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Home Opinion Health reforms inflict pain on Cameron's Conservatives

Health reforms inflict pain on Cameron's Conservatives

John McTernan - 18 April 2011

A groundswell of professional and public opinion has put the UK Coalition in hot water, giving Labour a real chance to fatally brand the Tories, once again, as the enemies of the National Health Service

Less than a year since the Conservatives and the Liberal Democrats formed a government, they are in deep trouble together. Opinion polls ratings for the coalition have plummeted to the extent that their combined support is barely equal to Labour's. In forthcoming elections for council seats, the Welsh and Northern Irish Assemblies and the Scottish Parliament the coalition partners will see their seats fall. In particular, the Lib Dems, who ran as a progressive alternative to Labour are going to be punished for putting the Tories into power.

All new governments get a honeymoon, but they're getting briefer and briefer. Moreover, anyone ushering in the scale of cuts the coalition are proposing (£81bn) can not expect to be popular, for even if they are convinced that their fiscal approach is the correct one, they also know that pain precedes any possible gain.

So far, so predictable, but something else is going on in Britain. A deeper hostility is being stirred amongst voters, and it is to do with that most British of institutions - the National Health Service. Ironically, while in opposition Prime Minister David Cameron staked his reputation on his support for the NHS. Having praised his first-hand experience of care for his family, he went on to pledge that a Conservative government would not pursue top-down re-organisation of the health service. Nor should we forget poster campaign which, in every city in Britain, featured an air brushed picture of Cameron alongside his personal promise - 'I'll cut the deficit, not the NHS.' Unequivocal, and one of many changes that ‘detoxified’ the Tory brand, it helped make them the single biggest party in Parliament.

Coalitions are about compromise of course, yet after the election the Tories and Lib Dems reiterated the same pledge in their coalition agreement. It came as a shock then. When by the summer Tory Health Secretary Andrew Lansley unveiled a reorganisation of the health service so great that the Chief Executive of the NHS said that it could be seen from space. It's genuinely hard to know what they were thinking. Was this top-down reorganisation OK because it wasn't 'pointless'. Or is it OK because, although top down (legislated from central government), it seeks to devolve power to GPs and is therefore, in the end, a 'bottom-up' reorganisation. Who knows? Whatever their motivation, it has proved to be a massive miscalculation.

This month one of the main nursing unions passed a vote of no confidence in the Health Secretary - with 96% voting in favour of the motion. We have to go back through 30 years of British political history to the days of Thatcher to find the last time this happened. This action follows the government’s unprecedented move withdraw the NHS legislation from parliament in order for the coalition to 'pause' and listen to concerns about the proposals.

This is an odd move given that Cameron previously boasted that his Health Secretary was a man who knew more than anyone else about how the NHS works, having spent five years in opposition shadowing health. In reality, it would appear Lansley learned next to nothing in his during his opposition years. He has an almost Maoist commitment to change, but lacks the ability to articulate the problem he is trying to solve. Public satisfaction with the NHS and health spending is at an all-time high. Labour's targets and investment were guaranteeing treatment from GP to hospital within 18 weeks and patients had the choice of any hospital - public, private or voluntary.

Destructive, unpopular and inexplicable reforms combined with broken promises give Labour a real chance to fatally brand the Tories, once again, as the enemies of the NHS.

A contribution to the State of the Left, a monthly insight report from Policy Network's Social Democracy Observatory

John McTernan is a commentator and political strategist who works internationally. He was political secretary to Tony Blair and has been an adviser on health, welfare, defence and Scotland

This is a contribution to Policy Network's work on Globalisation and Governance.


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05 January 2013 16:37

I have often had the same thought, what about the panittes in all of this? As with other chronic diseases panittes are often very knowledgeable about their condiionand to exclude them is to omit a very important dimension besides causing me to suffer a few shivers of apprehension for the future.I have often wondered if there is a longterm plan to replace doctors with nurses.The paient is acually powerless to change he policy in their GP's Practice so it matters little whether he patient considers one or the other to be more well informed.In any event, to be able to judge this means that we would have to be better-informed than either.I have reservations about Nurses taking over from GPs. They may be able to concentrate more on the disease itself and keep up to date wih the constant changes etc but might it not be dangerous to treat diseases in isolation like this.? It is natural for panittes with a chronic condition to attribute all symptoms to that condition .One would hope that a Gp would be able to see the wider picture, but I realise that this is not always the caseI worry a little about the quality of some of the nurses in Practices now just like those in Nursing Homes who seem to be able to rise to the rank of sister so much more quickly than those in hospitals,Unless nurses have a great deal of experience [not always the case} they are far less likely than experienced doctors to treat panittes as individuals .I suppose Nurses replacing Doctors is the logical conclusion of what we have seen over the last few years _I find it frightening.I have known one Nurse Practicioner and cannot believe that she had the intelligence or education to replace a doctor. Maybe if the system changes in the future this could work but in the meantime I feel threatened by it. I have found it a matter of great concern lately when Gps in my pracice show themselves to be almost ludicrously afraidto enter into into any discussion and avoid any mention of my diabetes on the grounds that the nurse attends more courses . There is obviously no chance whatsoever that we will move towards a more holistic system.It will definitely not be patient-centred.

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The Policy Network Observatory promotes critical debate and reflection on progressive politics. It is centre-left orientated but determinedly challenges social democracy. It is pro-European but restlessly questions EU institutions and practices.

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