It was a great pleasure to see Dartford’s former Labour MP, Dr Howard Stoate, on Friday 23 September where he addressed a packed meeting of the Dartford Labour Party on the subject of the government’s NHS reforms. Given his role as chair of Bexley’s Clinical Cabinet, which has given him a leading role in the reform process, his analysis of the government’s plans was impressively knowledgeable.
Dr Stoate was clear that a core principle behind the reforms – that clinical services should be commissioned at the GP-patient level – had considerable merit. