Building Britain's Future?


As Philip mentioned yesterday, the government's latest re-launch – titled Building Britain's Future – is extremely underwhelming. It exhibits no new thinking or ideas whatsoever, and is indicative of a ruling party that has run out of steam. Nowhere is this clearer than in Gordon Brown's 'new' approach to public services.

Rather than attempting to undertake any kind of serious reform, as Tony Blair at least tried to do, the prime minister has decided to simply create lots of new 'rights' or 'entitlements', enshrine them in legislation, and hope that does the trick.

Plainly the government still believes, despite more than a decade of experience which should have taught them the contrary, that all they have to do is pass a new law and everything changes. The lack of intelligence this suggests is truly astounding.

The way to ensure that all patients are treated within 18 weeks of referral is not to pass a law to that effect, but rather to reform the health system so that supply reacts to demand. That means ditching the NHS's soviet-style central planning and letting markets (whether internal, or otherwise) allocate resources.

The government's new 'entitlements' will be no more effective than their 'targets' were. GPs met the 'appointment within 48 hours' target by only allowing people to book appointments 2 days in advance. Similarly, the 'A & E treatment within 4 hours' target was often met by keeping people waiting in ambulance bays or not registering them on arrival.

Moreover, giving legal priority to some areas of healthcare – like cancer treatment, where patients will have to right to see a specialist within 2 weeks – will invariably mean that other areas of care suffer in order to meet the requirements of the legislation. Maybe that's the right call to make when resources are limited, maybe not. Either way, it shouldn't be up to a headline-chasing government to set medical priorities. The preferences of healthcare consumers who are free to take their custom elsewhere should really be the key factor.

One last point: the government is now trying to avoid criticism for spending cuts by talking about planned 'underspends' in health, education and transport. It's just laughable.