The future of the NHS


First published in the Newcastle Journal

At this time of year political commentators like to set out what they think the major challenges ahead.  So far the main topics have been the European Elections, The Chilcott Enquiry into the Iraq War, which is due to report in the summer, and the Scottish Referendum on Scottish Independence.

I want to add a fourth.  The future of the NHS, since this year may well be a tipping point as to whether we still have something we can recognise as an NHS at all.

In this country we have been blessed with two national institutions which, although not perfect, have stood the test of time.  I am referring to the BBC and the NHS.  These are admired around the world. Both were set up in different times and I doubt if they could be set up now since the power of commercial interests is so great. Look at the ferocious opposition Obama has encountered.  But most people like them, and are willing to pay to keep them.  They are institutions which bind us together, in which we all share.

I am not saying they are perfect, and when they do not deliver they must be called to account.  But on the whole they do deliver.  Despite its failings, the majority of people still report satisfaction with the NHS, and I note that the BBC scored the highest ratings for terrestrial television over Christmas. Its journalists are respected all over the world and it gives space to many different points of view.

But there appears to be one man who is not part of this consensus – Jeremy Hunt.  He does not like big state-run bodies, and prefers privately run ones. He wanted the BBC reduced in scope, and now seems hell-bent on privatising the NHS.  We all know that it is better to judge people by what they do rather than what they say.  When he was Secretary of State for Culture Jeremy Hunt did his best to encourage Murdoch’s Sky Corporation to achieve a dominant position in British Broadcasting. He was  known as the “Minister for Murdoch”.  What stopped him were the failings of the Murdoch empire, exposed by other journalists. Despite the various attacks on it, and reduction of its funding, the BBC seems to be thriving.

But one reverse hasn’t dimmed Jeremy Hunt’s enthusiasm for privatisation.  The public are perhaps not aware that a major programme of privatisation in the NHS is due to go ahead this year.  I am referring to the putting of the Commissioning Support Units out to tender.  These are a major part of the NHS administration which sort out the various commissioning intentions of the Clinical Commissioning Groups and arrange for services to be delivered.

At the moment they are just about getting themselves sorted out after the last reorganisation.  Many people fear that if private organisations take them over they will then favour private providers over NHS ones to deliver health  services. As Mr Hunt is no doubt aware this could lead to a major increase in private sector involvement in the NHS.

I would be the first to admit that there are aspects of the NHS which need improvement, but the public are probably not aware of the tremendous efforts currently being made to improve efficiency and “transform” services to make them more effective.  The NHS has two qualities which are difficult to quantify.  One is a genuine ethic of public service which motivates many of the staff.  The other is a coherence, an sense of unity.  Making it a market based organisation and splitting it all up between different contractors whose aim is to make profits will destroy both of these.

I hope I am wrong.  Many predictions  are.  But we need an honest debate about the NHS and Jeremy Hunt should say what he really thinks and then listen to the debate. I doubt if he would get much support.

David Taylor-Gooby is a free lance writer.  His latest book, “Reclaiming the Big Society” is available from the publisher, Searching Finance”