NHS league tables: ‘The ghosts of Labour reforms and rebellions past loom large’

As sure as night follows day, any attempt at NHS reform is going to provoke controversy. But as the party that founded the NHS, healthcare will be one of the key tests of Labour’s fresh term in office.

Health Secretary Wes Streeting is today  unveiling a part of Labour’s plan to get the ailing health service back to full fitness, with a set of tough measures aimed at boosting standards and outcomes for patients.

This will include a new public league table for NHS hospitals aimed at highlighting underperforming providers. NHS managers who fail to oversee improvements could face the sack.

However, it is not the first time a Labour government has set out measures of this kind.

Amol Rajan on the Today programme noted that a near identical proposal was put forward more then 20 years ago when Labour was last in power.

He quoted a government communication from 2001 saying: “The government has revealed the performance ratings of every major hospital in England, naming and shaming a dozen trusts as the worst performers in the NHS.”

History rhymed once again with disputes in the Labour ranks as to the best approach to NHS reform. The Guardian noted there was dispute between then Health Secretary Alan Milburn and Chancellor Gordon Brown over NHS reform under New Labour – during which time contentious measures reforms such as PFI and the introduction of foundation hospitals were brought in.

Streeting will no doubt want to avoid similar revolts over NHS reform, but has still made no bones about the tough medicine he intends to adminster. “I make no apology for wanting to manage out the worst, as we would in any other workplace, but where poor performance is too often tolerated in the NHS,” the health secretary told Sky News.

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Left-wing veteran Diane Abbott was quick to take to social media to critique today’s announcement, calling it a “pretext for further and faster privatisation.”

One major rebellion of the New Labour era was over reforms to bring in foundation hospitals, with scores of MPs – including Abbott – defying the government.

A Labour spokesperson said they would not comment on individual MPs’ remarks, but ministers’ commitment to a free-at-the-point-of-use NHS would “never change”, and they were “on a mission to fix the broken NHS” after Tory failure.

Little-noticed battle of the Blairites

The latest measures have seen some pushback in the health sector itself too, with Matthew Taylor, the chief executive of the NHS Confederation, saying: “NHS staff are doing their very best for patients under very challenging circumstances and we do not want them feeling like they are being named and shamed.

“League tables in themselves do not lead to improvement, trusts struggling with consistent performance issues – some of which reflect contextual issues such as underlying population heath and staff shortages – need to be identified and supported in order to recover.”

Notably Taylor is a former senior policy figure in Downing Street under Tony Blair. The reforms pit him against another New Labour veteran of the era, the former Health Secretary Alan Milburn , who was recently brought back into the fold at the Department for Health and Social Care – which suggests where Streeting will be looking for lessons when it comes to any future NHS reform under Starmer’s administration.

Indeed, even the free-market think tank IEA described today’s proposals as “reheated Blair-era reforms”.

But only time will tell what broader reforms Streeting has in mind for the health service, with further announcements due in the new year.

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