Monday, 17 January 2011

Cameron's spots the same as Thatcher's stripes

So David Cameron wants fundamental changes to the NHS which will, among other things, create more 'competition' between it and private medical services, and which have been branded as little more than privatisation by critics. Leaving aside the commitment in their coalition agreement with the Lib Dems, in which they said, and I quote, "We will stop the top-down reorganisations of the NHS that have got in the way of patient care," this is a bizarre concept to introduce to a publicly funded, not-for-profit organisation, the sole purposes of which should be to care for ill people and offer preventative advice. Exactly what sort of competition does he envisage?

"Undercut BUPA for a week's stay in intensive care and win a year's supply of Walnut Whips! You could even, if you perform exceptionally, win some medical equipment!!!"

We have, of course, yet to see the full text of the proposals, but I simply can't understand how you can introduce competition into an organisation like the NHS. Is it to remain free, apart from the bits you have to pay for? But never mind, according to Cameron on the Today programme this morning, the NHS is 'second rate' anyway, so any change is bound to be an improvement. Again, I quote: "I don't think we should put up with a second rate - with coming second best. We should aim to be the best."

See, that's where the NHS has been going wrong all these years. Instead of all the people who work their arses off within it wasting their time and energy caring about patients and making people well, they should be focusing on being better than Germany, or Spain, or Italy's medical care provision. That's what's really important.

So, Cameron will doubtless press on, trying to take the Lib-Dems with him. He clearly knows his stuff - I had no idea he was a medical practitioner, but evidently the negative comments from the Royal College of GPs and the BMA, apolitical organisations both, that the changes are unneccessary and savings and improvements could be effected without such drastic changes, have made little impact on a man who obviously knows better than they do. The plain fact is that the Tories will push on with stuff like this regardless of the advice from significant sections of the medical profession because they're idealogically compelled to do so. They can't not, because the NHS is one of those organisations that they simply can't understand. It's not there to make money, it's not there to make anybody rich, so it's an utterly foreign thing to them. A bizarre, huge, complicated abstraction that clearly does something, but the arcane depths of its function and its reason to exist are utterly opaque to them.

This hasn't changed since Thatcher's time and never will. I'm pretty sure that if it wasn't such a hugely important national institution that millions of people rely on, they'd ditch it altogether, and leave us with something like the American model, where you need a credit card when you need an ambulance, or you rely on charity. They know that would be catastrophic for their vote, so they can't take it that far and have to come up with some sort of fudge which satisfies their dogmatic impulses but can be twisted to sound like improvements to the service. The new caring, sharing Tories? Bollocks.

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