As the World Cup withdrawal symptoms abate (hugely helped by that abomination of a Final, over which the Dutch should stop whingeing about the ref and go kick someone their own size) I tuned into Newsnight and was pleasantly surprised by the depth and nature of the debate on the Tories’ health reforms.
I say Tories, because the Lib Dems have been quietly shoved aside on this one, as health secretary Andrew Lansley gets his way, with market forces coming in from all angles, and George Osborne gets his, with cuts and sackings a less voluble part of the overall plan.
Well done to Mr Lansley for putting himself up against a range of NHS professionals; and well done to Kirsty Wark for getting on top of the detail as well and as quickly as she did. As her interview went on, I could sense Lansley’s irritation rising. This was not, as is often the case with politicians and interviewers, because she was missing the point; but because she was getting unerringly TO the point(s) and he didn’t much like having to defend the nature and the possible effect of some of the changes.
‘More power to GPs’ is one of those no-brainers for a government trying to show its commitment to healthcare. Even in our culture of negativity, GPs remain among the most trusted and respected members of the community, so a minister saying he would take power from politicians and managers, and hand it to a nationwide network of Dr Finlay consortia, is superficially onto a winner.
But the qualities that make for a good GP may not be the same as the qualities required to handle that extra power, and the managerial and bureaucratic duties that go with it. That impression was rather borne out by the studio discussion. Added to which, any time I visit my surgery, the GPs seem pretty overwhelmed by the workload already.
Lansley looked and sounded more on top of his brief than Michael Gove has managed to do on schools, yet there were also too many unanswered questions to erase the impression that this policy was, a bit like free schools, being made up as it goes along, or that the driving forces remain cuts and growth of the private sector within the NHS.
And the really big unanswered question, which had Mr Lansley wriggling last night, is what happens when a new GP consortium or a foundation trust goes bust. I cannot believe they have not been asking that question, so it seems odd that there is no clear answer, or even the beginnings of one.
It will also be fascinating to see how managers who know they are likely to be out of work will help introduce the changes that are designed to lead them to the dole queue. Yesterday Mr Lansley did the easy bit – setting out a broad vision for a radical change. Making it happen won’t be quite so straight-forward.
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