Published on 17 Jan 2011

David Cameron joins the NHS debate

David Cameron came a bit late to the selling of tuition fees and is coming a bit late to the NHS reform debate too. And it’s not a reform that lends itself to the 20 second “elevator pitch” as he proved in a lengthy speech this morning. Tony Blair would’veĀ  started earlier and stronger, you can’t help thinking.

David Cameron’s main pitch today was trying to convince voters that this is not elective surgery that he is carrying out on the NHS but emergency surgery. A tricky sell when public satisfaction rates are high.

But there’s something else, related, that strikes you about the NHS reforms. The White Paper was dashed off in six weeks, remarkably short time for such a major reform, and No. 10, I’m told, didn’t make substantial changes to it.

Arguably, under Blair and Brown, No. 10 got too involved in departmental business, micro-managing. But some senior civil servants argue that it did act as a whetstone grinder. Policies were constantly subjected to test, scrutiny – often a painful process and not foolproof – but there is little to match that in David Cameron’s slimmed down No. 10 operation.

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3 reader comments

  1. Philip says:

    The NHS proposals, like many of the current Coalition, have been rushed through with insufificent thought & consuktation, as you suggests. There also appears to be no co-ordination across Government of a series of new polices which don’t seem to fit together, and could work against each other or make damaging outcomes worse. The NHS reforms are the classic case where a policy needs to be trialled loaclly to see how it works, wher=ther it works, what it needs to be successful. Instread we’ll have a massive experiment which is likely (a) to be vastly more expensive than expected/or will mean that the frictional costs of change will eat up resources which should be going to treating patients (b) to increase patient dissatisfaction – which will now be centred on their local GP (c) increase private sector involvement as GPs use private sector entities to do their purchasing for them – i.e. a new bureaucratic layer but in the unaccountable private sector (which also is only in there to make a profit). I’ve yet to find a good rational for WHY this is being done and WHY this is the best solution (rather than the next Government’s problem)

  2. Saltaire Sam says:

    As someone who has just benefitted from the NHS – two btilliantly successful eye operations- you can add me to that high level of satisfaction, and to the fear that the real reason for the changes is privatisation by the back door.

    Cameron said this morning that Lansley has been planning this for five years. If so, why were we not given a detailed policy during the election campaign? And why were we assured there would be no more top down changes?

    If Cameron thinks something as big as the NHS can be run without a large management, presumably we shall soon see the nationalised banks like RBS getting rid of their top management to be run by branch managers. That would also solve the problem of the bonuses.

    Cameron is being caught out in hidden agendas far too often and with his pal Clegg also willing to turn policy on its head, the last election (which none of them won) is starting to look like a mockery.

  3. Philip Edwards says:


    I believe most of the forthcoming Bill and its details are designed for a specific purpose: To deflect attention from the real Tory intention.

    This is the move to create a generation of doctors of the self-interested profiteering type prevalent in the United States, those who care more for their bank accounts than their patients. The method is one-step-at-a-time, known as “the salami method.”

    Firstly, separate them from genuine democratic responsibility. Secondly, create a climate of private profit in doctors’ surgeries. Thirdly, allow the “reorganisation” to bed in and doctors to profit. Fourthly, separate all doctors into private practices of the pre WW2 type, the kind that led to creation of the NHS in the first place.

    The Tories and their American “health” companies backers know very well they daren’t openly seek NHS abolition, but they can lie, mislead and rig the economic system – all of it backed by adverse propaganda churned out through monopoly control of media.

    Anybody who trusts CamClegg in this and other matters deserves the kind of ultra right society they will suffer.

    Aneurin Bevan was exactly right in his famous 1948 speech.

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