Thursday, 16 June 2011


Last week I met local NHS campaigners to discuss the concerns that they had with the current legislation going through parliament. I agreed with a lot of what they said and took their petition back to parliament. This week the government has made major changes to its proposals having listened to the views of thousands of medical professionals.

I used to work for David Cameron and I know that the NHS is very dear to his heart. He was the only party leader to guarantee an increase in NHS spending despite the pressures on public finances. He always argued that the NHS was special because of the commitment and sense of vocation among doctors and nurses. What motivates them is helping cure people who are ill, and that is more powerful than abstract ideas about markets.

That is why David Cameron was absolutely right to listen to the concerns expressed by doctors and nurses. Some political opponents will jump on his decision to amend the legislation and condemn it as a “u-turn”. But do we really want a government that refuses to listen? The brave thing to do is to have an open mind to your critics, take on board their views and reappraise your proposals. That is especially true with the NHS which is such a crucial British institution and which is literally a matter of life and death. So David Cameron has done the right thing and it comes as no surprise to those of us who know him.

The thrust of the government’s proposals on health is right. It cuts spending on managers and bureaucrats so that spending on the front line can be boosted. It gives more power to doctors and nurses so that they can decide what is best for their patients. It allows the private sector to offer a helping hand to our NHS so that waiting times can be cut. These are all things that people agree with.

However, when it comes to choice and competition in the NHS, I think we need to take a pragmatic view. The point about choice is that it should be an option for doctors, not a requirement. One of the problems with the way the legislation was originally drafted is that it suggested to some that competition was an end in itself rather than just a means to an end. The last thing we want to see is a bureaucratic process with unintended consequences.

In practice core services and major operations will remain within NHS hospitals and they need a critical mass of skills to remain viable. However, there are other areas where even the last government was open to making use of private providers such as occupational therapy, hearing services, physiotherapy and speech therapy. We would be foolish to close the door on such excellent services.