Labour claim victory after Cameron abandons patient's passport

Confirming the end of the patient's passport a triangulating Mr Cameron said:

"The left have spent too much time trying to get the private sector out of the NHS and the right have spent too much time trying to get people out of the NHS and into the private sector. Barbara Castle's attempt to abolish pay beds was an example of the first; Margaret Thatcher's support for giving tax relief on private medical insurance, and our Patients Passport policy at the last election, were examples of the second."

According to BBCi Mr Cameron promised to "defend the values of the NHS against those in his party who want a new system based on medical insurance."  Patricia Hewitt, Health Secretary, said Mr Cameron was in "headlong retreat": "David Cameron has had to abandon a policy that he himself was putting forward just six months ago," she said. LibDem health spokesman Steve Webb said that Mr Cameron was dumping old policies without putting anything new in their place.  Andrew Haldenby, of Reform, told the BBC that all the political parties should be more open minded about medical insurance.

The news that Stephen Dorrell MP and Baroness Perry have been appointed to Chair an 18-month commission on the public services confirms the idea that Major-era managerialism appears back in Tory fashion when it comes to the public services.  School choice has already been downgraded as a policy aim.  The Tory website now talks of public service improvement rather than reform.

Comments

[Selsdon Man]

Guido Fawkes thinks it is ........

A Spoonful of Sugar Helps the Policy Go Down

A journalist called yesterday to ask what Guido thought about Cameron, is he a free-marketeer or a social democrat? Its all "mood music" Guido said, and the tune is from Mary Poppins. Cameron has said (before he became leader) that he is insinctively a libertarian in favour of campaigning for capitalism. He is just realistic about what is politically achieveable, since he can neither promise or achieve a 10% flat rate tax and get elected, Irwin Stelzer is never going to be satisfied.

Murdoch's "vicar on earth" (never understood that title, shouldn't he be his "neo-con rabbi"?) has been let loose to demand tax cuts and the rolling back of the state in The Sun and The Guardian. In the blogosphere the Thatcherite comments over at ConservativeHome.Com and from the libertarians over at Samizdata are full of talk of "sell out" and "blue Labour". "We don't want Blair's heir" is the cry from people who just don't get it, the voters do want that. Hence Cameron is ahead in the polls. The Conservative party's right thinks the Tories are heading towards a Neo-Heathite government, but that is just a Hefferesque fantasy. Irwin was almost on to it in his article today:

After the disastrous defeat of the scary conservative Barry Goldwater in the 1964 elections, America's conservatives realised that it takes a spoonful of sugar to make the medicine go down. So we found Reagan, whose geniality made the curative powers of conservative medicine - lower taxes, less regulation, unambiguous defence of the realm - go down.

Zac Goldsmith is not going to be in charge of the DTI in 2010, Bob Geldof is not going to be running the Department for International Development. They are there to sweeten the message. Cameron knows that in our dumbed down celeb-culture they set the mood music, showing in a very symbolic way, that the Tories are changing.

[Guido Fawkes]

Selsdon,

Can you use hyperlinks in future? Please.

Thanks.

[a-tracy]

Patricia Hewitt, Health Secretary, said Mr Cameron was in "headlong retreat"

Talking of retreat were New Labour talking about patient choice before the Patient Passport was Tory policy? I didn't think so. I thought it was NHS policy just to put people off treatment lists (like Margaret in Warrington) when they were getting near to target deadlines by claiming they were too fat or shouldn't have smoked for the past 20 years.

I was concerned about patient passports because 1* hospitals that exist now (even after all the moneys been pumped in) would become the equivalent of towns like Calton in Glasgow mentioned on the other blog today. Where the poorest and most in need were left with the worst of the worst provisions with the best staff and surgeons being attracted to the best hospitals (even worse than we already have today).

Perhaps Cameron is exercising his equal rights to 'womans' prerogative' to change her mind.

[John Hustings]

If Guido Fawkes thinks Cameron is a closet libertarian, what reason has he for thinking this other than pure blind faith?

