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Martin Horwood MP

NHS Comment crack

In politics you have to be careful what you wish for. If someone unexpectedly does what you ask, it can cause its own problems.

Take Tory Health Secretary Andrew Lansley. In January he published the Health & Social Care Bill, which was hot on competition and a bit too kind to private healthcare providers. Had it gone through unchanged, private companies could have undercut NHS hospitals and hoovered up ever increasing shares of local NHS budgets. This could have been a real risk to smaller district general hospitals like Cheltenham. Whether or not this amounted to privatisation was debatable - patients were never going to pay for care but it could have undermined the kind of local NHS planning and co-operation that has actually made the NHS one of the most cost-effective health services in the world. ‘Commissioning’ (ie deciding how the local budget is actually spent) was to be given to bodies run entirely by GPs. Many of us feared less accountability to patients and the public.

Doctors and patients expressed their worries but it was a critical motion at the Lib Dem spring conference that finally took the wheels off Mr Lansley’s plan. We Lib Dems have taken a lot of stick for going into coalition with the Conservatives. In May’s local elections we did well in Gloucestershire but in the north and Scotland we got a fair old thumping. So however proud we may be of the coalition’s record on tackling the deficit, or its green record or its commitment to return powers to local authorities, we were in no mood to compromise on something as sensitive as the NHS. Labour and the media joined in and the pressure was on.

Mr Lansley, to his credit, paused, listened and agreed major changes to the plan. In the Lib Dems, it still comes as a bit of a surprise when governments do what you want. Some of our greatest past campaigns (against Tony Blair’s illegal war in Iraq, for instance, or more recently against tuition fees or for electoral reform) have not been spectacular successes. But this time, on the biggest political issue of all, we and the doctors and nurses and all the people who protested got our way. Not that we should celebrate just yet. Even with a rising overall budget, the NHS faces some tough years ahead and we can’t pretend it’s going to be easy, privatisation or no privatisation.

As for Tory MPs, some who loyally supported the original bill were clearly pretty irritated by what was widely called a U-turn. If it hadn’t been for those pesky Lib Dems..

But Labour were the most frustrated of all. What could they say? The Blairites in power promoted competition and even subsidised private ‘independent treatment centres’ from NHS funds. That’s now ruled out too. Even left-wing Labour MPs floundered in response to a government that had actually stopped and listened and changed course. They couldn’t really congratulate a Tory minister could they? This coalition business is taking some getting used to, for everybody.

Martin Horwood MP

To contact Martin, Tel: 01242 224889


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