This conference season was always going to be an important one for the NHS. And so it has proved.
It has duly moved it to the heart of the coming election campaign. But it has done more than that: it has also exposed genuine differences between the two main parties.
Labour has a plan for the NHS which is credible and funded whilst the Tories would continue to take it backwards.
On the two fundamentals – funding and policy – Labour has emerged from the conference season with a platform from which to fight the 2015 election that is much stronger than our opponents.
First, NHS funding.
The centrepiece of Ed Miliband’s speech in Manchester was a pledge to find an extra £2.5bn to help build the workforce of the future NHS. This “Time to Care” transformation fund more than meets the call made by the NHS Confederation and other leading health organisations going in to the conference season. It will be raised through a mansion tax on homes over £2m, by closing tax avoidance loopholes used by hedge funds and by introducing a new levy on tobacco companies.
It is now clear that Labour will go into the election having found money that the NHS is asking for but the Tories have failed to match it.
On future policy, the Tory position is even weaker than funding. And it is the combination of their ideology with the funding crisis – privatisation and cuts – that could subsume the NHS in the next Parliament.
David Cameron is either in denial or is being deliberately dishonest about the policy he has inflicted on the NHS through the Health and Social Care Act. Either way, a Prime Minister cannot be allowed to get away with it.
I was listening to his Today programme interview on Tuesday morning and my jaw literally dropped when he said this: “there’s nothing we’ve done that fundamentally changes the role of private or independent sectors in the NHS.”
This is simply not true and it is quite astonishing that a Prime Minister can make such a claim without being subsequently challenged by the media.
Cameron said it was up to GPs to decide whether to tender services on the market. I put this to the Chair of a CCG the following day. He said that their interpretation of section 75 of Cameron’s Act was that they had no choice but to put NHS services out to tender under the Any Qualified Provider principle.
Every CCG I speak to says the same.
This explains why £5.8bn of NHS services are currently out to tender, as the FT reported in July. Surveys suggest that 70 per cent of contracts awarded have been won by private providers. It also explains why the NHS is now wasting millions of pounds a year on tendering. Even when contracts are won by the NHS, such as for older people’s services in Cambridgeshire this week, the cost to the NHS is enormous. It is estimated that this single process cost £1 million. Far from putting GPs in charge, David Cameron has handed competition lawyers a lucrative NHS cash cow.
The truth is that market ideology is ripping through the NHS and, if it combines with a funding crisis in the next parliament, could prove utterly toxic for the NHS. The Tories have belatedly realised how unpopular their privatisation agenda is and are trying, from the Prime Minister down, to deny that it exists. Labour’s challenge over the next seven months is to explain this clearly to the public.
We will get our chance to do this in six weeks time when Clive Efford’s Private Member’s Bill comes before the Commons. It repeals the most noxious elements of the Cameron Act, including section 75 mandating competitive tendering.
This will be a big moment for Labour and we will be asking our members to build the campaign for it in every single community. Tory and Lib Dem MPs will be confronted with the reality of the legislation they passed which has proved so damaging to the NHS. Not one of them was given the permission of their constituents to put the NHS through this reorganisation and on a path towards privatisation. They will now have to account for their actions on Friday 21 November.
So the battle lines on the NHS are now very clearly drawn. Labour leaves this conference season in a commanding position. We have found the money to build a 21st-century health and care service, true to its founding principles. By contrast, our opponents are weaker on funding and in denial on policy – they have no credibility and no plan for the NHS.
In his conference speech, David Cameron resorted to an appeal to trust him on the NHS. People will remember that he tried that last time, promised no reorganisation and then brought forward the biggest ever. For that simple reason, he has forfeited the public’s trust on the NHS. And, after this conference season, people now know that the NHS simply can’t afford five more years of Cameron.
Andy Burnham is Labour MP for Leigh and shadow health secretary
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