We do not want to see the state withdraw from [the NHS] in any shape or form at all.
Yes. That is what he said on The Andrew Marr Show. Does this mean what it seems to mean or was this some very clever use of words? Is it a genuine reassurance or is it false? You could look at the draft manifesto to check but electoral manifestos are written to court popularity and, according to Wikipedia, "the status of electoral manifestos has diminished somewhat due to a significant tendency for winning parties to, following the election, either ignore, indefinitely delay, or even outright reject manifesto policies which were popular with the public". So where should we look for the truth? Perhaps a policy document not so widely read as a manifesto would be the place. And that is what Dr Grumble has done. This is what the Conservatives say in their Renewal/Plan for a Better NHS (pdf):
Over the past eleven years Labour have missed a golden opportunity to work in partnership with the private sector to provide better care, not privately, but free at the point of need on the NHS. Despite believing that market mechanisms work, they have failed to open up the market for the provision of NHS care so as to drive up standards.
We need a level playing field. All NHS patients should be free to choose any provider of care for their treatment – so long as that provider can provide treatment at the NHS price. So that could be an independent hospital or an NHS Foundation Trust, depending on the patient’s preference. Moving to this system, driven by patient choice, means people will get treatment more quickly and there will be a far stronger incentive for standards of care to improve.
Dr Grumble's patients cannot choose a private provider for their care. Not without paying anyway. Actually, and this is the truth, Dr Grumble would not necessarily advise them to obtain private care even if they wished to pay for it. Private care is not necessarily better and Dr Grumble is quite certain that it can be worse. Some of the very best doctors work for the NHS. Getting to the top in the NHS is not easy but any doctor is free to set up privately. It has been like that since 1948. It is one of the great strengths of our health service.
So Dr Grumble is left confused. Apparently David Cameron does not want the state to withdraw "in any shape or form" but we know from the policy documents that NHS patients should be able to "choose any provider of care" which could be "an independent hospital or NHS Foundation Trust". That presumably means a choice of either NHS or private provision or maybe third sector provision. How can that be achieved without "the state withdrawing from the NHS in any shape or form"? You work it out.
OK. If you have read this far you will now be wanting to know exactly what the wording is in the draft election manifesto. Here it is:
To give patients even more choice, we will open up the NHS to include new independent and voluntary sector providers – if they can deliver a service that patients want, to a high standard and within the NHS tariff, then they should be allowed to do so.
So there you have it. Essentially the same thing twice. No real obfuscation - except from David Cameron himself. There will be more independent and voluntary sector providers - full stop. The plans of the major parties for the NHS seem to to be much the same. When David Cameron says "We cannot afford to carry on like this" he is right. He can't. He needs to find something different. Not more of the same.