On Tuesday's Newsnight, shadow health secretary Andy Burnham made direct reference to the recently published Bow Group analysis of the NHS White Paper. Here, the paper's authors, Stuart Carroll and Gary Jones – who wrote about their paper on ConHome last week – respond to his assertions.
As the authors of the Bow Group paper, Equity and Excellence: Liberating the NHS – Opportunities and Challenges, we were delighted to see the Shadow Health Secretary, Andy Burnham MP, make direct reference to our paper on Newsnight on Tuesday (available for seven days on the BBC iPlayer) during a debate with Nadine Dorries MP. It is pleasing to see a former Labour Health Secretary expand his health policy reading above and beyond Labour leaning think-tanks.
Throughout the interview with Kirsty Wark, Mr. Burnham strongly attacked the Government’s White Paper, specifically in relation to the policy around GP commissioning and the abolition of Primary Care Trusts (PCTs) and Strategic Health Authorities (SHAs), saying “the NHS doesn’t need it”. As part of his supporting argumentation, Mr. Burnham cited the Bow Group as a Tory think tank warning “against the return of a postcode lottery”.
First, we want to make it absolutely clear that we disagree with Mr. Burnham’s major criticism of the Government’s White Paper. Although as an independent think tank it is normal for us to question and challenge the Government of the day on certain aspects of policy, we are overwhelmingly supportive of Equity and Excellence: Liberating the NHS, which we see as a great opportunity to reform the health service and thereby improve patient health outcomes and make the NHS one of the best healthcare systems in the world. In short, we think the “NHS does need it”, not least because the current status quo is not optimising patient health outcomes and taxpayer investment.
Second, it is because of many of the previous Labour Government’s failed policies that we have a postcode lottery and extreme variations in healthcare delivery. To warn against something that already exists seems to be missing the point.
Third, under the Government’s proposed plans we make one specific point regarding commissioning bodies and the potential for there to be different approaches to the prioritisation of treatments and funding decisions. This is what local decision-making is all about, i.e. making decisions in accordance with local imperatives, and something we support. As we point out in our paper, this does raise the potential for variations in the relative success of some GP commissioning consortia over others, and hence the critical need for the GP Commissioning Board to ensure the performance of consortia in the most deprived areas of the UK are monitored and supported to facilitate better patient health outcomes. This is not a criticism of the Government’s policy as implied by Mr. Burnham, but rather a commentary on the need for effective implementation – something on which the public will judge the Government.
Our analysis does not dispute the underlying philosophical premise of the White Paper, but rather points out some of the potential practical obstacles to implementation particularly around GP commissioning; the bold, reformist and courageous nature of the Government’s policies and the need therefore for strong leadership across the NHS; and the importance for detail over where the Government is going to make efficiency savings to hit its £20 billion target and 45% reduction in management costs.
In the light of Mr. Burnham’s referencing of our paper, we believe it is an important matter of fact and public record to properly contextualise our paper, its recommendations and our joint support for the Government’s White Paper.