Trade unions and the health secretary: is the tail wagging the dog?

When Unite, Britain’s biggest trade union, delivered a petition to the Department of Health last August urging England’s health secretary, Andy Burnham, to “roll back the privatisation of the NHS” its 3000 signatories can hardly have expected quite such a prompt and rewarding response.

The next month Mr Burnham gave a speech to the healthcare think tank the King’s Fund reversing a decade of health policy in a few sentences. Instead of allowing “any willing provider” to bid for NHS services, he said that in future the NHS itself would be the “preferred provider” (BMJ 2009;339:b4085, doi:10.1136/bmj.b4085). This loaded the scales heavily against any private or voluntary sector organisation winning a contract to provide NHS care.

Apologists for Mr Burnham have since suggested that this was a mere rebalancing of policy or, alternatively, that he had failed to understand fully what he was saying. As the policy subsequently unravelled Mr Burnham is reported to have had a rough ride in Cabinet and to have been told to find a diplomatic means of retreat.

This narrative—to use …