[malcolm]

Hear hear a-tracy.If Patients Passports were such a good idea why didn't our health spokesman or the parliamentary party have the courage to campaign for them? I suspect they knew it was going to be a massive vote loser.
Under Patricia Hewitts inept stewardship it is possible that for the first time in my lifetime Health will not be a bad subject for our party to campaign on.

[Ted]

I've got private health insurance but have never used it as my experience has always been through the emergency ward - either visiting A&E after yet again breaking something on my right foot or emergency admission as being a typical male I refused to accept I could possibly be ill.

A&E has worsened considerably over thirty years - first visit under Heath's government I was seen in less than twenty minutes, by 2000 it was six hours (about 2 in mid 80's, 4 in 1990).

Emergency admission resulted in fantastic operative care - operated on within hours of admission - and very variable post operative (given MRSA, relapsed into pneumonia, nearly died as no continuity of staffing).

So I'd like to see improvements in NHS as the priority - patients passports might have driven some of this but I'm not convinced. I want a general uplift towards standards of care in most of the deveoped world. Like a-tracy I don't want some great and some terrible hospitals, I want a general high quality healthcare system that is clean. efficient and available when you need it.

[James Hellyer]

"I was concerned about patient passports because 1* hospitals that exist now (even after all the moneys been pumped in) would become the equivalent of towns like Calton in Glasgow mentioned on the other blog today."

Not really. That would be the result of the government's new policy of hospital choice. All the Patient's Passport did was allow more people to be able to afford access to private care. A lot more people can - and do - afford the cost of one operation than can afford to go private. With record numbers of people opting out, this move would have broadened access to that option.

With the choice policy, the governmet will have to face the question of hospital failure though.

[James Hellyer]

"The news that Stephen Dorrell MP and Baroness Perry that they have been appointed to Chair an 18-month commission on the public services confirms..."

That radical thinking is the very last thing we should expect.

[Guido Fawkes]

"I am an instinctive libertarian who abhors state prohibitions and tends to be sceptical of most government action".

David Cameron, Friday May 17, 2002

[Chris Palmer]

Found this on the BBC Have Your Say forums. Thought it was quite a good one:

(Unedited)

"While I strongly support the Conservative Party, I believe that the 'old' policy was very sensible: Those that can, pay half for treatment; those that cant, pay nothing but now get better treatment as those that can are not sitting in their queue.ALL would have benefited. I am sorry that such a policy has fallen, owing to the paranoid socialist nature of British voters, nonsense written in the Labour controlled press and too much image awareness from inside the Tory Party."

[James Hellyer]

"I am an instinctive libertarian who abhors state prohibitions and tends to be sceptical of most government action".

David Cameron, Friday May 17, 2002

But his actions suggest the opposite. His signature policy was imposing one method of literacy teaching on schools. His aopproach to the public services appears to be one that accepts government management, rather than recognising the consumers as better arbiters of quality (see "rigour" vs "choice").

[Goldie]

Cameron has now said that he would never support a health-care system based on the principle "insurance". He stands for the communist system of health care 'free' at the point of use.

This is not 'modern', it is not 'compassionate' and it is not 'conservative'.

It is troglodyte and inane.

All continental European countries, hardly beacons of unfettered capitalism, have such system. Their health care is superior in every respect to the British health care, which is an embarrassment. It's deeply disappointing that Cameron is so insecure that he does not realize that his personal charisma is sufficient to sell actually interesting conservative policies.

According to Francis Maude at the Conference, the problem was with the IMAGE of the Conservative Party: when people heard of our (former) policies, they said they liked them. When they heard they were Conservative policies, they said they didn't like them anymore. I thought that Cameron had understood this and was trying to changing our IMAGE, so as to better sell our policies. I fully support his efforts to do so. But Cameron is doing the reverse. He thinks he needs to change our policies to change our image.

It shows he is actually UNDERESTIMATING his own qualities as a politician.

[John Hustings]

In fact I'd turn Guido's assumption on its head. Statements such as this:

"I am an instinctive libertarian who abhors state prohibitions and tends to be sceptical of most government action".

were the *real* mood music. That was the sugary stuff that was to make Cameron's "radical changes" easier to swallow.

