A Jolly Look at NHS Reform

Andrew Lansley’s proposed reforms of Britain’s health service came as a shock to many Liberal Democrats, as they were not part of the Coalition agreement; in fact, there had been an assumption that there would be no major top-down reorganisation. So it’s not surprising that the ensuing debate has been both extensive and contentious. Paul Burstow, as junior Minister, has done a great deal to ensure that the Bill stumbling its way through parliament has a significant emphasis on social care. But a lot of the most dogged attempts to make the proposed changes more palatable have occurred in the House of Lords, so it was good to have the opportunity last night to hear from Baroness (Judith) Jolly — at a Pizza and Politcs put on by Islington Liberal Democrats — her take on where we are at in the process. One element she stressed was the way that competition based on price (as originally proposed by Lansley) has been succesfully replaced by the concept of a an agreed price for which providers would then compete on the basis of quality of delivery. There is also now much more emphasis on the patient, though more progress still needs to be made. Judith had good experience working with health trusts before being elevated to the peerage last year and is therefore up to speed on much of the detail. But as I pointed out in the discussion following her presentation, it is very difficult to get a persuasive case based on detail across on the doorstep. In the London Mayoral and GLA elections this May, the Labour Party is bound to attack the Liberal Democrats on the issue of NHS Reform, even though health is not a competence of the Mayor or Assembly. Judith’s points were subtle and nuanced, but London politics is neither. I suspect the Labour approach will be like a twin-bored shotgun, with the two pithy criticisms: that the Coalition is destroying the NHS, and that it is privatising the NHS. Neither accusation in its blunt form is true. Health care will still be free at the point of delivery. And the opening up of parts of the service to private elements was in fact initiated by Labour. But we Liberal Democrats need equally pithy messages to refute Labour’s distorted charges. And we need them quickly.