Chris Lancelot: Why have we forgotten Bevan's core NHS vision?

I am irritated by the way some opponents of the Health Bill are using sloppy, emotional arguments rather than rational ones.

The GP Record, by Fran Orford
The GP Record, by Fran Orford

Increasingly the rhetoric is that 'the government wants to destroy the NHS' and that any attempt to change it is 'a betrayal of the cause'.

What rubbish! - peddled, I suspect, for cheap political gain rather than any rational concern for the NHS.

Let us be clear: Aneurin Bevan's core vision was of a healthcare system, free to everyone at the point of need, and paid for out of general taxation. I agree with him entirely - an excellent idea.

But many NHS supporters make the false assumption that the method of delivery of this care is somehow inextricably part of this core vision, and that any attempt to alter it is an attack on the NHS itself. It doesn't follow.

Bevan's central idea was for free healthcare for everyone, whatever their financial means. Being a socialist, he also thought of providing that care through a nationalised body, but his core vision was the protective package itself, not its means of delivery. Does it really matter who supplies the care, as long as the care is supplied?

In his recent Panorama programme, Sir Gerry Robinson hit the nail on the head: 'I've never met an organisation like the NHS - as dysfunctional as it is loved.' And that's the point - or rather, these are both the points. Yes, the NHS is a treasure which needs to be kept secure: but in its current configuration it doesn't deliver Bevan's dream with anything like the effectiveness it should. The dream is right, but its execution is wrong.

Competition works. It keeps costs down, standards up and forces organisations to evolve into efficiency. Paradoxically, Bevan's vision will be more securely preserved by keeping his core NHS principles, while using competing providers to deliver the care itself.

So I'm very comfortable with a left-wing idea (the NHS) being delivered effectively using right-wing (free market) methods. Far from undermining the NHS, competition is the best way to support Bevan's vision - provided that the NHS always remains in overall control of the finances, and monitors carefully the way they are used.

Or do you think it is better for NHS care to be delivered inefficiently?

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