Not a day goes by now without the UK press having story after story about necessary and impending public spending cuts to solve our problematic national debt. Although there is much speculation about where these cuts will fall, I am sure that in the run up to the election there will be much posturing about the NHS being “safe in our hands” and that “the NHS and its services are beyond monetary considerations.”
However, we are way past being able to carry on in this vein. The dire financial situation that the UK is facing gives the next prime minister an historic opportunity to put right the past sixty plus years of failure of the NHS. He now has the chance to provide the population of the UK with affordable, high quality healthcare.
Politicians can no longer have the luxury of pretending that the NHS can do it all, that healthcare has to be funded and provided by the state. This book, published last year by the IEA, shows that opinion formers are already admitting this privately if not ready to do so publically.
So, what can be done? First, all NHS institutions, i.e. hospitals, clinics, community services etc, have to be removed from the NHS. Whether by management buyouts, sales to for-profit or not-for-profit organisations or by the setting up of charities, the NHS must no longer own them. It must no longer employ the staff or have any influence on the services that they provide.
Second, the NHS must be re-cast as a funder and standard setting body. It can negotiate contracts with either these former NHS institutions or with providers from the existing independent healthcare sector.
This must be real privatisation of provision - not a half-hearted attempt as we have seen with private finance initiatives or the mere contracting out of services such as the railways, but a real, honest and permanent removal of all of the NHS estate, services and employees from the public sector.
This, and only this, will ensure that the UK starts to gain a real and deserved reputation of having health care provision that is the envy of the world.