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| Can the Tories face down opposition on the NHS? | Can the Tories face down opposition on the NHS? |
| (about 5 hours later) | |
| Tue 13 Jun 2017 12.00 BST | |
| Last modified on Mon 27 Nov 2017 22.48 GMT | |
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| It was a curious election from an NHS point of view. The state of the health service was voters’ number one priority, but the NHS still did not dominate the campaign debate. Labour gained favourable headlines for several health policies, such as scrapping both the NHS pay cap and sustainability and transformation plans (STPs), and the party’s NHS focus was doubtless a key factor in the Corbyn surge. Theresa May looked both out of touch, when she insisted that “complex reasons” explain why some nurses use food banks, and uncaring on NHS staff’s stagnating pay. | It was a curious election from an NHS point of view. The state of the health service was voters’ number one priority, but the NHS still did not dominate the campaign debate. Labour gained favourable headlines for several health policies, such as scrapping both the NHS pay cap and sustainability and transformation plans (STPs), and the party’s NHS focus was doubtless a key factor in the Corbyn surge. Theresa May looked both out of touch, when she insisted that “complex reasons” explain why some nurses use food banks, and uncaring on NHS staff’s stagnating pay. |
| The result: the NHS has the same prime minister (for now) and the same health secretary (now heading towards his sixth year in post), and certainly the same familiar problems – too little money and too few staff to do its job properly in the face of a tsunami of rising demand and costs. However, the fact that the Tory manifesto included a new and radical prescription to revamp the NHS means the nation’s most cherished institution will keep generating political heat for those in office. | The result: the NHS has the same prime minister (for now) and the same health secretary (now heading towards his sixth year in post), and certainly the same familiar problems – too little money and too few staff to do its job properly in the face of a tsunami of rising demand and costs. However, the fact that the Tory manifesto included a new and radical prescription to revamp the NHS means the nation’s most cherished institution will keep generating political heat for those in office. |
| Largely unremarked on when the manifesto came out, the government backed the big programme of hospital unit closures envisaged by the STPs, albeit “providing they are clinically led and locally supported”. It is also prepared to introduce legislation to clear the way legally for STPs to morph over time into “accountable care partnerships” – beacons of the new NHS which both NHS boss Sir Simon Stevens and May are committed to deliver by 2022. It plans for good measure to sweep away the NHS’s internal market - the purchaser/provider split, which a previous Tory administration created in 1990. And it wants to slash the service’s “costly bureaucracy”, which – more irony – is code for the 209 NHS clinical commissioning groups introduced by none other than Andrew Lansley in his disastrous, damaging Health and Social Care Act 2012. | Largely unremarked on when the manifesto came out, the government backed the big programme of hospital unit closures envisaged by the STPs, albeit “providing they are clinically led and locally supported”. It is also prepared to introduce legislation to clear the way legally for STPs to morph over time into “accountable care partnerships” – beacons of the new NHS which both NHS boss Sir Simon Stevens and May are committed to deliver by 2022. It plans for good measure to sweep away the NHS’s internal market - the purchaser/provider split, which a previous Tory administration created in 1990. And it wants to slash the service’s “costly bureaucracy”, which – more irony – is code for the 209 NHS clinical commissioning groups introduced by none other than Andrew Lansley in his disastrous, damaging Health and Social Care Act 2012. |
| Pursuing that agenda will make it impossible for the prime minister to realise her ambition of keeping the NHS off the front pages. | Pursuing that agenda will make it impossible for the prime minister to realise her ambition of keeping the NHS off the front pages. |
| But the unavoidable political pain along the way may be worth it, if modernisation on this scale and another NHS reorganisation creates a health service that is both fit for tomorrow’s medical and care challenges and better-equipped to live within its budget. | But the unavoidable political pain along the way may be worth it, if modernisation on this scale and another NHS reorganisation creates a health service that is both fit for tomorrow’s medical and care challenges and better-equipped to live within its budget. |
| But how much reform will May or her successor dare to push through? Labour’s seizure of Canterbury after 176 years as a Tory seat, when its candidate Rosie Duffield made saving the at-risk Kent and Canterbury hospital a key priority, is likely to have a chilling effect on government backing for controversial NHS reconfiguration schemes. This is especially true when that involves a Tory MP, as many of the STP-driven plans to overhaul the role of local hospitals do. As one trust chief executive puts it: “Canterbury could prove to be another Kidderminster”. That was the hospital, the threat to which led to its Labour MP losing his seat in 2001 to a doctor from it, Richard Taylor, who was elected not once, but twice, on a ticket to protect it. | But how much reform will May or her successor dare to push through? Labour’s seizure of Canterbury after 176 years as a Tory seat, when its candidate Rosie Duffield made saving the at-risk Kent and Canterbury hospital a key priority, is likely to have a chilling effect on government backing for controversial NHS reconfiguration schemes. This is especially true when that involves a Tory MP, as many of the STP-driven plans to overhaul the role of local hospitals do. As one trust chief executive puts it: “Canterbury could prove to be another Kidderminster”. That was the hospital, the threat to which led to its Labour MP losing his seat in 2001 to a doctor from it, Richard Taylor, who was elected not once, but twice, on a ticket to protect it. |
| Unless the government faces down opposition in the many equivalents of Canterbury to come, what is the point of ministers pledging to “back the implementation of the [Five Year Forward View] at a local level”? The Stevens plan to which May and Hunt swear allegiance involves unprecedented centralisation of services; if they rule out every controversial change, they will defenestrate it. | Unless the government faces down opposition in the many equivalents of Canterbury to come, what is the point of ministers pledging to “back the implementation of the [Five Year Forward View] at a local level”? The Stevens plan to which May and Hunt swear allegiance involves unprecedented centralisation of services; if they rule out every controversial change, they will defenestrate it. |
| In that scenario, given Stevens’ huge investment in the five-year plan, why would he hang around, his plan potentially fatally neutered? Beyond the fantasy finances and unrealistic pledge of an NHS providing “exceptional standards of care, wherever, whenever”, what would the government do? May, forced to produce her own NHS policy, would find this prospect terrifying. | In that scenario, given Stevens’ huge investment in the five-year plan, why would he hang around, his plan potentially fatally neutered? Beyond the fantasy finances and unrealistic pledge of an NHS providing “exceptional standards of care, wherever, whenever”, what would the government do? May, forced to produce her own NHS policy, would find this prospect terrifying. |
| NHS | |
| Opinion | |
| Health | |
| Theresa May | |
| Jeremy Hunt | |
| Simon Stevens | |
| General election 2017 | |
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