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Reforms needed to save NHS

Leading academic argues health service reforms must be stomached

A FORMER health policy advisor to the prime minister urged patrons of the Royal Free Hospital on Thursday to accept controversial NHS reforms.
At the hospital’s annual Marsden Lecture, Julian Le Grand – professor of social Policy at the London School of Economics – explained the logic behind plans to contract out a number of core NHS services to the private sector.
The reforms include improved patient choice, payment by results, the introduction of independent treatment and diagnostic centres and foundation trusts.
Prof Le Grand (pictured) said the NHS was failing to live up to its founding principles and that the reforms, which many see as a step towards the privatisation, were “the least worst” alternative.
He said the decision to reform the NHS came after Tony Blair fielded an embarrassing question on the breakfast show GMTV.
Mr Blair was told he would have to answer a question on average waiting times for hip operations. Prof Le Grand said Mr Blair rang him at 6.30am in a panic.
He said: “Mr Blair woke me up to ask me what the average waiting-time for a hip operation was. I rang up half the health department and found out that they hadn’t kept proper records on waiting times but for hip operations, eight months was the average. He wasn’t very pleased with either answer.”
Despite the promise of universal health care, Prof Le Grand said long waiting lists meant people were left in pain for months.
He said: “Chronic under-funding of the NHS left a service creaking at the seams. By trebling investment by 2008, the government will have corrected this historical under-spend.
“Targets have had some success, but they are too blunt an instrument to achieve the long-term aims of the NHS,” he said. “Many in Parliament felt that what was needed were embedded incentives in the system so people provided a high-quality service because they wanted to and not because of an endless barrage of orders from the top.
“Choice on its own is not sufficient to provide the appropriate incentives: there must be benefits for those chosen, and costs for those not. Providers that fail to meet patients’needs have a powerful incentive to improve.”
The accusation that the reforms were just another step closer to privatisation were dismissed by Prof Le Grand who said the government was committed to maintaining a service that judged patients on health not wealth.
He said: “We’re not looking for the best, but only for the least worst but there are risks along the way.
“The challenge is to deal with them in the most effective and equitable way.” Prof Le Grand was criticised by trade union leaders when he became health advisor to Tony Blair in May 2004. He angered unions by labelling public sector workers opposed to reform as “knaves” motivated by “plain self-interest”.



Angelino's finest are put to the test

WE came across Angelino Wines, sandwiched between two colourful and aggressively self-promoting Australian wine sellers, at Islington’s London Wine Event at the end of October.
Its owner is Farrell Anglin, whose imagination was caught by a lecture on the history of wine making at Southgate College.

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