Ed Miliband will make his move on the NHS today, with a committment to cross-party dialogue on health service reform, if Cameron and Lansley drop their current plans. Miliband will also make the case for reform more generally, stressing that defence of the status quo is not an option.
In his speech to the RSA at 11am today, Miliband is expected to say:
“I come today as a reformer of the state as well as the market.
“It is particularly incumbent on those who believe in the role of public services in our society to be always seeking for them to be better.
“My conviction stems from the experiences of my own life and those of my constituents. I have seen first-hand the ability of the state to protect and empower, to extend opportunity and to transform lives.
“And yet I have also seen the sense of powerlessness and frustration that comes when people have to deal with services which are unresponsive or which let them down.
“An accountable state, just like an accountable market, is integral to a country which offers the opportunities and chances which we hope for in a modern, fair Britain.
“The NHS is an extraordinary institution. I believe it i s an institution which each generation has a responsibility to pass on to the next in better condition than the last.
“And my argument today is that to do that, to create an ever better health service, change will be essential. The new pressures on the NHS are too great, the new challenges too large and the need too important for us to think that preserving the status quo will be enough.
“The choice for the NHS is not between change and no change. Its a choice between competing visions of what that change should be.
“My contention today is also that this Tory-led government is proposing to take the NHS in the wrong direction.
“I believe they are about to make a serious mistake in pushing through change which fails to learns the lessons of a decade of reform under Labour when – although we did not get everything right – there was clear, sustained and substantial improvement. It is worth remembering that in 1997 waiting lists were sometimes 18 months. Whe n we left office, they were down to a maximum of 18 weeks. And now they are already creeping up again.
“I believe David Cameron is betraying the trust he asked the public to put in him at the election.
“We read in the newspapers that horse trading is taking place as the two coalition parties try to reconcile their differences over a broken Bill.
“The way this Conservative-led government has gone about NHS reform is a disgrace.
“Contradictory briefings to the newspapers from Tory sources, from Treasury sources, from health department sources and – in case we forgot – from the Lib Dems. Each one adding to the sense of utter confusion and chaos about a Bill that has completed its committee stage of the House of Commons.
“It is bad government. It is not how the future of the health service should be determined. This is a direct consequence of a coalition based on power, convenience and ambition rather than values.
“It is an insult to the peopl e who work in the health service, it is an insult to the people who use it and the Prime Minister should be ashamed of the way he is running the NHS, the proudest institution of Britain.
“He is treating those who have spent 8 months uncertain about their jobs and their future with utter contempt.
“The NHS is too important for its future to be the result of a back room deal which would then be bounced on MPs with precious little scope for proper debate let along public consultation.
“That’s why today I say this, Mr Cameron, go away and think again.
“Don’t come back with piecemeal changes. It’s a bad bill, built on bad assumptions and dangerous ideology.
“If this plan to re-organise the NHS is going to be significantly changed – and it must be – let any new plan be the subject of a new White Paper and a new national consultation.
“My commitment is this; if there is a genuine attempt to address the weaknesses of this top-down reorganisation th en my Party will enter into a debate about a new plan with an open mind and accepting that any NHS plan must be delivered within a tight spending settlement.
“How do we improve the NHS? We need to learn the right lessons from our reforms.
“First, change was successful where it came from a clear-eyed focus on the current and future challenges faced by the NHS. Successful reform must prepare the NHS for the huge challenges it faces – initially that was the challenge of poor access and poor patient focus. Increasingly it is to respond to an ageing society and with it, growing pressures of chronic and lifestyle-related diseases.
“Second, change in the NHS worked best where it created a strong focus on patients and strengthened accountability.
“Reform is not an end in itself, but from targets to greater choice and control for patients to Foundation hospitals, it was effective where it enhanced accountability for quality, access and value for money.
“A nd third whilst reform requires difficult and sometimes unpopular choices it is only successful if it protects the sense of national mission and the values of cohesion and collaboration that underpin the work of our health service.
“More power to patients, more responsibility in the hands of patients, underpinned by greater collaboration between patients, professionals and across all parts of the NHS. That is Labour’s way.”