I was still on my late summer holiday during much of the renewed skirmishing which heralded the return of Parliament and the latest battles over the Health Bill.
NHS officials engaged in secret (do we mean “private” here?) email discussions about letting foreign firms manage up to 20 hospitals; that sort of thing.
So within hours of this development I was listening to an expatriate Brit extolling the virtues of French healthcare while seated on his sun-kissed terrace, tasting the wines which he and his wife lovingly produce.
Since my host was aware of England’s NHS reforms row I expressed mild frustration that talk of “privatisation” usually focuses on excesses in the US health economy, not the widely admired mixed system he enjoys in France.
Well, yes, replied the winemaker, who has been successfully treated for cancer at both the public hospital and the private clinic in the nearby town (“the hospital was much better”), and explained that both are subject to heavy state price regulation in the French fashion – as if regulation alone, not competition, makes possible the (costly) French health miracle.
I mention this because I frequently find myself frustrated with the tribal simplifications deployed by both sides of the debate on Andrew Lansley’s Pandora’s Box of a bill.
No, I do not instinctively defer to the pressure group 38 Degrees’ assertion (supporters funded a legal analysis) that the secretary of state is cunningly excusing himself of any duty to provide an NHS.
But I do share the group’s concern that the bill will – despite Lansley’s denials – open the NHS to all sorts of EU/UK legal challenge on competition grounds. No one can know for sure. But we all know what lawyers are like.
So suspicion of private sector motives and behaviour is entirely legitimate. When I read in the Indy (a visiting friend brought a copy) that big tobacco barons are using Freedom of Information requests to stalk Whitehall’s discussions on cigarette policy (plain logo-free packaging is what barons fear) I remember 50 years of their own secretive, dishonest efforts to decouple smoking from cancer and wish we could FOI them too.
Ditto opaque private finance initiative contracts, about which MPs complained the other week. We did not need the banking crisis or the outrageous day rates charged by top-flight management consultants for the loan of their teenage staff to know we have to keep a sharp eye on Goldman Sachs and McKinsey types too.
But does that mean that allowing UK and foreign healthcare providers – the German hospital chain Helios is reportedly in negotiation – to have a well regulated crack at managing some NHS hospitals marks the privatising end of civilisation as we know it?
No, it doesn’t. Lidl and Aldi have provided some welcome (often cheaper) competition to our local Tesco-ish monopolists, yes?
In any case, we all know that chunks of NHS provision are already in private hands and that Circle Health is close to being given control of Hinchingbrooke Hospital in LansleyLand with surprisingly little fuss. Let’s see how well – or badly – they do.
Let’s ask Baroness Shirley Williams – lovable but often feather-brained – and other Lib Dem rebels to focus their fire on the bill’s confusing small print, not on the supposedly secret plot to flog off the NHS.
Our neighbours still have much to teach us. On waking in a hospital bed after a holiday heart attack another friend realised that a) he was alive b) he was in France. Why so? The lunch trolley was passing and he could hear someone asking: “Rouge ou blanc?”