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My recent article for the Institute of Economic Affairs blog has been well recieved within the high circles of the blogging world and featured on both Conservative Home and Mark Wadsworth’s Blog.

Conservative Home is one of the UKs leading centre right blogs and Mark Wadsworth is one of the most read Libertarian bloggers.


Today I have made my first contribution to the Institute of Economic Affairs Blog.  

The piece details my view that, with the inevitable public spending cuts that will be happening in the UK, there is an historic opportunity for reform of healthcare provision by removing all NHS healthcare facilities from the NHS and putting them in to private ownership.  The NHS can then re-cast itself as a funding and standard-setting institution. 

I hope that this will be the first of many pieces that can generate some lively discussion as I have been asked by the IEA to become a regular contributor.

I am so fed up with reading negative headlines about  drug companies making profits from swine flu in the UKs National Press.  The Daily Mail and the Daily Telegraph seem to have the biggest hang ups about this.

So let’s get a couple of things clear.  First, scientists and drug companies invest vast amounts of money in the development of drugs, it costs them a fortune.  If they don’t make a profit they will not have the incentive or funding to go on to make more scientific discoveries and new products in the future.  The media have to accept this and get over it!

Second, and in my opinion, far more importantly, almost everyone involved professionally in the flu pandemic (or in fact any aspect of health care) will make a profit from it.  Every Doctor, Nurse, Physiotherapist, Social Worker, Porter, Cleaner, Occupational Therapist, Pharmacist and Hospital Manager will earn money from carrying out their jobs, i.e. they will make a profit.  As too will every journalist who has one of these ridiculous stories published, as I doubt very much that they are submitting their copy out of pure altruism!

More than sixty years on from the establishment of the NHS, members of the medical profession yet again are demanding that their ‘mouths are stuffed with gold’.

This time it is the General Practitioners who, during the ‘flu pandemic, want to make sure that they have their cake and eat it.  Not only are they refusing to give the UK population ‘flu vaccinations unless there are extra payments made by Government, they also want guarantees  that they will not lose their performance related payments if they have to cancel routine health checks and clinics due to the pandemic.

I could not put it any better than Matthew Elliott from the Tax Payers Alliance who has said;

Most ordinary taxpayers who are concerned for their health in the midst of the swine ‘flu epidemic will see this behaviour as greedy and inappropriate.  

GPs are trying to have it both ways: if they are cutting other work to treat swine flu, they can’t expect to be paid more.

Vaccinating patients against illness is a core part of GPs’ duties, and they should be getting their heads down and tackling the epidemic, instead of obsessing about their pay packets.

Two stories here and here hit the press yesterday on how the NHS is continuing to fail patients.  The first details how Doctors, though uniform lack of knowledge, are failing to treat patients with kidney disease effectively.  The second is about how NICE is, yet again, denying patients in the early stages of Altzheimer’s disease effective treatment that can prolong a reasonable quality of life for a significant amount of time.

I am sure that with the expected cuts in NHS spending we are going to hear many more stories like this.  How many will it take before the Government starts to make some real reforms that will stop the obsession with the out-dated model that is the NHS and start to think about how they can really help to assure – rather than provide – improved health care for all.

The NHS Confederation will announce today that by 2011 there will be a major shortfall in NHS funding leading to a crisis in the provision of care.  The Confederation are concerned that the NHS will not survive unchanged.

Well I hope they are right!   As I have blogged before here and here, the NHS is not doing the best for its patients now with the historically high amount of funding received since Labour came to power in 1997.

The unions are apparently up in arms as they fear more use of the private sector in health care provision.  The time has come for the unions, such as the Royal College of Nursing, the British Medical Association and Unison, to wake up.  For more than sixty years the NHS has tried and failed to provide uniform health care for all, and it has failed.  Now is the time for the independent sector to increase its involvement in health care provision.

Andy Burnham must not give in to pressure from the unions.  He must push through vital reforms that will be good for health care.  It must also be recognised that that will not necessarily be good for the NHS.  The NHS is an out-dated institution that has had its chance and failed, it is now crying out for reform.  The next few years might just be the right opportunity for a determined and right thinking Secretary of State for Health to push these reforms through.

As far as the main stream media have been concerned, things have been very quiet at the Department of Health recently, so this prompted me to have a dig around to find out what our erstwhile health team have been up to.

Interestingly, Lord Darzi, one of the Health Ministers, is initiating a little publicised project called Personal Health Budgets (PHB), a new way of funding NHS care for chronically ill patients.  I first wrote about this here in January, but this week the Trusts undertaking the pilot schemes have been announced.

My criticisms of this project remain the same, while I applaud this initiative, I do not think that it goes far enough.  My view is that if projects like this are to really work, patients must be able to purchase care from the private sector as well as the NHS.

As part of my digging around I telephoned the PHB office.  Here while asking one question, “Will patients be able to purchase care from the private sector?”, I was passed around to speak to a number of people within the department.  The general gist of the replies I got was that the guidelines have not been developed yet, most of their experience is in social care not health so they are not sure what will be decided for health care and finally, they are not sure what will happen if patients become acutely ill because patients do not have the experience or knowledge to make such ‘difficult’ decisions! (or to put it bluntly, patients are not trusted to make decisions because the bureaucrats might not like the outcomes!).

This leads me to suspect that yet again an enlightened project will be derailed a bureaucracy that really doesn’t want patients to behave like customers.

This story from the Daily Mail, is evidence that Government and Politicians never learn from their mistakes and should not be left in charge of health care. It is a report that despite a lovely new contract and a bonus filled salary scheme for the doctors, patient care is no better.  Apparently, once General Practitioners have met their targets of signing up enough patients to be paid the full bonus amount they do nothing further to enhance or improve their patient’s health.

This Government obviously does not remember that in 1948, following a long stand off with the British Medical Association, Nye Bevan was forced, at the last moment, to “stuff their [the doctors] mouths with gold” to ensure that the plans for the new NHS became reality.  The medical profession had put the Government in position where improved patient care was not guaranteed  but the medical profession was financially better off what ever the outcomes.

Surely, it is time for the Government to realise that it cannot continue in this vein?  It has failed time and time again in trying to improve health systems.  It is now time to try something different, and surely it is the turn of the free market?

More reports are appearing in the press about the need to improve NHS dentistry, including one from a new think tank saying that dentists should be forced to spend half their time working in the NHS.  As I wrote here earlier this week this is not the way forward.

The NHS is a broken system and NHS dentistry is no exception.  It cannot be mended by forcing staff to work in it or allowing dentists to fine people for not turning up to appointments.  The time has come to “think out of the box” as all of these management consultants say, and rather than trying to mend the un-mendable look for new ways of ensuring provision of the service.

Surely, it is time for politicians to accept that the state has failed in trying to provide this service and give the market a chance?  I don’t know what the market solutions would be anymore than I could not have predicted the plethora of mobile phone devices that we have now when Margaret Thatcher privatised British Telecom in the 1980s.  What I do know is that the market is a discovery process and that we know have an historic opportunity to discover the wonderful tapestry of services that it can provide.  And, while I know that no service will ever be 100% perfect I do know that the market can be no worse than the NHS!