Brown's plans for the NHS are bonkers
One word sums up Brown's big idea for the NHS- bonkers. When a local hospital is closed by Labour's managers with no right for politicians to intervene, ask who is accountable? On Monday at the Labour conference, Brother Brown raised the idea of hospital closures being removed from the labour politicians with the introduction of yet another layer of bureaucrats taking the blame.
The policy of giving the Bank of England the power to set interest rates, free from political interference, has been an undoubted success. So now Mr Brown wants to extend that model to the public services, with the NHS most commonly named as the first to be reformed in this way. An "independent board" will be established to administer the service, with the role of politicians restricted to setting overall goals and strategy.
Apparently the Conservatives are sufficiently enthusiastic about the idea to claim that Mr Brown has stolen it from them. The day will come when the Tories will pretend that they had nothing whatsoever to do with it.
The problem with policy ideas is that you either discover that someone has done them already or that it was such a flawed notion that no one would want to do it. Well, congratulations to Mr Brown.
The NHS is not like the Bank of England. The Bank is setting the price of money. The NHS has an output not far off that of Portugal. It handles something like 10 per cent of our national income. It still employs over half a million people. It is a very different animal.
There are two ways of holding such a body to account. The first is through voice — the right to protest to a political representative who depends on your vote. The alternative is exit — the right to take your custom elsewhere, with the seller dependent on your patronage in order to thrive.
Mr Brown plans to remove both these forms of accountability. When he describes the new board as independent, you just have to ask: independent of what, exactly? And the answer, it turns out, is independent of you and me.
Sir Peter Lachmann, former president of the Royal College of Pathologists, felt moved to write to the Times saying that Mr Brown’s new policy was “probably the best news the NHS has had in the past 30 years”. This endorsement from a lickspittle is hardly surprising. The senior management of the service is bound to conclude that the interference of meddling politicians is nothing but a nuisance. They want to run their NHS with our money and without us pesky voters sticking our nose in the whole time.
The Chancellor is arguing that the closure of a local hospital ought to be decided by health service managers without the right of politicians to prevent it. If he isn’t saying this, he is saying nothing. But is it really acceptable that such sensitive decisions be made only by a group of unelected people, accountable only to each other and without appeal to the local electorate?
The model that Mr Brown intends to apply to the NHS is not really the Bank of England at all. It is, well, the model that the Tories tried to apply to the NHS in the mid-1980s.
In 1985 Norman Fowler, then the Health Secretary, appointed Victor Page as the chief executive of the NHS with the idea of relinquishing political control of administrative matters. It was perhaps with this experience in mind that another former Health Secretary yesterday said that he thought Mr Brown’s plan was “bonkers”. Political pressure from voters and the media ensured that it didn’t last five minutes. And neither will Mr Brown’s plan.
The Chancellor has set his face against such a Blairite (actually Tory) solution. But his third way between two forms of accountability is to provide no accountability of all. His NHS board idea was intended to reinforce his image as a man of substance instead it will show him up again as Bonkers.
The policy of giving the Bank of England the power to set interest rates, free from political interference, has been an undoubted success. So now Mr Brown wants to extend that model to the public services, with the NHS most commonly named as the first to be reformed in this way. An "independent board" will be established to administer the service, with the role of politicians restricted to setting overall goals and strategy.
Apparently the Conservatives are sufficiently enthusiastic about the idea to claim that Mr Brown has stolen it from them. The day will come when the Tories will pretend that they had nothing whatsoever to do with it.
The problem with policy ideas is that you either discover that someone has done them already or that it was such a flawed notion that no one would want to do it. Well, congratulations to Mr Brown.
The NHS is not like the Bank of England. The Bank is setting the price of money. The NHS has an output not far off that of Portugal. It handles something like 10 per cent of our national income. It still employs over half a million people. It is a very different animal.
There are two ways of holding such a body to account. The first is through voice — the right to protest to a political representative who depends on your vote. The alternative is exit — the right to take your custom elsewhere, with the seller dependent on your patronage in order to thrive.
Mr Brown plans to remove both these forms of accountability. When he describes the new board as independent, you just have to ask: independent of what, exactly? And the answer, it turns out, is independent of you and me.
Sir Peter Lachmann, former president of the Royal College of Pathologists, felt moved to write to the Times saying that Mr Brown’s new policy was “probably the best news the NHS has had in the past 30 years”. This endorsement from a lickspittle is hardly surprising. The senior management of the service is bound to conclude that the interference of meddling politicians is nothing but a nuisance. They want to run their NHS with our money and without us pesky voters sticking our nose in the whole time.
The Chancellor is arguing that the closure of a local hospital ought to be decided by health service managers without the right of politicians to prevent it. If he isn’t saying this, he is saying nothing. But is it really acceptable that such sensitive decisions be made only by a group of unelected people, accountable only to each other and without appeal to the local electorate?
The model that Mr Brown intends to apply to the NHS is not really the Bank of England at all. It is, well, the model that the Tories tried to apply to the NHS in the mid-1980s.
In 1985 Norman Fowler, then the Health Secretary, appointed Victor Page as the chief executive of the NHS with the idea of relinquishing political control of administrative matters. It was perhaps with this experience in mind that another former Health Secretary yesterday said that he thought Mr Brown’s plan was “bonkers”. Political pressure from voters and the media ensured that it didn’t last five minutes. And neither will Mr Brown’s plan.
The Chancellor has set his face against such a Blairite (actually Tory) solution. But his third way between two forms of accountability is to provide no accountability of all. His NHS board idea was intended to reinforce his image as a man of substance instead it will show him up again as Bonkers.
posted by Wise Money at
9:21 AM
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