Revised NHS Reforms - Any More U-Turns On the Horizon

With the government poised to backtrack on the NHS reforms, what will be the effect on other public sector cutbacks?

From before its creation in 1948, and in the years since, the National Health Service has been the subject of heated, and sometimes bitter, debate.

Those who insist that the means to pay should be the determinant of access to medical care have never given up the hope that one day a government would succeed in reversing the hard-fought achievement of a free health service. The problem for right-wing ideologues is that the NHS was instigated during the post-war Labour government of Clement Attlee and driven through by the determination of Aneurin Bevan: therefore it is seen as a socialist creation.

On many occasions since then, commencing with the 1951 Conservative government, the NHS has been subject to review and, sometimes, reform, such as the radical changes of the 1991 Conservative government. Therefore, we should not be too surprised to find ourselves, once again, in the middle of a fierce debate concerning its future. 

There is no doubt, despite the coalition's reassurances to the contrary, that Andrew Lansley's bill intended to shift the NHS towards privatisation. This government's obsession with 'small' government and 'big society' means that it is inevitable that a publicly-funded institution which employs 1.3 million people would be a prime target for privatisation. The thought of drastically reducing a £105 billion budget by trimming the workforce, and allowing privateers to bid for the right to provide services is too tempting for them to pass up. 

The government would have expected the usual opposition groups to rail against the changes. However, as in the embryonic days of the NHS, it is the opposition of doctors that appears to have had the biggest effect on the change of tack by the government. In combination with the panic spreading through the junior partners in the coalition in the wake of May's local elections, the resistance of medical professionals has forced the government back from the brink of back-door privatisation. There also seems to be a realisation on the part of the prime minister that this is an issue too far for the British public. There is still an overwhelming feeling amongst the British people that the health service belongs to all of us.

Meanwhile, without a powerful professional body behind them workers in other parts of the public sector are more vulnerable. Although these workers do have the trade union movement behind them in most cases, the government has proved itself more likely to back down on issues which arouse opposition in its own natural constituency (such as the countryside lobby during the move to sell off forests.) By contrast, it sees the unions as the natural foe of free enterprise and is willing to engage them in battle. 

The issue of trimming 'unnecessary' jobs from public institutions is part of the NHS debate. The question that politicians are rarely asked in these situation is 'what do they think these people do all day?' It is rare to find people in today's employment culture who have time to take a full lunch break, so we must then assume that their workload is, at best, 100% of their capacity. If these people are removed then where does the burden of that work fall? The obvious answer would be on doctors, nurses and auxilaries. Personally, I would prefer these people to be performing the task for which they are paid rather than having to deal with additional administrative duties. 

The NHS is not the only institution where this dogmatic assertion that somehow a person working in a clerical role for a public body is contributing less to the economy than a similar person in the private sector. Having worked in both the public and private sector, it is evident that both sectors contain a similar proportion of staff who do not pull their weight. However, this is a matter for management to deal with and is in no way going to be resolved by indiscriminate job shedding. The ongoing cull of local government jobs brought about by the cutbacks is already having a devastating effect. The bald truth is that the private-sector jobs which will supposedly replace them are not being created quickly enough. A poll of people who have been laid off in this way would surely find that they would be happier with a public-sector job rather than no job at all. 

There is an obvious need to balance any nation's finances, but the government also has a duty of care for its people. The degree of uncertainty rife in the country today does not make for a healthy society. With the official opposition failing to provide a real alternative to the consensus, it does seem as if Britain is in for a long lean spell. Despite David Cameron's now-famous propensity for u-turns it is difficult to see this latest reverse of NHS changes being repeated across the board. When it comes to the central cost-cutting ideology of his party, the easier targets are still going to be picked off.