Guido supports Cameron because he thinks the only people Cameron is going to screw are the social conservatives; it is becoming apparent that it's not just social conservatives who are going to be unhappy with our new leader.

[Daniel Vince-Archer]

""I am an instinctive libertarian who abhors state prohibitions and tends to be sceptical of most government action". - David Cameron, Friday May 17, 2002"

Is this the same David Cameron that today criticised W.H. Smith for offering discounts on chocolate at its railway station outlets and suggested offering discounts on oranges instead? Aside from the serious point about this being a nod towards state interference, has he tried eating an orange on a train?

[Matthew]

Yes I saw that, I winced at the time I have to say! He then tried to claim it would make good business sense. Hm. Only if government offered incentives, but then he is a libertarian at heart who 'abhors' interference. I agree with most of what he is saying right now, but not that!

[Derek]

It is a pity that he has dropped the patients passport, because it was a policy which encouraged saving, by rewarding those who had put something aside for a rainy day. Conservatives should reward those who help themselves. I could never accept the argument of those who said that tha patients passport took money away from the NHS, when in fact it only offered a patient half the cost of the NHS treatment to go private - so it actually saved the NHS half the cost of each operation, while shortening the waiting list at the same time. A win-win situation, but somehow we have lost the argument!

[Jaz]

Cameorn has it spot on, but he must work harder to cement labour, tory differences in the future. Cameron MUST, very soon make some headway on some subject, he can't just expect to be the same or similar to labour...frankly he HAS to cause a stir somewhere...

He did well in stressing that the Tories will never bring in private health insurance instead of the NHS. The NHS is a system, which by far everyone loves, yet people know its not as good as it should, or could be. Conservative or not, health insurance would but frankly criple any election campaign in this country.

[Chris Palmer]

"The NHS is a system, which by far everyone loves"

Funny, I always thought that was something put about by the Labour party who created the NHS. Interesting that the Labour party love to do away with anything "old" or "traditional" and yet the aging NHS system created in a post-war environment has seemingly infinate ammounts of cash thrown at it, just because it is a Labour institution. I am certain that were the NHS a Conservative creation, it would be gone by now.

[James Hellyer]

"The NHS is a system, which by far everyone loves"

That's untrue. Last year the government conducted polling which indicated that the public were on the verge of losing confidence in the NHS - they could see that vast amounts of money were spent on it, but could also see services weren't improving. That's why the government knows it has to show results soon.

[Michael McGowan]

I want to know how and when David Cameron is going to deliver patient-centred healthcare of equivalent quality to the French system. That is a social insurance-based system which provides universal coverage to all including the poor and the choronically ill. The French system saved my life when I had been misdiagnosed twice by the "envy of the world". That was before the evil Mrs Thatcher came to power and imposed non-existent cuts in the NHS Budget. I don't care how Cameron does it. I want to know when it is going to happen and I want to see how he is going to achieve it. My expectation is: not in my lifetime.

[Simon C]

The full text of the speech is at:

http://www.conservatives.com/tile.do?def=news.story.page&obj_id=127083&speeches=1

The Editor's point that the party's website now refers to "public service improvement" rather than "public service reform" is an interesting one. It puts the emphasis on outcomes, which is important for two reasons.

The first is obvious: no-one wants public services to get worse. The second is presentational. Labour has successfully educated the electorate to be suspicious of Conservative attitudes towards health and education. We need to persuade people that we are committed to excellent health & education. To do that we need to talk far more about good outcomes. Once we have demonstrated that is our objective, people may be more open to a rational discussion about the mechanisms by which those outcomes might be achieved. At the moment, there is a perception that we are interested in reform for reform's sake, not reform for the sake of better outcomes.

[James Maskell]

I didnt like the idea of patient passports anyway so I guess thats now two good things Cameron has done since December 6th...

