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Cameron's comparison to Blair only highlights the differences

Labour leader Ed Miliband challenged David Cameron at last week’s prime minister’s question time over the critical editorial on NHS reform published jointly by HSJ, the BMJ and Nursing Times.

In response Mr Cameron quoted Tony Blair, saying: “It is an important lesson in the progress of reform that when change is proposed it is announced as a disaster, it proceeds with vast opposition, it is unpopular… opposition is inevitable, but it’s barely unbeatable”.

Brave words – but ones with little substance.

Paul Corrigan was one of the leading architects of New Labour’s health reforms. He wrote this week: “If the Health Bill is passed it will in fact move reform backwards.” He concluded the legislation would not “bring about the change that it was intended to”.

As readers know, HSJ is not a fan of the way the government has gone about restructuring the NHS. But we retain a strong belief in the need to challenge the service to respond to changing demands and pressures. This requires reform – well judged, sensibly paced, sometimes radical, appropriate reform. Mr Corrigan’s comments echo HSJ’s editorial of last April, in which we wrote that the government’s execution of its NHS plans “could set reform back a decade – a far more toxic legacy than even the damage that the changes are wreaking in the system at present”.

Mr Cameron cannot claim to be a hardened reformer after ordering a belated “pause” to listen to concerns, and shovelling scores of amendments into the already overstuffed piece of legislation in order to calm opponents.

During the 1988 US presidential election, the Republican vice presidential candidate Dan Quayle regularly compared himself to one of America’s most iconic heads of state. His Democratic rival famously cut him down to size by declaring: “You’re no Jack Kennedy.”

When it comes to NHS reform, David Cameron is no Tony Blair.

Readers' comments (3)

  • When will the Great British public learn that the NHS is never safe in Tory hands? Good article as usual Alistair.

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  • There are similarities between the two and I am no admirer of TB but at least and unlike Cameron he was not embarrassed or wrong footed by the reforms his numerous SoS for Health pursued. Lansley has been front bench Health for 8 years but it is clear Cameron was out of touch with what he was concocting. This is not out of character for a PM who quickly gets bored with his homework.

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  • I sent this to The Times, yesterday:

    Alan Milburn (Feb 8; p.25) has a cheek. His flagship reform of the NHS in 2001 ('Shifting the Balance of Power') created far too many small purchasers (PCTs), which were overseen by too many 'Strategic Health Authorities', themselves overseen by four 'Regional Directorates'. It was a punishingly expensive reform, in terms of both start-up and recurrent costs. Milburn genuinely wanted 'devolution' but it was ill-thought-through and poorly-implemented. Paradoxically, 'devolving' too much to too low a level reinforced centralism as the Department of Health and its satraps had to knock heads together and fill the vacuum left by poor capacity at the local level.

    Sound familiar? The tragedy is that Mr. Lansley - in correctly diagnosing the trail of chronic-'re-disorganisation' left by so-called 'modernising ' New Labour - has come up with a prescription which is more of the same: cod devolution which will result in more centralism.

    (Letter signed:) Calum Paton
    Professor of Public Policy (Health Policy)
    Keele University


    Paul Corrigan was not working for Comrade Alan in 2001, but he was heavily involved in later New Labour 'modernization' which incurred lots of cost and questionable benefit (eg Foundation Trusts and the tariff - respectively, preserving in aspic the shape of 'yesterday's' hospital sector; and deepening the purchaser/provider split, damagingly in terms of both 'integrated care' and the possibility of using 'strategic commissioning' to keep - and get- people out of hospital.)

    The HSJ et al are quite right to slam Lansley's reforms and their (lack of) strategy. But make no mistake - they are one step further down the road chosen by 'Miligan', as I used to call Milburn and Corrigan.

    The other 'Mili' - Ed Miliband - should remember that uber-Blairites like Milburn and Corrigan oppose the current Health Bill because it is too 'compromised ie not geared enough to market forces. They are useful 'enemies of his enemy'....but dangerous friends (being essentially to the Right of the Coalition), if Ed and Labour want to move away from a 'neo-liberal' NHS.


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