A new government and a new dawn. But what will the future hold for health and related policy?
The only certainty today is that the public spending deficit is still there. It won’t go away and we now await the emergency budget to tell us where the promised £6 billion of cuts will fall.
Health policy is less certain. Of course, just because there’s now a Conservative at the helm of the health department it doesn’t follow that Conservative health policy will survive intact. The impact of appointed Lib Dem ministers, the Treasury (surely now the considerably strengthened chief operating officer role of government), coupled with a roving Lib Dem Deputy Prime Minister, will all be felt by the big spending departments including health.
The Lib Dem health policy is, I believe, the most radical and thoughtful and when compared to the other parties, the most coherent. But surprisingly I see lots of synergy between Lib Dem and Conservative health policy.
The coalition agree on structural change (for the first time to include the DH), greater use of the private sector (surely now a fully accepted partner in public service provision?), integrated health and social care budgets (long overdue), a stronger role for GPs (better to have them in than out and isn’t it what the public would want anyway?), and clearer blue water between providers and commissioners that hopefully should at last provide structural coherence from the top to the bottom of the NHS.
However, how far we see Lib Dem implementation of their wishes for greater democracy via elected local health boards (a transfer of NHS commissioning to local government in all but name?)is debatable. But of course, we’re in new terrority so all speculation at this stage may come to nought if much of current policy eventually ends up being ditched in favour of maintaining the coalition. We’ll have to wait and see.
Finally, it will be worth watching the behaviour of the coalition itself, not in terms of policy but how political relationships and partnerships develop. There’s now a greater need than ever before for collaboration and partnership across health and local government systems, if only for organisational and service survival. So, we shouldn’t be surprised to see local political and managerial leaders watching with interest how their new political masters model their own collaborative behaviour, which - rightly - they’ll be undoubtedly espousing as the best approach to managing public services locally.