In terms of the anxiety and concern felt by Wycombe constituents, no other issue compares to the future of our hospital and local health care. That's why, as MP for Wycombe, the NHS is my top local priority.
As you can see by searching our local paper for stories relating to my work in relation to our hospital, the current structure of the NHS manufactures discontent and ill-will. We simply must move beyond the present cycle of despairing powerlessness amongst local people, including clinicians.
That's why I'm backing Andrew Lansley's health reforms.
I am delighted that the coalition is planning to empower patients by introducing what amounts to a shadow-voucher system. By enabling patients to choose their general practitoners and then routing the vast majority of NHS funds through their hands, we will finally be able to reduce bureaucracy by scrapping Strategic Health Authorities and Primary Care Trusts.
I am also pleased that the government will return NHS hospitals into a rich and diverse tapestry of independence. In the future, no one in this country should have to go into any hospital owned or directed by the state. Whether for-profit or not-for-profit, mutual, worker co-operative or charity, all our hospitals, clinics and care homes must be set free from political control: they must reside in a greatly expanded and genuine independent sector.
These organisations should then be free to raise money commercially, free to reap the rewards of delivering excellent service to patients, and freed from the shackles of the Treasury. In the future, not only should all hospitals be allowed to raise investment and capital as they see fit from non-governmental sources, but the caps on their private work should likewise be removed.
For too long, high-quality independent provision has been the sole preserve of the well-heeled and those able to afford exclusivity. For too long, private hospitals have exploited high margins as a result of the manifest failings of state hospitals. It is, as we have said, time for change.
With Nurses for Reform and other campaigners, I believe that national collective pay bargaining has run its course and should be abandoned. Alongside denationalising NHS hospitals, I therefore urge the government to similarly encourage a more vibrant and open labour market for the benefit of all doctors, nurses and other health workers. No one in healthcare should have their professionalism and integrity undermined by one-size-fits-all politically-decreed pay scales. Nor should remuneration be imposed and held back at regional levels. To properly value doctors, nurses and other health workers, remuneration must be set at proper commercial levels and this will only happen in a more open, dynamic and responsive market.
Employment contracts should be a matter for each independent employer and their staff – not the government or any of its ‘appointees’. Indeed, it is in this context that trade unions should proactively push for, and embrace, this new world of welcome opportunity. Gone will be the tedious days of top-down state direction, beer and sandwiches at number ten, and endless, counter-productive, national strikes.
Today, unions should know that, to be relevant, they must provide representation and engagement in a new world of work which will increasingly be built on collective self-help through worker ownership, co-operatives and mutuals. In some cases, unions already provide, not just legal advice, mortgage discounts and so on, but also private health cash plans: this should continue and develop in a rediscovery of the labour movement's tradition of mutuality, a rediscovery which can be expected to increase membership.
When Tony Blair first sought support for independent foundation trusts nearly a decade ago, he was vehemently attacked by an unholy alliance that included elements of the Labour Party and the trade union left plus new-found friends in Britain’s private hospitals. Riven with a fear of putting power in the hands of patients, professionals and consumers, the private hospital sector in particular encouraged the Labour left and the Conservative Party variously to oppose Blair’s legislation.
And so it came to pass that Gordon Brown watered down the foundation trust bill while the Conservatives opposed it on the grounds that “it did not go far enough”.
Now, for the sake of patients and health workers alike, our trades unions and health privateers must find a more positive way forward, not fall back to reactionary opposition. That means not only supporting the government, but also joining me in urging the coalition to go further. For if we strive for real openness and diversity, not only will we push more resource to the front line of healthcare but, crucially, we will open up independent provision for the benefit of all.
It is to this end that I welcome the government’s recent white paper on the future of the National Health Service and I urge the trades unions and private hospitals to do the same. Anything less than full support will be bad for our unions and Britain’s private hospital bosses. For it will further compound their challenges and put them squarely on the side of history’s losers. British people deserve better.
If we get these reforms right and if they are sufficiently radical, then we can re-engineer the NHS as a key funder of healthcare, delivering more and higher quality care where it matters. We can also obtain better pay and conditions for those who provide care, skill and long-term dedication. If we are bold, we can end the present cycle of local disempowerment and staff disenchantment.
It is in this sense that I believe these much-needed health reforms will positively challenge private hospitals and trade unions.
People deserve health care which meets their needs and aspirations. It is time government provided the right environment. Health professionals, unions and management, right across the spectrum of health provision, should seize the moment.
