite sceptics, however, noted that nowhere did the letter state to which parts of the public services this should apply. All of them? Or merely in prisons, which the private sector now runs; or welfare to work services, where a big expansion of private sector involvement is planned; or in schools, where Mr Brown has publicly thrown his weight behind privately sponsored city academies? Nowhere did it say specifically that it would apply to the NHS.

This publication has 0 references indexed in Scilit: