Re: Does anyone understand the government’s plan for the NHS?
Professor McKee’s essay is a clear exposition of the essentially vacuous nature of the UK Government’s arguments for the Health and Social care bill and the so called reforms that are being implemented even before Parliament has passed the Bill.
But that is not to say that the Bill is purposeless or that its proponents are determined to wreak wanton damage to the NHS.
I believe it is part of the Government’s response to the wider economic mess we find ourselves in after the banking crisis of 2008 and the mounting debt burden that threatens to cripple the economy.
If we were a third world country in a similar economic situation with the world’s money-men uncertain of our ability to repay our external debts, we would have had to turn to global financial institutions for aid. The IMF and World Bank would have offered financial help but on condition that we introduce one of their notorious Structural Adjustment Programmes.
The essential feature of an SAP is the scaling back of public services, reducing the state's expenditure on education, social welfare, help for the disabled, and health care; and handing them over, wherever possible, to the market to be provided on a pay-as-you-go basis.
This happened in numerous emerging economies since the late 70s and 80s wherever periodic banking crises led to the threat of sovereign default. People like Dorothy Logie were at the forefront of the campaign against such destructive programmes that led to great damage to public health in countries that were too small or too powerless to resist, or were ruled by an unaccountable elite who made common cause with global financiers.
But the UK is not a third world country; it has a leading place in the IMF. And so the Government is itself dishing out the same medicine that it prescribed to other highly indebted countries in the past. And because we are a democracy the reforms have to be dressed up as a necessary response to a health system that is falsely accused of failing patients, is overly bureaucratic, expensive and wasteful, and not responsive to people’s demands for choice. Where coercion is prevented by the rules of a democratic system, rulers have to resort to subterfuge to justify changes that are unnecessary and damaging.
The real tragedy is that the Government does not have the courage to come out with the truth – and say, "we can’t afford public services on the scale we have become accustomed to, we need to cut back, can we all agree on the least damaging way to do that." That would have required political courage and leadership. Instead we have a set of reforms that may or may not achieve its stated goals but will almost certainly dismantle the NHS as we know it, widen inequalities, enrich a few people and businesses, and leave the majority with worse health outcomes than before.
Rapid Response:
Re: Does anyone understand the government’s plan for the NHS?
Professor McKee’s essay is a clear exposition of the essentially vacuous nature of the UK Government’s arguments for the Health and Social care bill and the so called reforms that are being implemented even before Parliament has passed the Bill.
But that is not to say that the Bill is purposeless or that its proponents are determined to wreak wanton damage to the NHS.
I believe it is part of the Government’s response to the wider economic mess we find ourselves in after the banking crisis of 2008 and the mounting debt burden that threatens to cripple the economy.
If we were a third world country in a similar economic situation with the world’s money-men uncertain of our ability to repay our external debts, we would have had to turn to global financial institutions for aid. The IMF and World Bank would have offered financial help but on condition that we introduce one of their notorious Structural Adjustment Programmes.
The essential feature of an SAP is the scaling back of public services, reducing the state's expenditure on education, social welfare, help for the disabled, and health care; and handing them over, wherever possible, to the market to be provided on a pay-as-you-go basis.
This happened in numerous emerging economies since the late 70s and 80s wherever periodic banking crises led to the threat of sovereign default. People like Dorothy Logie were at the forefront of the campaign against such destructive programmes that led to great damage to public health in countries that were too small or too powerless to resist, or were ruled by an unaccountable elite who made common cause with global financiers.
But the UK is not a third world country; it has a leading place in the IMF. And so the Government is itself dishing out the same medicine that it prescribed to other highly indebted countries in the past. And because we are a democracy the reforms have to be dressed up as a necessary response to a health system that is falsely accused of failing patients, is overly bureaucratic, expensive and wasteful, and not responsive to people’s demands for choice. Where coercion is prevented by the rules of a democratic system, rulers have to resort to subterfuge to justify changes that are unnecessary and damaging.
The real tragedy is that the Government does not have the courage to come out with the truth – and say, "we can’t afford public services on the scale we have become accustomed to, we need to cut back, can we all agree on the least damaging way to do that." That would have required political courage and leadership. Instead we have a set of reforms that may or may not achieve its stated goals but will almost certainly dismantle the NHS as we know it, widen inequalities, enrich a few people and businesses, and leave the majority with worse health outcomes than before.
Competing interests: No competing interests