Labour threat to NHS

Frank Dobson MP

Speech to Catalyst fringe meeting at TUC Congress, 9 September 2003

The Labour Government's health policies will mean the end of the NHS. It makes me sad to say so, but it's true. The Prime Minister has said he wants a mixed economy in health care. Ministers have started to re-define the NHS as a health insurance system not a health care system.

They want to set hospital against hospital competing for patients. Foundation Hospitals will compete against non-Foundation Hospitals. All NHS hospitals will have to compete with private diagnosis and treatment centres. Hospitals the Government decides are "failing" will be handed over to private managements.

When the Tories introduced competition through their Internal Market, bureaucratic costs soared, hospitals stopped co-operating with one another and the spread of new and better ways of looking after patients was held back. All that was bad for the tax payers and patients alike. Worse still, Bristol University's study of the recovery of patients from heart attacks showed "competition is associated with high death rates, in other words competition is associated with lower quality."

Against these facts the government have not produced a shred of evidence in favour of competition. We can't accuse them of "over-egging" the case for competition. They haven't got a case. All they have is a few assertions from think tanks and a curious faith in the superiority of the private sector.

And the competition is going to be rigged. Foundation Hospitals will have more money, more staff and more freedom than non-Foundation Hospitals. They will have the further protection of legally binding contracts and be allowed to keep all the takings from land sales, instead of sharing them across the NHS.

The new private sector diagnosis and treatment centres will have a much easier task than a district hospital. No fluctuating demands from Accident and Emergency. No emergency admissions. Just a steady flow of patients for a set of standard operations. And, would you believe it, this Labour government has agreed to help them get off to a good start by charging more per operation than an NHS hospital will be paid for the same operation.

And this commitment to commercial health care goes even deeper than that. Primary Care Trusts have been urged by Department of Health officials to approach problems with the same attitude of mind as American health care corporations. Perhaps they meant that the NHS should imitate the American system where the insurers and providers try to keep costs down by no covering the old, the sick and the people without jobs. I never thought I'd live to see the day when a Labour Government was trying to remodel the NHS on the lines of the USA.

What the Government should start to do is to ignore the think tanks, the shadowy unaccountable advisers and siren voices from Washington. Instead, they should listen to the people who kept the NHS going through the lean years of the Tories. The NHS ambulance staff, porters, cleaners, doctors, nurses, midwives, therapists, scientists. They must listen to the people who have supported the NHS through thick and thin, the people who believe in the NHS, not the people who have always opposed it.

And above all the Government should stop criticising the NHS and stick up for it instead. It is Labour's greatest achievement. It is a working example of the best instincts of the people in this country. It is the most popular institution in Britain. That is partly because it does a good job for most people in most places most of the time. It is also partly because the people of this country recognise the NHS doesn't just bind the nation's wounds, it helps bind the nation together.

Of course it needs to be improved. No wonder - according to the Treasury it has been under funded by £220 billion compared with European systems. Now it's getting the extra funds. Now it's getting more doctors and nurses. Now the number of beds is actually increasing after decades of decline. Now is the time to let people who work in the NHS get on with the job of looking after patients. Now is not the time to throw the NHS to the wolves.

The Right. Hon. Frank Dobson MP was Labour Secretary of State for Health from 1997 to 1999.

This speech was delivered to a Catalyst fringe meeting at the TUC Congress in Brighton on 9 September 2003, entitled "Foundation Trusts and the new health service market: what future for the NHS?". He was speaking alongside Bill Morris, General Secretary of the TGWU; Karen Jennings, National Secretary of UNISON; and Professor Allyson Pollock, Head of the Public Health Policy Unit at University College London.

Also available:

"In place of Bevan?" Catalyst briefing on Foundation Trusts