Market reforms to the NHS symbolise the Conservative Party I want to be remembered serving
Nick de Bois MP says competition is the core of the Health and Social Care Bill and if we miss this opportunity for reform we won’t get another for a generation.
There is nothing worse than watered down policy. In the past, half-hearted reforms to public services and the economy have had none of their intended positive effects, and a myriad of flaws due to the fact that their core principles have been eroded, and also in so far as the legislation creates warped incentives and overly-complex bureaucracies.
This is nowhere truer than for the NHS in the creation of a market based on quality in healthcare. Many have attempted to tinker around the edges in the hope that they can improve this “sacred cow” of modern politics without the public noticing and objecting.
These previous reforms have failed to provide the efficiency, quality and modernisation that are needed not because they are the wrong reforms, but because they haven’t gone far enough.
For the first time we have a real chance to grasp this formidable problem and solve it. We have a coalition government with a broad base of support, a prime minister with a strong personal mandate, and a large new intake in the Commons eager to make their mark on Britain’s public services.
If we are going to do this, we are going to have to do it now. This opportunity will not present itself again for a generation.
That’s why I have been so tenacious in my defence of the key principles of the Health and Social Care Bill. Because I truly believe that their implementation is the only way to fix our struggling National Health Service. We desperately need the rigour of competition between public, private and not-for-profit providers to deliver efficiency and increase innovation.
Many have asked why competition is so important and have questioned why it is this particular “red-line”, the most publicly controversial, that I am most squarely behind. I answer that competition is the absolute core of this bill.
GP Consortia cannot be considered independent and cannot cater to local needs unless they can choose between a genuine range of providers delivering services (at the same tariff) to NHS patients.
Patients cannot genuinely be empowered and be given choices unless the money follows them, from provider to provider, whichever sector they come from. The massive bureaucracy cannot genuinely be eliminated if the NHS remains entirely public, as the private sector will always deliver the same services at a fraction of the cost and paperwork.
Make no mistake also, the suggested removal of Monitor as an economic regulator would not be a minor tinkering around the edges of the bill. Without an effective regulator to ensure a fair market and a level playing field, there will be no market in quality and therefore no competition. It will be a return to Andy Burnham’s “preferred provider” policy. It will be an unqualified disaster.
So, over the next weeks and months I will be working with colleagues to ensure that we stay strong on competition and on the role of Monitor because, for me, the pairing of competition on quality with a taxpayer funded NHS, free at the point of use, perfectly symbolises the kind of Conservative Party I want to be remembered serving:
A party that is radical and reforming, applying the sound principles of a free market and the primacy of the individual to our great public institutions;
A party that aligns this conviction with a strong “One Nation” belief that the NHS should always, I repeat, be free at the point of use and based on need, not ability to pay;
A party that recognises that only by digging our heels in with this bill can we ensure that the most vulnerable in our society have a world class safety net when they lose their most important asset, their health.
Nick de Bois is the Conservative MP for Enfield North
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