In the 2001 general election, the majority in my Redditch seat was cut from over 6000 to under 3000 and my good friend and parliamentary neighbour David Lock lost his Wyre Forest seat to an Independent Save Kidderminster Hospital campaigner. The downgrading of Kidderminster hospital was undoubtedly a defining issue for me and David in that election campaign. Constituency MPs fight any cuts of local NHS services tooth and nail because they understand the local impact of the issue on their electoral chances, but to what extent will the NHS be the defining issue of the next general election?
While David Lock and I felt the local impact of NHS cuts, Labour won the general election in 2001 convincingly. The economy was strong and a broad coalition of the public felt that the Labour government was in touch and taking the country in the right direction. These are the defining issues for every general election. If the NHS plays into or exemplifies these, then it will be crucial. But that will need us to do far more than simply oppose the current NHS bill.
The campaign against the NHS bill has been robust and effective. The government is on the back foot and in disarray. As I write this, the tables in No 10 are being arranged for another ‘summit’ on the NHS bill. David Cameron has had to step in to try to rescue both the bill and his reputation for detoxifying the NHS for the Tories. While the bill will probably limp on to become some sort of act, the Tories’ reputation on the NHS is once again damaged. This whiff of incompetence will still be hanging around at the next election. People will certainly experience longer waiting, fewer key staff and poorer service. These must be placed clearly at the door of coalition health policy.
We now have the opportunity to go further in developing our policy and argument about the NHS. What are the big choices that we would make about the priorities for the NHS at a time when money is not just tight, but falling. Andy Burnham is right to offer cross-party support on developing further GP commissioning. This is smart opposition. It sends the important message that we are not interested in simply defending the status quo in the NHS. We want to support the further transfer of power to the frontline which the current bill so obviously fails to deliver. How do we ensure further choice and control for patients in a way that focuses on quality rather than simply cost competition? This week, Ian Austin opened up a great debate about giving patients far more choice about when and where they see a GP. Liz Kendall is leading the way in thinking through how we design and pay for elderly care as the population gets both older and more demanding. Good stuff which demonstrates that it’s not just the NHS which is safe in Labour hands, but NHS reform too.
The next election will be fought on the battleground of economic competence and aspiration for our country. The approach to the NHS that we develop in the next couple of years could put flesh on the bones of Ed Miliband’s argument for fairness in a time of austerity. It could demonstrate that Labour is not backing off public service reform. If it does those things successfully, then the NHS may well be a defining issue at the next election.
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Jacqui Smith is former home secretary and writes the Monday Politics column for Progress
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My sadness is that surely Labour policies, when in office, ‘opened the door’ for many of the NHS ‘reforms’ the Tories are pushing through?
Labour must always fight strongly to preserve the integrity of the NHS. We hear little of how, on most international comparisons, the NHS is towards the top of league tables for health outcomes and cost effectiveness. (Always above USA which is the system we seem to be headed towards!)
That is untrue, Lance. Labour reforms in office, that Jacqui and her colleagues pushed through where not the reforms we are seeing being presented by Andrew Lansley.
The reforms Labour brought in where reforms whereby private providers were used to actually help the NHS, and supplement the NHS. Labour inherited situations whereby not only waiting times were extremely high but also you had patients waiting years for operations, and the private-NHS link was used in these cases but it was regulated, not a free-market (in fact Labour abolished the Internal Market). Also, it is right that we have patient choice in the NHS which is what Labour introduced. But it was done with record investment that the NHS never saw.
The current health ‘reforms’ aim to rip apart the NHS by opening up external competition including international private companies (even from the USA), they want to deregulate the private providers and even allow them to bid for care done on the backdrop of real-term cuts. That is worlds apart from what Labour did, and what the Coalition is doing – don’t listen to likes of Owen Jones on this issue.
Rubbish tell me where the cleaners helped anyone ,I had MRSI through labours private contractors. labour wanted and tried to flog off area of the NHS to the private sector to meet demands of the EU.
That is untrue. Some of cleaning staff were privatized before 1997. They didn’t want to flog it off they tripled investment in the National Health Service with the highest patient satisfaction, more nurses, more doctors and waiting times down to their lowest level ever. But if you are an old woman in need of a life saving operation, should she not get her treatment from the private sector if the NHS can’t do it qucik enough, with support of the NHS? To sya ‘no’ would be saving ideology before saving lives!
Above a country (USA) which has basic treatment for the poor, but below a lot of other countries including some African, I will always fight for the NHS but our biggest fight came against an NHS under New labour which saw the increase in the private sector, now labour fights the Tories over the same private use that labour campaigned for.
The problem for Labour, people are tired of this continued battle they want us to believe in, labour cares, no it does not, it cares about using the NHS as a way of getting back into power.
The NHS and the Economy will be the defining issues , The reality is we got reform in NHS very badly wrong wasted miilions on structure /bad governance and capital programme especially IT was a disaster. Reliance on Mangement tools which were not very good or used well , Creating tiers that were ineffective because they were filled internally with people who were policy driven with poor business management skills.
We can be proud of what we did achieve ,waiting ,lists,hospital based increase in nurse doctors etc ,we made a bad deal with GPs , capital build prgramme etc. We did enable the growth of private sector in NHS ,we should Patient choice more and remember not to give power to GPs and Commissioners against patients who are likely to become consumers in a competitive markets . How ,Why Who gets NHS Hospital and Community based servcies in a Rationing process leads to inequality of Patients. ?
The NHS and the Economy will be the defining issues , The reality is we got reform in NHS very badly wrong wasted miilions on structure /bad governance and capital programme especially IT was a disaster. Reliance on Mangement tools which were not very good or used well , Creating tiers that were ineffective because they were filled internally with people who were policy driven with poor business management skills.
We can be proud of what we did achieve ,waiting ,lists,hospital based increase in nurse doctors etc ,we made a bad deal with GPs , capital build prgramme etc. We did enable the growth of private sector in NHS ,we should Patient choice more and remember not to give power to GPs and Commissioners against patients who are likely to become consumers in a competitive markets . How ,Why Who gets NHS Hospital and Community based servcies in a Rationing process leads to inequality of Patients. ?