What I dont like though is the image which will inevitably be thrown about, if it hasnt already, that the Conservatives are trying to out-Labour Labour. I hope Camerons proposals will have more clear water because right now I think we are going to have some unsure voters come 2009. Its a matter of degree rather than wholoesale differences between the Parties.

[Graeme Archer]

I hear people complaining about their treatment on the NHS all the time ... the point is, if I say to them, would you support abolishing it, and replacing it with an insurance-based system, then they look at me as if I'm in cahoots with the devil and have just proposed the abolition of their first-born. Something is so ingrained in the mentality of the British that they won't see past "free at the point of contact". You can have as many policies as you like saying as many credible alternatives as you like, but that fact of nature about the British is never going to change.

If it were possible to change the belief system in the NHS, the outcomes which are very obvious (to me) in insurance-based systems (I mean the hard endpoints such as the outcomes for patients diagnosed with cancer) would have led to a voter-led demand for change; it has not; I cannot explain this but I can't wish it out of existence either.

That said, how do you get some right wing reform in place? Well here's some ideas...

1) First, win an election. Sorry to sound like Mrs Beeton ("first catch your rabbit") but there you go. That usually means not scaring the horses.
2) Second, why not start with bringing back the fundholding practices that the socialists first of all abolished, and are now limping back towards (Conservative policy now, no?)
3) Third, why not bring in wholesale deregulation to allow different firms to compete for contracts within the NHS superstructure ... sounds quite right wing to me ... in fact it sounds revolutionary - did everyone else miss that part of the leader's statement?
4) The selection of the contracts would have to be done either by a self-governing hospital trust (Tory policy) or a health authority. If we are all localists now, what do you think the chances are that these will be directly elected by the time we're back in government? Can't see any other Tory way around the hysteria of the "post code" lottery.

[Andy]

Cameron clearly said in his leadership campaign that he was againg patiant passports,wanted out of the EEP and said the party would talk about issue's like the enviroment and poverty.ON THIS MESSAGE he was elected by an overwhelming majorty,YET it is exactly these topics in whitch the party seems to be against.YOU installed him as leader,he is doing well in the poll's,he is regarded as the most poular leader we have had in ages and has a great chance of winning the election.Get a grip of yourselves,stop living in the ice age and get behind the leader,if you fail then,the REAL reson we have failed to be elected once again is the fact that the membership are so far up there own backside that they fail to see what is right for both the party and the country.Anyone who thinks sending out the same message as the last election will get us back into power are living in the past.The party needs a new message,a more freindly approach and a better look,EXACTLY what cameron is doing,why cant you be happy?

[Mike Smith]

The party needs a new message,a more freindly approach and a better look,EXACTLY what cameron is doing,why cant you be happy?

Aah. What a sad, sad, world we inhabit.

The fact is that if the new message is - as increasingly appears to be the case - simply a cynical bid for votes, then Cameron deserves the growing opprobrium he is attracting from fellow-Conservatives.

Another Cameron supporter on this site (they seem to be rather thin on the ground at the moment) said that once the Tories had got back into government they could clear all the 'consensus' window-dressing out of the way and get down to some Real Tory Policies.

This admirably candid fellow then suggested that core supporters must be pretty dim not to have grasped the obvious truth of Cameron's Machiavellian strategy.

If that is indeed the truth it runs directly contrary to Andy's understanding of the situation, but then, as jesting Pilate would have said...

Incidentally my wife is still a member of the local Tory Executive and she for one was utterly disgusted with the way that - yet again - Cameron was toting his disabled son on TV this morning as a blatant campaign prop.

I can't make up my mind whether 'Dave' is modelling himself on Machiavelli, Wackford Squeers or both...

[Jaz]

"Real Tory Policies."

Cameron's job is to lead the country. At the moment, his job is to get into government..Not write the capitalist equivalent of the communist manifesto. I don't give a rats ass about Tory policy at the moment, I'm more concerned with ending labours dominance.. and whatever the people want, they will get...socialist of conservative. Only in power can we actually do something, only in power will the true sceptism that we are the nasty party and won't ruin the NHS idea go. Only then can we ACTUALLY do something conservative... Because after 4 terms of conservative dominance people do not trust us to do anything radical with the NHS...A way to regain that trust is to deliver good quality healthservice in power for a period of time and then suggest more radical changes after.

