A good few of Dr Grumble's readers take the view that the NHS is an inefficient behemoth and the more it can be privatised the better. It is a reasonable view to take. They could be right. They might well be wrong. What grieves Dr Grumble most is the lack of public debate on the topic. Reading between the lines of what New Labour has done and what the Conservatives seem to think they should have done more of, it seems to Grumble that the only major difference between the two parties is the rate at which they think the privatisation process should proceed. But you have to read between the lines. Privatisation of the NHS is not something either party wants to be explicit about.
One of Dr Grumble's colleagues, Professor Parrot, takes the view that it has been easier for New Labour to move towards NHS privatisation than it would have been for the Conservatives. Rightly or wrongly Labour is more trusted as a custodian of the traditional NHS than the Conservatives. The paradox is that the NHS could just be safer in Conservative hands. Whatever they say we all know the Tories are not really the party of NHS. In the event of a Conservative government an untrusting public would be on the lookout for shenanigans and privatisation of the NHS would be high on their watch list. Any 'progress' in this direction would have to be very cautious.
How far has Labour be able to expedite its covert privatisation plans? The figure below from the Department of Health gives an idea. Since the election of Tony Blair, spending on the purchase of healthcare from non-NHS bodies has gone up over fivefold.
Many of the Grumble readers might think this is a good thing. And they could be right. But health services managers might not be so enthusiastic. Take a look below at the views of these top managers on the role of markets and competition to increase quality.
OK. Dr Grumble can hear his critics. The table just shows the views of health service managers. What else would these people say? But they weren't just NHS managers. The managers whose views were surveyed came from Australia, Belgium, Canada, Denmark, Finland, France, Germany, Hong Kong, Italy, Malaysia, the Netherlands, Norway, Poland, Singapore, Slovenia, Spain, Sweden, Switzerland, the United Kingdom, and the United States. Just like Dr Grumble they do not think that the use of markets and competition is a particularly good way of improving quality. Top of the list for improving quality the most was better coordination of care. How is piecemeal privatisation going to achieve that? What kind of structure would you think is best to achieve better coordination of care? Dr Grumble will leave you to decide.
Department of Health Annual Report 2009 (pdf)