“The National Illness Service”?!
Here’s one Lib Dem politician’s view on the Health and Social Care Bill 2011:
“We need to .. replace the National Illness Service that we currently have”
You can read my many other posts and note that I don’t quickly resort to expletives and such. But that kind of comment deserves a blunt response: [I disagree with you], Mr Kemp, [for being so smug]. No wonder the public doesn’t trust politicians with the NHS.
The UK has an efficient health care system that largely delivers high quality outcomes, considered by the World Health Organisation to superior to such countries as Ireland, Switzerland, Belgium, Sweden, Germany, Canada, Finland, Australia, Denmark and the United States (and FAR more cost efficient than the US). I’m embarrassed to find I’m in a party with a muppet who even thinks to use such a phrase as “the National Illness Service”, let alone write it down and publish it online.
(Note: that WHO survey is quite old, although they do track the individual measures. However, there’s no reason to believe things have changed significantly since 2000, particularly with the heavy investment under Labour in that time. The other countries aren’t perfect, either.)
Then again, it was no surprise to find Mr Kemp is the Leader of Lib Dems in Local Government. I’m from Glasgow, where Labour’s stronghold on the council (they used to have 94 out of 97 seats before STV) was an excellent introduction to how local government can be just as condescending, closed to public input, and in hock to private or personal interests as central government. A pandering, self-aggrandising statement about how wonderful things will be with “local decisions will be made by locally accountable people based on local priorities and local opportunities” would be par for the course.
(Another note: I do believe in local government, subsidiarity, and so forth. But it’s not a blind faith.)
This is a long, complicated bill affecting a huge, complex organisation. Both the detailed letter of the law and the spirit of the legislators are important. Mr Kemp’s piece is light on detail and utterly lacking in good spirit; it’s depressing to have such pieces being written by a senior party figure.
The outcomes in a major change often come down to the soft factors: the weight given to executive sponsorship, the emphasis on risk management, the clarity of language detailing lines of responsibility. The Bill strikes me as weak on these counts. The Health Secretary is eager to hand off all these issues to a mix of quangos, consortia, local government and community representatives. If the reforms work as currently, it will be as much by luck as by design.
(Yet another note: it is possible, for instance as seen in France, to have a more hands off approach to the health service. However, success would depend on culture, and does anyone honestly believe the Tories are seeking the same culture as found in France? The Bill is transparently written to allow as much taxpayer money as possible to be channeled to the private sector. That doesn’t bode well for long term cost control, which is a fundamental goal of the reforms. Mr Kemp’s piece suggests governance by naïveté. It’s not reassuring.)
This is a bit of an incoherent rant, I know. But seriously, “the National Illness Service”? [How dare you].
Update 27/09/11: I really should hold my temper better, and have edited this article to make it more suitable for pre-watershed viewing. It reads funnier, too.