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Alan Milburn attacks Andy Burnham for making NHS the preferred provider

Former health secretary Alan Milburn has attacked Andy Burnham’s decision to move away from competition and make the NHS the “preferred provider” of services.

Speaking at the Labour Party conference yesterday, Mr Milburn directly criticised the current health secretary’s decision to move away from the Department of Health’s “any willing provider” policy to one where the NHS would be the preferred provider.

“I disagree with Andy Burnham when he said the NHS should be the preferred provider. There should be no preferred provider. Quality should be the only yardstick, not the type of provider.”

There should be no preferred provider. Quality should be the only yardstick, not the type of provider

Alan Milburn

Last week Mr Burnham said new guidance would be issued clarifying that where NHS services were failing, the provider would be given at least one chance to improve services before commissioners went out to tender for an alternative.

The union Unison was pleased with the announcement, but it raised questions from primary care trusts and independent sector providers, who warned it went against the principles of competition.

Mr Milburn told a fringe event: “I’m not saying competition is always correct for any service, but the only yardstick that counts for patients is quality and the only yardstick used by the public is efficiency.”

He said the NHS would be unsustainable without significant changes including transferring commissioning to local authorities, abolishing strategic health authorities and giving foundation trusts greater autonomy.

Failing to accelerate the pace of NHS reform will put frontline services at risk, he warned.

The architect of the 2000 NHS Plan, under which private sector providers were embraced and thousands more workers employed, called for state control over the NHS to be reined in.

He said: “The NHS is in transition between a 20th century model of state control and monopoly provision and…a different model where the citizen has more control.

“The policy question is whether that journey is going to be finished or truncated. We have to take it to its final destination.”

Payment by results also needed to be adjusted so it rewarded quality over quantity, he said. In addition, patients deserved greater control over their care.

He said: “These sort of reforms are necessary if we’re going to make the NHS sustainable in the long term.

“Failure will result in two things. We will put frontline NHS services at risk.

“It will give permission to those on the right to question the whole validity and sustainability of our NHS.”

Speaking to HSJ after the event, Mr Milburn said he thought the pace of reform needed “more oomph”.

Health minister Mike O’Brien, who was also speaking at the event, responded: “The appetite for reform is undiminished.”

Readers' comments (12)

  • Although he sometimes misjudged his speed and overshot the corner, at least with Milburn we had a sense of direction. Now we have...HIECs and WC Commissioning... Come back Alan!

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  • Milburn has failed to understand that the public's mood has shifted. There is now suspicion of "private" providers, and of the creeping privatisation of the whole of the NHS.

    Burnham has rightly read the public's desire that all health services should be within the NHS, unless there are very good reasons for them not to be.

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  • No shift that I can detect. There always was suspicion of private providers, or at least active promotion of such 'suspicion' from the Unison/Pollock crew. The phrase 'creeping privatisation' has been around for at least two decades. Dobson also thought he'd read the 'public's desire' in 97/98 when he said similar things, holding back service reforms that would have put us in a much better position to offer better quality.

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  • A clear statement from Milburn of the New Labour agenda of soft privatisation. Also in the same theme I am given an absurd choice under choose and book of 13 providers for a referral to a sight consultant. The reason for the public sector is that competition does not work in supplying a universal health service. Quality is the responsibility of the government and management and cannot be delivered by a 'market'.

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  • doesn't Alan Milburn have private business ventures related to the NHS e.g. radiology etc.? This rumour has floated about the NHS for many years and I am still unclear. If so, these statements may be around self interest rather than any political ideology.

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  • Please - stop all the fighting and point scoring and just give us an NHS that works, where the staff feel valued and as such give quality care to patients. Now all we see as patients are sullen (to the pint of rude) staff. Why should I be so amazed as to comment to all about the cheerful, helpful and efficient care I received - shouldn't this be the norm? Take the politics out of the NHS

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  • Tracey Austin - whatever interests Alan Milburn and other former Government Ministers have, they are inconsequential by comparison to the influence of the unions. He who pays the piper calls the tune, and the unions, not the private sector, hold Labour's purse strings. So if you're looking for undue influence, start there.

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  • Alan Milburn - out of touch and out of government. Outdated ideas that the market will solve everything in a year where markets have almost brought economies to the point of collapse. Does he seriously believe that fragmenting services amongst a multiplicity of providers is going to drive up quality? Many staff won't put up with it. They'll walk. They are not economic units subject to the flows of the market. Staff dont work in the NHS to get rich; they do so because they have a pride in the NHS and share its values. So why shouldn't NHS providers and NHS staff have first opportunity to improve or deliver new services? Co-operation should come before competition. Only if that fails should other solutions be considered. Cost wise this makes sense as well. The NHS remains best value for money compared to other national health systyems partly because it is not burdened with the administrative bureaucracy of managing a market. Andy Burnham is moving this debate in the right direction. Alan Milburn is yesterday's man.

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  • Alan Milburn is not just yesterday's man he is last decades man! It is quite clear that the mood of the country is moving towards public services being provided by public servants not the market. Given the events over the last 12 months in the banking and finance sector it would be utter folly to let markets control the provision of healthcare in this country, or any other for that matter!!

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  • Dear Anonymous. I understand Unions have a huge influence in the health care sector. That is a no brainer.
    It is important to raise the issue that many ex MInisters have business interests in sectors that they once were aligned to in political office. This gives them access to particular corridors of power that other people in the private sector do not - I worry about the line of politician and lobbyist being blurred. I'm not naive to think that it doesn't happen time and time again - it is politics after all. I think the HSJ should scrutinise this territory more.
    I live in the States and I see this happen with politicians who have now moved from senior positions in Gvt into the private sector. My point is that none of us should be blind to these issues as consumers of health care. There is nothing we can do about it as it is 'business' and 'politics' but this often sits uncomfortably with me and raises issues around ethics for me. I do not have a particular agenda be it private business or union - just hopefully a switched on citizen who wants to see analysis of these statements made by the likes of Alan Milburn etc. dug around a bit more and interrogated with some depth.

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  • ps I do think there is room for not for profit independent sector contributions in healthcare and there are some good examples here in the US. NHS shouldn't be a monopoly by any means. I have no problem with competition at all but the free market (as the US proves) brings many limitations.

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  • Today - 2 October's - TCN report says it all - both ways - how about an NHS provided service rather than a contractor provided service of whatever origin? Should have in 1948.

    Can we at least now have some decent audits of "out of hours" services, with the RGCP leading from the front?


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