Brown's NHS dilemma
- 14 Jun 07, 12:38 PM
The idea of an independent NHS board is dead - under this government at least. The soon-to-be-ex health secretary killed it off in a speech today. Even though Pat Hewitt won't hold on to her job when Gordon Brown takes over, and she knows it, she did consult him before delivering her speech today.
Brown-ites first floated the idea of doing to the NHS what their man had done to the Bank of England last autumn. However, they were met with a fierce backlash. Blair-ites warned that they'd be creating the equivalent of a nationalised industry board which might resist reforms and budgetary control. Backbench MPs expressed their fears that they'd be unable to seek political redress for NHS problems in their constituencies.
The Department of Health has done work on creating an "NHS headquarters" or a separate "management executive" to separate strategy and policy from management and implementation. This would not be the same though, as entirely devolving the running of the NHS to a separate board. Even so, the Tories and the BMA remain wedded to the idea.
Health, Brown says, is his priority. No wonder given the fact the Tories are ahead in the polls on the NHS. He sees it though, as a political problem rather than a policy one blaming Tony Blair for constantly picking fights with the staff and in a way which has distracted from the huge sums of money poured in, the many new hospitals and shorter waiting lists.
So, what will he do?
I believe he's likely to
• change the ministerial team
• reassure most areas of the country that their hospitals do not face closure (or re-configuration in the jargon). Ministers complain that thousands of people have gone on marches to save hospitals that are not even under threat
• launch a grand consultation with staff and public over the NHS's values leading up to the NHS's 60th anniversary next spring and, perhaps, ending with a new constitution for the NHS
• focus on primary care and improving out-of-hours access to doctors
The last is a puzzle though. He can only get what patients want by having a fight with the doctors. It is the anger of doctors that have fed public feelings that the NHS is in trouble. Tony Blair came to the view that you could either be on the side of doctors or patients and not both. Can Brown prove him wrong?
