Wednesday, October 6, 2010

NHS reform: a big challenge for a big society

Some say that to the Cameron Conservatives don't really regard the national debt as the terrible legacy of Labour mismanagement as they love to say but as a heaven sent opportunity. They argue that the Tory austerity package is more to do with an ideological commitment to reducing the size of the state - replacing big government with, snigger, the big society - than economics. Today's conference speech in which the Conservative leader appeared to reintroduce the old Elizabethan poor law distinction between the deserving and undeserving poor will only have increased those concerns.

So is the government plan for the NHS, evidence for or against this? If money was the main concern why spend an estimated £3 billion on another reorganisation - especially when you were constantly criticising Labour for behind the scenes fiddling while front-line services burned? Certainly the plan for GP consortia to replace Primary Care Trusts sounds horribly like GP fundholding, the disasterous pre-privatisation plan of the last Conservative government that hemorrhaged the NHS along an artificial purchaser-provider faultline.

The MHF wisely hasn't engaged with this ideological debate in its response to the government's health white paper. Instead it has stuck to the purely practical, offering the government help with, for example, a Gender Equalities Board to ensure that inequalities in health outcomes are addressed. This is one of 10 specific suggestions which if they are adopted could reform the NHS for the better. They won't protect the health service from the drip-drip of privatisation but they will protect the hundreds of men who die prematurely (before the age of 75) every single day. In a country where 42% of men die prematurely, they've got to be worth trying. Yes, 42% - a big number for a big society.

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