Reforming the NHS is so vital that we shouldn’t have to wait until after the next election, says Helen Evans .
With the NHS again moving centre stage in the run-up to the general election, the mainstream political parties will be quick to reassure voters that nationalised health care will only be safe in their hands. Indeed, we have already seen campaign messages from David Cameron’s Conservatives promising that they will “cut the deficit, not the NHS”.
However, in reality, the UK’s structural financial situation is now so dire that the NHS will have to be substantively overhauled, irrespective of who wins the next general election or whatever they say beforehand. Rather than simply wait for the next government, Nurses for Reform (NFR) believes that as front-line carers, nurses must now put the case for a fundamentally different and better health-care system.
That is why NFR not only recognises the urgent need for reform, it also believes too many nursing and medical trade unions remain wedded to fundamentally old and outdated ideas. Instead of promoting substantive reform – and in doing so, championing the rights of patients and consumers – they predictably default to the short-term platitudes of demanding more taxpayers’ money or new forms of legislative favour. Such an approach is not only disastrous for nurses and the other medical professions, it is also catastrophic for patients.
NFR believes that the next government must liberate health provision from the costly and counterproductive world of top-down and un-innovative state control. On a practical level, this means a detailed consideration of the following key points:
- All health provision in the UK, such as hospitals, clinics and care homes, should be placed in the independent sector, be it for-profit, co-operative, or not-for-profit forms of ownership. What matters here is genuine diversity and openness.
- Following the logic of planned Conservative Party changes to education and schools, local planning laws must be reformed in order to enable a much greater diversity of – and non-government investment in – health facilities. In a truly post-bureaucratic age, the Secretary of State for Health should no longer have any say over when or where hospitals are built, opened or closed, and nor should local politicians.
- The laws surrounding health censorship should be repealed so that patients can be empowered with much greater information. In this context, hospitals, GP practices and pharmaceutical enterprises should all be free to advertise and build trusted brands. Only by allowing reputations to be freely built will people be able to realise the advantages of competitive standards and judge for themselves who they can trust in a health-care market.
- National collective pay- bargaining for health professionals should be ended, monopoly bodies such as the General Medical Council and the Nursing and Midwifery Council should be opened up to genuine private alternatives, and all health-related training should be paid for by independent providers – thereby boosting the diversity and opportunities available in a more vibrant labour market.
- Finally, tax-funded “public health” should regain the trust of people by only concerning itself with those areas that specifically overlap with, and are akin to, warfare: for example, natural disasters and pandemics. Beyond these limits, any further health initiatives aimed at informing or nannying people should only be undertaken by independent-sector organisations, be they for-profit or not-for-profit, and providing they do not use any taxpayers’ money in their execution. All initiatives should be created and funded without any involvement from any aspect of the public sector, again including local government.
Today, more than ever, such a package of reforms is necessary so that health care is finally depoliticised and led by the people who matter most: patients as consumers. In short, we can do a lot better than the NHS without ever going the way of highly regulated and state-funded American health care. What we need is a genuine market.
The Telegraph