Sunday, 17 April 2011

Clegg's fake 'red lines' for the NHS.

What follows is a master class for all hopeful future politicians. A handy trait to master is the art of talking tough, to ease voters worries, whilst simultaneously bending over backwards to please your superiors and assorted vested interests. To demonstrate this beautifully, step forward the nation's darling, Nick Clegg.

He today wrote to all 56 Liberal Democrat MPs, in what the Independent called "the clearest sign yet of a major coalition schism over the reforms", setting out his five 'red lines' that were non-negotiable in relation to the NHS reform. He said that these amounted to 'substantial changes' to the bill and would save the NHS from privatisation. The rhetoric is strong, but the measures set out as his 'red lines' are pitifully weak. Here's a look at his five 'red lines', and what they actually mean:

1. Competition should be driven by quality, not price. -

This has already been amended in response to BMA lobbing in March. Whilst competition is now not to be explicitly based on price, the competition itself is still being implemented, leaving the NHS open to EU competition law and turning health care into a market. The role of Monitor will remain as a competition enforcer as opposed to regulating Foundation Trusts as it does presently. This first 'red line' therefore has not only already happened, but fails to meet any of the demands of the BMA or RCN who have been so damning in their verdicts on the Health and Social Care Bill.

Verdict - Already happened.

2. Family doctors should not commission services alone. -

Whilst the last 'red line' has already been changed, there was no need to amend the bill to comply with this red line. It was never, ever going to happen. Indeed, one of the issues with the reforms would be that not only would doctors be commissioning services, but that they would likely turn to private providers to help with commissioning. Doctors tend to study medicine in order to help people. If they wanted to commission services they would have taken an accountancy course.

Verdict - Was never going to happen.

3. GP consortia must not go ahead in 2013 if they are not ready. -

Again, this has already been agreed, as seen in the Health Service Journal interview with David Nicholson back in February. It also does nothing to address the issues raised by the prospect of certain areas being run by consortia outside of their local area, thus destroying the primary goal of these reforms.

Verdict - Already happened.

4. The principles of the NHS constitution must be protected. -

This is a very woolly 'red line' at the best of times, without specific examples you can essentially interpret the constitution to fit any set of reforms that might be put forward. Even so, this again is a case of Clegg demanding something that has already happened. It is explicitly mentioned on pages 330, 332, 333, 340, 365, 375, 395 and 402 of the revised bill.

Verdict - Already happened.

5. GPs must work ‘hand in glove’ with councils. -

This is already included in the bill through the inclusion of Health and Wellbeing Boards, which states the many ways in which the consortia will be working closely with the local authority, 'like hand in glove' as Mr Clegg may prefer.

Verdict - Already happened.

So, having actually looked at his 'red lines', which will apparently ensure 'substantial reforms' to the Health and Social Care Bill, we see that he has actually included four things that have already been included and one measure that was never included in the first place. Quite an achievement.

That only serves to show just how impressive it is that Clegg has managed to turn this letter, which adds nothing new, into a statement which newspapers are proclaiming as the Liberal Democrat fightback. He has managed to create a fake difference of opinions, which will no doubt help him in local elections, whilst causing Andrew Lansley no problems whatsoever.

There are many people within the Liberal Democrat party who are anxious to see real changes to the NHS reforms, including those with real influence such as Norman Lamb and Evan Harris, but Nick Clegg is once again folding as easily as a house of cards caught in a tornado.

He has shown himself to be a vacuous salesman, a pawn of the Tory hierarchy, and in doing so has provided an excellent example of how to dupe the British public into believing you are listening to their demands. Here's to hoping he doesn't succeed.

Hat-tip to Health Policy Insight for some links and highlighting the vacuity of his letter.

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