Labour’s stewardship of the NHS resumes today

As of today the NHS system of healthcare and the legal responsibility of the government to provide adequate healthcare comes to an end in England.  There will be no big bang.  Slowly, over the next decade, care will become more fragmented and provision will vary greatly.  The ethos of the NHS will be gradually replaced by something insidious.

Patients will die needlessly because of it.

Section 75 of the Health and Social Care Act requires Clinical Commissioning Groups to open all provision they commission to competition. This financial year it is anticipated that £750 million will be tendered.  This is small change in comparison to the £100 billion NHS budget that is now up for grabs.  Furthermore, the guidance provided to Clinical Commissioning Groups is so confused that these groups have no idea what today will look like.  Those working within them have little definition in their professional roles.  The NHS is now unorganised amateurs versus multinationals.

Those of us in the Labour Party, and affiliated groups, should be under no illusion as to what this is: this is losing.  This is what happens when we surrender our stewardship of the NHS through pathetic, clan-like infighting and embarrassing general election campaigns.  This is what happens when we spend the formative months of a new government indulgently selecting our leader, rather than scrutinising and opposing.  This is what happens when those in key positions forget that an effective opposition is a vital part of governance.

After many years of waiting, like sailors on shore leave, Letwin and Lansley have been allowed to have their way with the NHS.  What Labour will reclaim in 2015 will be badly damaged and will require substantial care and repair.  It is therefore a notable positive that Andy Burnham is in the post that he should have held since the defeat in 2010.  However, to wait until 2015 before reclaiming our stewardship of the NHS would be a mistake; it starts today.

A huge amount of power has been placed in the hands of local councils.  As of today councils are responsible for public health services, obesity programmes, drinking reduction initiatives, smoking cessation programmes, etcetera.  If the public health crisis in the UK is not reversed it will only add weight to the neo-liberal calls for a further dismantling of the NHS.  The greater the health inequalities that exist in a population the easier it becomes to argue for an insurance system, based on individual risk.

The inner-city councils in the Midlands and the North are almost all back under Labour control.  This means areas with the poorest population health are our responsibility.  Cabinet Members for Health in Labour councils throughout the country now play significant roles in maintaining the viability of a one payer health system, funded through taxation.  Relative political unknowns now hold responsibility (but not the publicity) that government Ministers lust after.

The smoking ban is evidence of how a political party can make a significant difference to public health, in a relatively short time.  A well informed, well led and committed legislature can notably improve the health of a population.  And, the stakes are high.  The next ten years will determine whether we maintain our NHS system or whether we revert to ordinary, grubby systems of care that many other countries have settled for.  The first step is in local government.  Labour’s stewardship of the NHS resumes today.