You’re joking! Not another re-organisation?

Labour Health Policy

Oh no.

In this world nothing can be said to be certain, except death and taxes. And NHS reorganisations.

The next election could be in 2022, unless the current Tory government falls under the sword of Brexit. So, with all of the current government’s efforts being taken up with exiting the European Union, it might seem intuitively odd at Jon Ashworth might want to think the unthinkable – another redisorganisation of the NHS.

By 2022, some of the ‘integrated care organisations’ might be up-and-running. Or, possibly, by that stage, accountable care organisations might have been killed off in the law courts?

We are all Corbynites now, which means we are all singing from the same song sheet. Jon Ashworth MP is likely to, in reality, want to keep his cards very close to his chest before being forced to ‘reveal his hand’. ‘Labour is socialist in that it’s always had socialists in it’, a saying made famous by the late Tony Benn. And one thing that Labour wishes to be seen to be is democratic.

A wholesale reform might be ‘popular’. Whenever Andy Burnham, as Shadow Health Secretary for Labour, promised to repeal at the Labour Party Conference the Health and Social Care Act, there would always be massive applause.

There would always be huge disdain about the cost of the reforms, occasionally estimated at a few billion, but it’s uncertain whether Labour voters feel the need for austerity any more. After all, George Osborne’s policy in ‘paying off the deficit’ put the economy into meltdown.

The narrative from the Conservatives has been ‘you’ve never had it so good’. Except – one commentator remarked at Question Time, some disabled citizens had been propelled into a premature death. Everyone, it seems, was not awarded the personal independence payment. And there’s always money for foreign wars and things like HS2.

Andy Burnham had always maintained that he would use existing structures to do different things. Whilst Ashworth might want to abolish the ‘internal market’, or abolish the purchaser-provider split, the details are unclear. Will Labour wish to ‘buy back’ some PFI contracts? Would Labour wish to ‘take back control’ of outsourced contracts?

I’ve never heard a politician say that he will strip funding of public services, even if (s) he ultimately does that. But will Labour in real terms be able to increase the funding for physical and mental health as well as social care? Will Ashworth make ‘parity a reality’?

Will Ashworth continue with the ‘personalisation’ agenda? If Ashworth wishes to abolish certain parts of the infrastructure, who is going to administer ‘integrated health and care budgets’? Will the replacement of clinical commissioning groups still have to ‘plan’ services, even if not as such ‘commissioning’ them?

How much of the NHS can Ashworth bring under the State’s ownership? Would Ashworth dare to nationalise social care? How will he rationalise “integrating” a universal, comprehensive, free-at-the-point-of-use NHS with a means-test social care system? Is the ‘divide’ between health and social care tenable anyway, for example for people living with long term conditions such as frailty or dementia?

How much can Ashworth do before being set off course from exiting the European Union? Will ‘taking back control’ unleash millions and billions of ‘state aid’ which only Corbynites had previously dared to dream of? Will it mean that the NHS be rid of those dreadful EU competition directives which the Blairites loved so much?

I have absolutely no idea what Jon Ashworth wants – what he really really wants.

But, if it’s any consolation, nor does Jon Ashworth………. yet.

@dr_shibley