On Monday, Tony Blair gave an excellent speech on the introduction of ‘truly personalised’ services across the public sector – specifically in healthcare and education.

Signalling a commitment to the idea of the privatisation of provision across the NHS he said that people wanted services tailored to meet their individual needs and they wanted greater choice. Arguing that there should be a “much greater diversity” in provision he railed against the old, top down, monolithic state.

Blair clearly understands that a real market in health provision would not only encourage more private for-profit hospitals but also a wide range of mutual, co-operative and charitable institutions. In the future, private and voluntary sector organisations will be able to compete to deliver a wide range of services once the purview of the Department of Health and the Treasury. Already, the government is using the rubric of social enterprise to move this agenda forward and one can expect an even greater radicalism in the months ahead – irrespective of who the Prime Minister is.

With the NHS is being recast as a funder of healthcare but no longer the owner of the facilities in which its services are provided there are huge opportunities for nurses. It is no accident that the Prime Minister and his team at No.10 talk in terms of giving nurses the opportunity to expand their responsibilities and make certain prescriptions. Determined to introduce ever greater supply side reform the government wants to break down professional demarcations and so add value for patients.

However, for NFR, much more needs to be done. Not only do we need to get health and social care provision out of the public sector but we need to end national collective bargaining for pay. We have to encourage more information to patients through greater advertising and we need to encourage more private funding. In the long term we need to encourage private medical insurance, health savings accounts, private health cash benefit schemes and much more besides.

Crucially, instead of reactively winging about these changes we need to get the churches and the trades unions – including Unison, the BMA and the RCN – to positively engage this future and start thinking about what products and services they can offer in this market not only for their followers and supporters but others besides.

In writing this I am mindful that British trade union movement was not made great because of its commitment to nationalisation or beer and sandwiches at No.10. Historically, the trade unions became powerful and respected institutions because of the high quality friendly society services they offered their members and those in need.

Instead of asking for ever more tax payers’ money for a failed NHS, these institutions and their leaders need to reposition themselves for the twenty first century. They need to recapture the moral and intellectual high ground of the health and social care debate by taking practical steps themselves and in doing so stop passing the buck to politicians.

In embracing the reform agenda, healthcare professionals and their representatives should make it clear that they have a real vision for the future and not one that has its roots in the failed post war settlement of the late 1940s and a fully nationalised NHS.

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