Richard Short is the Deputy Director of Conservative Workers and Trade Unionists, and was Parliamentary Candidate for Warrington North in 2015.
Labour are very fond of reminding anyone who wants to hear that they created the NHS in 1947. Conservatives are just as fond of bursting that bubble when they point out that the very idea for the National Health Service was that of the Conservative Health Minister Sir Henry Willink in 1944.
This is all good political fun, but there are important and serious differences between Bevan’s and Willink’s NHS, and these differences, debated in the 1940s, are being rerun in the post Brexit debate on a US/UK trade deal. Nye Bevan would have been outraged at any thought of foreign interference in his version of the NHS, but to Sir Henry, the debate on US businesses being able to access the NHS would have been welcomed with open arms.
To understand why, rewind to Labour’s 1945 General Election manifesto. This was an openly stated socialist agenda. The party’s view was that mass nationalisation of our industrial infrastructure was exactly what the country needed in post-war reconstruction, and the country agreed, delivering a shock landslide victory to Clement Attlee.
With Labour firmly in the driving seat, the NHS, that all parties were now talking about, was going to be Bevan’s version. It was to be full nationalisation of health care. Hospitals were then owned and run by charities, local authorities and other not-for-profit voluntary organisations, and provided, by the standards of the day, excellent health care. There was little debate on the quality of care, just on access to it regardless of means. On this all parties were united.
The Conservatives, led by Sir Henry Willink, were absolutely against the NHS owning hospitals fearing it would break the personal bond between the individual and their health care. To create a huge single property-owning and managing entity would not be in the best interest of the patient, and so it has come to pass culminating in scandals like Mid Staffs, where impersonal treatment was a watchword for the worst run NHS hospitals.
Despite reforms to create NHS Trusts, Foundation Trusts and CCGs, (Clinical Commissioning Groups), the state remains a provider of health care while WIllink’s vision was of the Government being an enabler of health care free at the point of use regardless of provider.
Conservatives did indeed vote against Nye Bevan’s proposal to take ownership of hospitals, but remained committed to the NHS provided through the existing network of hospitals without transferring ownership to the state. Ironically the fiercest opponent to any principle of a National Health Service was the BMA which organised protests and non-co-operation even after the NHS was formed.
If he had been alive today, Sir Henry Willink would have been an enthusiastic supporter of a comprehensive US/UK trade deal where the skill and expertise of American health professionals could be brought in to improve our NHS. American access to the NHS is not new with billion-pound contracts for peripheral services handed to American giants Accenture and CSC as long ago as 2003.
In recent years, clinical services have been awarded to providers, but the market needs to be opened fully to get the full benefit of competitive tendering. Allowing US business to compete in this way will potentially allow access for better outcomes for patients, and, more broadly, make the way clear for a full and comprehensive trade deal.
In a post-Brexit US/UK trade deal, the NHS should have an increasingly enabling role rather than a provider. In this role it has a very important part to play in this vision.
Just as a company franchising its brand will defend its reputation to the death, so the NHS must be the defender of clinical excellence and hold providers’ feet to the flames to maintain them. It would deliver for the first time a fully Conservative vision for the NHS fought for and lost during its birth in the 1940s. And, above all, it’s what Sir Henry Willink would have wanted.