It’s all very well for Nick Clegg regaling us each day with what he’s going to do to Lansley and the NHS Bill if his amendments to it aren’t accepted by the Tories. And now we learn what the Tory backwoodsmen are going to do if their ‘red lines’ are not accepted by Clegg. But where’s Labour in all this? We should all be grateful that Clegg – thanks to the electorate’s dumping him on 5 May – is now (at last) sticking his oar in over Lansley’s assault on the NHS. But the fact is, Clegg’s position, flip-flopping all over the place on the NHS as on every other issue, isn’t ours. His aim is to find a formula, if there is one, to keep his own party intact whilst staying (just) inside the Coalition. Ours is a principled rejection of the whole Bill.
Clegg’s floundering has finally arrived at four adjustments to the Tory bill. The membership of the new GP consortia should be opened up to Councillors and other health personnel, the 2013 deadline should be extended, the opening up of all NHS services to “any qualified provider” (originally “any willing provider”) should not suddenly be introduced, and the health regulator Monitor should not ‘push competition’. All of those are of course welcome mitigations of the pure marketisation model inherent in the Lansley bill, but they are merely ameliorations of a fundamentally wrecking bill.
The voice missing from this debate is Labour’s. Our position is that we want a wholly public service, not a privatised service where the NHS survives only as a kitemark. We want a health service that is not crippled by £20b cuts over a 4-year period which no other health service in the West has had imposed on it in such a timetable. We want a health service that takes only 8% of GDP, absorbing almost the lowest share of national income of any comparable health system in the Western world, to be protected from closures, service cutbacks, job losses and deteriorating patient care. Cameron promised no real terms cuts, and has reneged on it. Labour would deliver it because we are not trying to shrink the state, we are not seeking to pare back all public services, and we would not pursue a massive cuts strategy as the means to reduce the deficit.
So why don’t we commit ourselves to this position and say so loud and clear, not least when all the leaders of medicine – the RCP, RCS, RCGP and the BMA – are all on side and when the public is crying out for an unambiguous and principled repudiation of the Lansley Bill? Ed Miliband calls for a ‘national mission’: this would be a perfect place to start.