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A lot of hot air

In wanting rid of Blair, back-benchers look little more than a bunch of amateurs.  It's back to normal. It doesn't matter who you voted for, the government got in

Hot air balloonsIt's back to normal. It doesn't matter who you voted for, the government got in. I understand several thousand people enjoyed having 26 postal votes each and as it was a nice sunny day, just for luck they popped along to the polling station to have another go. Banana republic, or what?

What have we learned? We've learned that you can deliver a record, historic and momentous Labour third term and the idiots on the back benches will be baying for blood, resignation and ritual decapitation.

Gratitude for you
Labour back-benchers, given a hard time on the doorstep over the Iraq war, have brought their frustrations to Westminster. They think they will do better without Blair. They are, of course, all totally barmy. But that's politicians for you.

Politicians do not live in the real world. Few of them have ever had a real job, created wealth, provided employment or juggled their cash flow. Britain is largely run by well intentioned amateurs.

Indeed, the new Secretary of State for Health, Patricia Hewett, has a lightweight background working as a lobbyist for Age Concern and Liberty (the human rights pressure group), then two think tanks. Now she is in at the deep-end, running the world's largest nationalised industry and is responsible for 1.3 million staff and over £1.5bn of public money. We can only wish her good luck.

Good luck indeed, when the press finds out Age Concern wants free social and healthcare for pensioners and it is not English healthcare policy! She will be bogged down in that one for weeks.

Survival instincts
If Blair gives way to Brown, what does it mean for the future of healthcare?  To survive, the NHS must forge links with the private sector. The Bermuda Triangle of capacity, training and demand cannot be squared without help from outside.

By 2008 even the Department of Health admits we will not have trained enough staff, built enough facilities or have enough money to meet demand, never mind expectations, without the help of the private sector.

Labour's 67 majority is enough for any government to pursue all of its manifesto commitments. In post-war terms, it is a thumping good majority. The problem is the majority is composed, in the main, of MPs from safe Labour seats and that generally means old Labour and left wing. So, that's the problem. Never mind the inevitable punch-up over identity cards, what about Labour's health policy?

New walk-in centres for commuters; specialised diagnostic and testing services; comprehensive out-of-hours services; high street drop-in centres for chiropody, physiotherapy and check-ups. In case you missed it, they are all promised in Labour's health manifesto. How many do you think can be created and delivered without the help of the private sector; without public-private partnerships?

I say none! You can hear the old Labour row now: Public money providing profits for the private sector, or how about the break-up of the health service. So forget that lot. What about this... `By 2008 patients will be able to choose from any hospital providing care at NHS medical and financial standards.'

Got that? `Any hospital' - and that means the private sector. It's another Labour promise. Frank Dobson's angry brigade will rise up, chanting: No public money to pay for going private. So forget that as well.

Then there is the promise of `personalised budgets in social care'. That means giving service users the cash to spend on whatever help they want; they make the choice. In reality, it is a voucher system. Vouchers mean broadening the supplier base to include choice, the private sector and taxpayers' money being spent outside the public sector.  The old-Labour brigade will want to nip that in the bud.

Let's not forget the Labour promise to `Öencourage entrepreneurial GPs to expand'. `Expand'? `Entrepreneurial'? Sorry, these words are not in the old Labour lexicon. Put it from your mind. Yet, what about the policy to provide `case management for 18 million patients with long-term conditions'. Oh yes, they'll like that.

Hugely bureaucratic, almost impossible to measure the outcomes and no one knows how to do it. Perfect old Labour policy.

Let's not forget however that `the pharma-ceutical industry will have to register all clinical trials and publish all of their findings'. Yes, the end of the commercial (confidence) protection big pharma relies on and a perfect tool to drive the pharma industry away from the UK. Old Labour loves to bash industry.

Having a laugh
Get rid of Blair? You must be joking. Get rid of Blair and we go back to the Donkey jacket era of Michael Foot. We all know Brown is old-Labour. There is nothing wrong with that, unless you want the NHS to survive in a modern era.

Get rid of Blair? Are they out of their collective mind? If the Labour Party has any sense it will get rid of Brown and give our Tony a run at a fourth term. By then the Tories will be on their umpteenth leader, the great unwashed will have forgotten the war, Iraq will be a democracy and the rest of the Middle East will be falling into line. And, on the doorstep, everyone will want to take the credit!

Why won't they do it? I'll tell you why. Members of parliament, by and large, are not courageous, they are not brave and they are not bold. They all think they are leaders and they are not.  They think they lead public opinion, they don't, they follow it. They think they shape public opinion - they don't. They are too malleable for that. They are back-benchers, that is all.

Acts of leadership are difficult to take. Leadership is lonely. It requires courage, self belief and a clear vision. Modernising the NHS strikes at the heart of belief, conviction, principle and passion.

The NHS is our most precious national asset. Change it at your peril but leave it to perish and you pay the price. In the modern era, `what works is what counts' - who said that? I'll vote for it.

The Author
Roy Lilley is a healthcare author and broadcaster. He has written several books and is well known for his sometimes controversial opinions

2nd September 2008

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