"Something is so ingrained in the mentality of the British that they won't see past "free at the point of contact". "

I'm one of them...I can't see the public, or myself wanting a system where its not taken from tax and healthcare...When you're ill you dont want to worry about having 10k cash lying about for an operation or if my insurance isnt about to expire.

[James Hellyer]

"We need to persuade people that we are committed to excellent health & education."

That just means we have to link structures to outcomes in our discourse. One failing of Conservative politics has been that we'll talk about introducing school voucher schemes, say, as if that's an end in itself. People aren't interested in structures, but promises of improvements have no credibility if you don't explain how you'll achieve them.

[James Hellyer]

"...why not bring in wholesale deregulation to allow different firms to compete for contracts within the NHS superstructure

Have you ever noticed how bad the public sector is managing private sector contracts? Or seen how the current practice of subcontracting certain forms of operations (like cataract surgery) actually degrades hospital services, denying doctors experience?

"... sounds quite right wing to me"

It's an old fashioned supply side reform. It's not good enough. The spiralling costs of the NHS requires demand side reforms too.

[howard stevenson]

The one thing that worries at the moment is the 18 months that we have to wait for the various tasks forces to report back so we can formulate our policies. Given we are already 6 months into the New Labour 3rd term, that only leaves 2 maybe 3 years to get those policies into the public conciousness.
So far Cameron has done an excellent job of making us seem like a friendly bunch of people who want the best for everyone. The key question is how? He has bought himself 18 months of no concrete policies, but what then? Will he listen to what IDS has to say on social justice? Will he listen to KC on democracy etc?

[James Maskell]

Someone was wondering if DC had a tie on during the speech earlier today...he did, a light blue one.

[Mike Smith]

Someone was wondering if DC had a tie on during the speech earlier today...he did, a light blue one.

Very light I imagine.

With pink dots?

[James Maskell]

Unfortunately the tie did not have pink dots. It was a plain light blue tie. Though pink dots is an idea for the next speech. It would prove he was open to all ideas!

[Mike Smith]

Though pink dots is an idea for the next speech. It would prove he was open to all ideas!

Yes.

Except Conservative ones, it would sadly appear.

[Chris Palmer]

"Aah. What a sad, sad, world we inhabit."

Don't drag us all into your cynical world please Mike.

[Richard]

From today's Sun

Choice is healthy

SO is that it, David?
The Tory masterplan for saving the NHS is to maintain the status quo, with a minor adjustment or two.

No promise of major reform. No mention of how the Tories would stop billions of Pounds of public money disappearing into the void.

Quite the contrary, in fact. Tory plans to expand the NHS and make it more efficient will not be cheap, Cameron pledged — to reassure us that they take the matter seriously.

Where will all this new money come from? Taxpayers are at the limit of their bank balances and their tolerance.

Besides, throwing cash at the problem will not improve efficiency, as Labour has demonstrated. It just creates MORE waste.

Cameron’s speech was a masterclass in stating the obvious.

But he was convincing when he said the NHS’s care of his disabled son strengthened his knowledge of it and commitment to it.

He was right to emphasise targeting illness at source, for instance by reinstating the hard-hitting sexual health ad campaigns successful in the 1980s.

And he was right that retailers must take responsibility for our obesity crisis — by ending the cynical practice of luring kids with junk food and chocolate.

Cameron’s aim was to scupper Labour’s lie that the Tories would scrap the NHS. But being inoffensive to voters seems to be the limit of his current ambition — though it’s early days, of course.

Tony Blair has spent eight years promising NHS reform but all the extra money has achieved too little.

It would be healthy for Britain if the Tories offered the choice of something different at the next election.

