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May 2001

 
             
  The Institute of Directors' prescription for the NHS  
             
The National Health Service makes a massive contribution to a civilised society.  No political party would survive that tried to destroy it’. wrote Bevan in his political testament ‘In Place of Fear’.  How true.  Even Mrs Thatcher did not dare privatise the NHS.  Instead an artificial internal market was created.  Thousands of managers and accountants were hired.  The bureaucracy mushroomed whilst the numbers of nurses and doctors fell.  To remedy the situation Labour has produced the new NHS Plan to reform state-owned healthcare.  Will it work?  ‘Who should own the NHS?’, ask the NHS’s critics,  Ruth Lea from the pro-business Institute of Directors recently suggested in ‘Healthcare in the UK: the need for reform’ that the NHS should be scaled down and run as a mutual.  The NHS has suffered from under-funding for many years.  But its management is not up to the job either.  'The NHS is a 1940's system operating in a 21st century for reform’ that the NHS should be scaled down and run as a mutual.  The NHS has suffered from under-funding for many years.  But its management is not up to the job either.  'The NHS is a 1940's system operating in a 21st century world.  The service is over-centralised: its patients are being disempowered’ says the NHS Plan. 
Does  the Plan provide the solution?  The new IoD Research Paper ‘Management, Mutuality and Risk:  Better Ways to Run the National Health Service’ written by Business Research Executive Geraint Day examines the issues in depth.  Mr Day is a former senior manager in the NHS and is currently a director of several large co-ops.  Whilst agreeing that improved management is needed urgently, he fears that the NHS Plan could lead to more wasteful bureaucracy generating more quangos and committees.  Other topics covered include how the NHS deals with risk, the health and safety issues and with the need for more honesty about the risks of clinical intervention.  Mutualising the NHS is examined too.  Comparisons are made with the high quality healthcare provided by mutuals overseas.   Mutuals already supplement the NHS by providing sheltered housing, nursing homes, domiciliary care etc.  In future, they could also provide cottage-hospital type short term medical care and respite for carers. 
Occupational health schemes are also worth  looking atAgain low cost health insurance for dentistry and optical services helps people on low incomes.  But turning the whole NHS into a mutual is another matter.  Would it work any better than now?  It’s doubtful.  After all. the NHS was  set up precisely because of the failure of pre-war mutual healthcare.  Nevertheless, Mr Day’s paper forms part of the wide-ranging debate that needs to take place about reforming the NHS. Readers will find it an interesting and thought-provoking read.
     
     
 

This article was published in the CHARTIST May/June 2001

 
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