Alan Milburn swallows Andrew Lansley’s agenda whole….
Alan Milburn, having been touted as a potential saviour of the shipwrecked NHS Reforms pursued by this government, has now found his way into the pages of the New Statesman offering his vision for a reformed NHS. He starts from the fundamentally wrong principles; healthcare is not a business nor should it ever be, no real place exists for private enterprise in the supremely delicate matter of a person’s health and well-being. The mixed economy in healthcare has done real damage to people’s lives and also, since Mr Milburn is so concerned with these, the states finances.
He praises Labour’s investment in our National Health Service, as well he might. However, he fails to criticises the mechanism through which much of this investment was achieved. He fails to develop a rounded critique of the fiscally wasteful and irresponsible terms of Private Finance Initiative deals; deals which have now left the NHS with an urgent cash-crisis. None of these deals represent good value for money and although they delivered short-term service improvements they are now leading to a long-term crisis in service provision. Dishonesty therefore exists in his assertion that the crisis in subsidised health provision is due merely to a rise in demand; the crisis is really caused by the operation of a mixed economy in healthcare.
It is not surprising, for example, that a rising demand for drugs and medicines is causing a cash hemorrhage in the NHS when pharmaceutical companies are normal enterprises run for profit and service provision only to the extent that it maximises profit. The NHS, like the welfare system, has become a private sector cash-cow which it has milked bone-dry at our, the taxpayers, expense. We lose out both in the money we have to fork out and a service which is reduced and so diminished we end up paying tax and for the service its meant to fund in the first place.
Lets be clear. Mr Milburn does not fundamentally disagree with the direction of travel of the government;
The Conservatives failed to gauge how much political permission they had to make change.
This is an aesthetic, not a substantive critique of the position espoused by David Cameron and Andrew Lansley. Another specific failing of Labour in government, to collect tax, is something that he cites as a reason for choking our NHS of much-needed resources and privatising it through the back door. Labour made a fundamental error in its taxation policy – there is no point having a policy framework on tax while the same policy framework allows the absolute ravaging of actual incomes. Taxation and incomes policy go hand-in-hand and by careful re-calibration of the two in tandem, the state can actually start to build a more socially equal society although it is true in doing so it will find itself ceding more and more control (control being different to supporting something with resources) to the people.
The article is shot through with the usual hocus-pocus rhetoric about ‘bottom-up change’ that is so beloved of the political right. It loves to talk about accountability and ‘grassroots’ control while in practice taking that away from even nominally accountable elected representatives and handing to the unelected and unaccountable tyranny of the market and boardrooms. It’s a shallow excuse to privatise and commercialise every aspect of a person’s life and remove the last supports and safety nets even our inadequate system has; the left needs to expose these fallacies and reclaim the concepts of democracy and empowerment for itself.
Labour must be careful not to accept the false framing of ‘choice’ versus the ‘bureaucratic state’. This is especially true when it comes to healthcare where its campaign against the NHS Reform Bill has been creditable. The right-wing in this Party is urging the us to go ‘further, faster’ in areas like NHS and welfare reform but it is doing so without realising that the crash laid-bare the disastrous failings in both its intellectual and political vision. It learns the wrong lessons from our history and wants to take us down a cul d sac on the road to nowhere. We should beware these siren voices from a failed past and ultimately dismiss them out of hand.