Saturday 27 February 2010

"Make the NHS work for patients not managers" ... or is it the other way around?

So this is the beef?

1785 days since David Cameron wowed the Tory party conference on his way to the party leadership by making a speech without notes, the Conservative party leader will tomorrow respond to concerns in his own party that they "don't really have a message or a purpose" (as one of Cameron's press officers told The Spectator this week) by ... making a speech without notes.

But wait! There's more. Andrew Grice of The Independent reports the Conservatives' exciting plans to use their Spring conference to challenge the idea that they are all soundbite and no substance.

The Tories will use the conference to display "the meat behind the message", highlighting six key pledges: to cut debt; boost enterprise; make Britain the most family-friendly country in Europe; support the NHS; raise standards in schools and reform politics.

And ConservativeHome breathlessly refers us all to an exciting Daily Mail graphic spelling this out.

Let's take "make the NHS work for patients not managers".

At first glance, this sounds like the usual Hiltonesque gobbledegook, served with lashings of motherhood and apple pie.

Who, after all, would pledge to make the NHS work for managers, not patients?

Well, maybe the Tories.

The Spectator's Fraser Nelson has run a consistent campaign challenging Tory Health Spokesman Andrew Lansley as effectively a spokesman for the BMA.

Nelson, like many commentators on the right, regards the Tory pledge to protect current levels of NHS spending as wrong-headed. Where there is broad agreement among commentators across the political spectrum is the incredulity at the lack of interest in accountability or reform to go with the cash.

Former new labour policy advisor Conor Ryan has also consistently critiqued the Tory "producerist" health policy, including noting that:

Nelson worries that he has gone native on NHS spending, after a series of gaffes and unapproved funding commitments. Cameron should be equally worried that Lansley is opposed to any sensible accountability or reform for that money. After all, his every pronouncement is an echo of what the BMA says, and apart from shoving patient records securely on Google, he shows no interest in what patients experience at the hands of their members.

The Independent's John Rentoul said in his 'Take the NHS away from the people' of David Cameron's own deeply contradictory health statement and speech last month.

He must be well aware, meanwhile, of the contradiction between "giving the NHS back to the people" and handing it over to the doctors' trade union, the BMA. He must know that "the people" are in favour of targets for treating cancer within two weeks, yet he happily promised to abolish them. Dire.

Yet another example came when the extraordinarily vague Tory mutual plans oddly proposed public sector worker cooperatives without the user representation which is part of current public service mutuals.

Of course, all of this reflects Steve Hilton's emphasis on "brand decontamination" with public sector workers - which was the Tory campaign theme on the day of the Osborne annoucement.

But it would also seem to highlight the extent to which David Cameron seems to have prioritised electoral messaging over serious policy analysis in preparing a manifesto for government.

In the in-depth four part Financial Times profile of Cameron's Conservatives, George Parker finds that several senior Tories find their leader's lack of interest in policy beyond the campaign slogans remarkable:

“He’s not ideological,” said one senior Tory. “He can pick up a brief very quickly but he’s only interested in policy to the extent it helps to get him elected.”

A shadow minister said: “Can you really tell me what the purpose of a Cameron government is?”

“One of the odd things about Dave is he’s a cipher,” said one policy adviser.

“You present things to him and hope he’ll like them, but you never really get the idea that he might have any ideas of his own,” said another.

So it is that we end up with a Tory pledge to get rid of "wasteful and harmful NHS targets", like the commitment to treat cancer patients within a fortnight.

So perhaps surprisingly "Make the NHS work for patient not managers" might not be quite as meaningless as it looks - if only anybody was interested in trying to rework Tory health policy around it.

1 comment:

Anonymous said...

Why do they want to be the most family-friendly country in Europe only? What about the rest of world? Are they all a bit OTT in supporting the family?