As a participant in the Dispatches programme The NHS - Where did all the money go?, may I offer the following reflections to your correspondent Donald.Reid. He is right that there have been improvements in key areas, including waiting times.
As a longstanding believer in the NHS and a published critic of the last Conservative government's market reforms (including in the HSJ through the 1990s), I also believe that so much more could have been done with the money which has been wasted on circular reform. It is fair to call this the New Labour record, because the policy-making style of New Labour is 'initiative-itis' - a policy incontinence which, moreover, is increasingly repeating mistakes from recent history (ie the 1990s). I think Tony Blair, like Henry Ford before him, believes that 'history is bunk'!
It's always a dilemma, and a calculation, Mr Reid, as to whether to speak out, for fear of giving succour to the enemies of the NHS.
The sad truth is that this government is losing the 'propaganda war' as to whether what enemies of the.NHS call 'state medicine'.
This has to be a major political own goal, given the extra expenditure. It gives me no pleasure at all - but simply hanging on to nurses for fear of something worse is no longer an option. My own motivation in speaking out is to suggest that a publicly-funded NHS is indeed viable, and without obsessive, defensive and expensive 'market reform'.
The government's approach is to seek to placate the 'marketeers' - but the spin in reaction to New Labour's reformed NHS is that even extra money is wasted.
We have to show that a properly-planned public NHS can work. We need more high-level specialists actively involved in patient-care to shorten lengths-of stay, and 'integrated care' bringing together primary and acute in one organisation. Reform opposes both, and unfortunately New Labour opposes the latter, as they have been persuaded by their 'marketeer' advisers that 'purchaser-provider splits' are a necessary symbol of market virility.
As someone who advised Robin Cook and other Labour spokespeople in the 1990s, you may guess that I am not a Tory! But (after ten years of New Labour government), asking for the opposition to be similarly 'critiqued', Mr. Reid, misses the point. Indeed that has been New Labour's downfall in terms of policy-making - nervously watching the Tories, even during Labour landslides, and creating ill-judged reforms such as Milburn's 'Shifting the Balance of Power' in 2001 in partial response to what they thought the Tories were going to propose!
Calum Paton, director, Centre for Health Planning and Management and professor of health policy, Keele University
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