Paying for health: Lansley woes and pre-NHS healthcare
History & Policy opinion piece (February 2012)
The Coalition has found few, if any, of its policies to be as controversial as the NHS reforms contained in the Health... more
The Coalition has found few, if any, of its policies to be as controversial as the NHS reforms contained in the Health and Social Care Bill. The pressure has increased in recent weeks, with both British Medical Journal and public polls showing overwhelming opposition, another Lords defeat, reported cabinet concerns and speculation over the future of Health Secretary Andrew Lansley. It was rumoured that former Labour Health Secretary Alan Milburn could be ennobled to take over the role, which would fit an analysis of the government's problems as essentially political, rather policy-based. If Julian Le Grand is right that the Coalition's reforms are a 'sensible evolution of previous strategies', then who better to see them through than Milburn, who introduced foundation trusts in 2003?
Nearly a decade earlier, Milburn had to assure Parliament of his own reforms: 'This is not privatisation, it is democratisation.' The proposed GP consortia look rather different from the membership communities of foundation hospitals, which Milburn and colleagues were keen to justify by harking back to a largely mythical pre-NHS culture of mutualism and working-class governance. An 'evolution' is evident, however, in the increase of the private income cap to as much as 49 per cent for NHS trusts, an extension of the financial freedoms awarded by Milburn. Shadow Health Secretary, Andy Burnham, claims this would be a return to 'the bad old days in the NHS when people were told to wait longer or go private'. However, the fear of private practice in hospitals 'squeezing out' those with the greatest need has a longer history than the NHS itself...
"Tätigkeit ... nicht müssige Stempelei". Arbeitsbeschaffung, kollektives Arbeitsrecht und Lohnpolitik
published in: Leimgruber, Matthieu, Lengwiler Martin (eds.) Umbruch an der "inneren Front". Krieg und Sozialpolitik in der Schweiz, 1938-1948, Zürich (Chronos-Verlag), 2009 S. 47-73