You will never please some people. For years, Labour has been preaching about the evils of the private sector being allowed to impinge upon the NHS and of the wrongheadedness of the NHS’ internal market.
Then, along comes a Tory health secretary who wants to sweep the lot away and concentrate the role of the state in healthcare and what does the shadow health secretary, Jonathan Ashworth, say? “Boris Johnson must explain why a reorganisation in the midst of the biggest crisis the NHS has ever faced is his pressing priority.”
Wouldn’t a more appropriate response be: “Alleluia! We told you so. At last we’re going to have a proper National Health Service owned by the people and run for the people”?
Well, yes it would be a more logical way for Labour to receive the news. Nevertheless, I think if I were Ashworth – still more were I a Left-leaning NHS employee – I would be a bit nervous about Hancock’s sudden conversion to a centralised, wholly state-owned and run NHS. Having seen the health secretary in action over the past few months I would be biting my fingernails, fearing it could turn into a reign of terror.
Not so long ago, Hancock was trying to persuade us all to opt out of our local GP service and instead sign on with a private, app-based primary health service called Babylon. In 2018, the year Hancock became health secretary, the Government handed a record £9.2 billion worth of NHS contracts to private firms such as Virgin and the Priory. Just six months ago he said that the idea of a divide between the NHS and the private sector was “for the birds”.
What has caused him to change his mind and now want a much more centralised NHS with less private involvement? Has he really had a late-life conversion to socialist principles – or has he simply grown a taste for power?
Circumstantial evidence leads me to the latter conclusion. You only have to look at his face when he is telling us what he is going to ban next to see how deeply he is enjoying it all. Beneath his bland exterior lies a natural authoritarian who trusts his own judgement on what is good for us rather more than he trusts people to make those judgement themselves.
It is a natural progression, then, for him to seek to grab more direct control of the NHS. Why leave decisions to Sir Simon Stevens, the NHS chief executive who is likely to lose his job in these reforms, when you could take them yourself? Why have to sit down with private providers and have to persuade them to bid for a job when you can order your own underlings to get on with it?
If I worked in an NHS hospital I would be a bit worried. The same hectoring attitude we have witnessed from the lectern at Downing Street briefings headed by Hancock – is going to be directed at NHS managers soon. I have a suspicion that even the most committed of socialists on the NHS payroll may soon be yearning for the good old days of the internal market.