The History Boys

“Those who cannot remember the past, are condemned to repeat it.” I’d like to paraphrase those words by George Santayana and say they are condemned to become politicians. More precisely they become health ministers.

Whenever a new party takes office, especially after years in the wilderness, it has to run around with dynamic zeal and change all that went before it in the NHS because it was just plain wrong.

They know the cure for the ills of the health service, except that the medicine is usually the same as the one that failed before, but with a different label.

Labour did it during there time in office. GP fundholding was “bad” but GP based commissioning was “good”; privatising was “bad” but attracting private health companies to provide “additionality” was “good”. I could go on so I suggest you read Polly Toynbee’s article from 2005 which is as good a precis as any for the circles New Labour ever decreased in.

Since the NHS began in 1948, it has been reorganised on average every six years, which might not sound so bad except that the gap between reorganisations grows smaller and smaller. It also means that the politicians never pause for breath to figure out what has worked and what hasn’t.

Andrew Lansley seems set on the same course with his bill to put GPs in charge of the coffers which sounds awfully like the failed GP fundholding, although he has compounded his error by removing the primary care trusts, the only real check on the abuse of the system by the unscrupulous.

Here’s an analogy; instead of your health, let’s imagine we’re talking about your car. You have a garage round the corner that services it, gets it through its MOT and takes a sharp intake of breath when its anything more serious.

Let’s also imagine that you have saved up £20,000 to replace it, but instead of choosing the make and model, the money is handed to the local garage for them to choose for you.

If you’re lucky, they might let you have a Ford Focus of roughly the value of the cash you’ve given them. But if they can pocket the difference, what’s to stop them handing you the keys to a second-hand Skoda instead?

Meanwhile the Labour benches are bleating about the privatisation of the NHS, the same Labour government that happily continued with the Tory PFI policy when the Treasury pointed out that it couldn’t actually afford to build new hospitals. And the same Labour party that brought in healthcare companies from around the world to provide NHS care.

One in particular is the newly elected MP for Oldham East, Debbie Abrahams. She resigned as chair of a PCT some years ago because the South African company, Netcare, was running an NHS facility in Greater Manchester.

Could their standards possibly be up to ours? How well trained were the medical staff? Why not spend the money with the average-bad Rochdale Infirmary?

That would be the same Netcare that runs the hospital in Johannesburg that successfully treated and discharged Nelson Mandela this week. But then I suppose he’s just an old right-wing reactionary.

Nobody’s prefect. If you find any spelling mistakes or other errors in this post, please let me know by highlighting the text and pressing Ctrl+Enter.

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