[Michael McGowan]

I never cease to be astonished about how little people know about the way social insurance works just across the English Channel in France, Germany, Switzerland and the Netherlands. Take Jaz's comment that when you are ill, you don't want to have to worry about whether you have money in the bank or whether your insurance is about to expire. In all the European countries where there is social insurance, everyone is covered, the poor and the unemployed have their subs paid by the state and the insurers CANNOT by law exclude the old and the chronically ill. In other words, there is universal coverage PLUS the patient has real control and choice over their own healthcare. Result: a patient-centred responsive service where the postcode lottery is far less of an issue because you can shop around....and people do. In European countries, this is rightly regarded as a civilised, socially just outcome. In the parochial hubristic backwater called the UK, where we think we are special just because we won the World Cup in 1966, we would rather cling onto an outmoded inefficient healthcare rationing system where politicians reign supreme and the public - especially the poor public - get what they are given.

[James Hellyer]

David Green of Civitas makes a similar point in today's Telegraph. He sas that Cameron could have said somthing like this:

"The moral principle behind the NHS is the right one. No one should go without essential healthcare because of a lack of money.

"But the NHS method of public-sector monopoly is the wrong one. The NHS has failed to achieve its primary aim. Older people need healthcare the most, and tend to be poorer. Yet, by common consent, they receive a lower standard of care than in countries such as France and Germany.

"We must admit that our European neighbours have found a better combination of economic viability and social solidarity. European social health insurance has fulfilled the NHS ideal more faithfully than the NHS itself."

That would have made clear his commitment to care which was free at the point of need, but would have allowed a scope for evidential arguments for reform, which would have had he government on the ropes.

That's clearly what the press wanted to hear. The Sun, Times and Telegraph all lament that Cameron has let his party - and country - down, and has denied the electorate choice at the next election, offering instead only an echo.

[Michael McGowan]

James, correct. And the reason why Cameron didn't go down that route is that far from being a classless meritocrat with a 21st Cnetury outlook, he is a good old-fashioned patrician Tory in the mould of Lady Bountiful.

[Ted]

Cameron made a pragmatic choice to take NuLabs ground away and reduce the negative perceptions of the Conservatives as regards NHS reform. I think he was wrong to close off alternatives in longer term but it was politically an astute action as whenever we discuss funding we come across as heartless cost cutters.

There are two issues - the effectiveness of the system in providing high quality healthcare and the costs & funding of provision.

In effectiveness the advantage of social insurance is that it puts the purchaser of health care at the centre rather than the NHS model of centralised supply side decision making. The Thatcher reforms (and to a small extent those neoThatcherite moves in NuLabs policy) looked at bringing in a patient centric change through increasing patient choice and decentralising control towards individual hospitals. By creating independent trusts and allowing increasing private provision within a free at point of use model we may achieve the patient centric advantages of the social insurance model without changing the funding model.

The second is cost - the proponents of insurance see this as a way of moving costs from taxation to insurance and as a way of hiding health service rationing. Neither is particularly attractive to sell to the electorate. The arguement that the bureaucratic costs of insurance are higher than direct taxpayer funding is quite persuasive.

We do need to address the funding issue before it becomes a crisis but at this stage in our electoral re-launch making this a central issue of Tory Health policy would be counter productive.

[Paulojao]

Pensa classificados quinto classificados gratis cidade a tarde classificados existe classificados do diario do nordeste seus membros primeira mao classificados viajar odia classificados casa classificados estadão monitor gazeta de limeira classificados vidro classificados campinas navio afundando? A resposta e site. Internet tornou-se pessoas queriam apartamento panfletos opções taxa unida a furb classificados escritório custo seus diario catarinense classificados classificados brasil os
classificados de veiculos fim.

odia classificados
classificados o globo

[BedBugDogNYCs]

I wanted to write you a bit of note to finally thank you very much as before with the extraordinary things you've featured at this time. This is certainly surprisingly generous with people like you to allow unreservedly what a lot of folks would've sold for an electronic book in making some profit on their own, mostly seeing that you could possibly have done it if you ever wanted. These smart ideas also acted as a easy way to be aware that most people have similar desire just like mine to know the truth a good deal more regarding this problem. I'm sure there are some more pleasurable times ahead for individuals that go through your site.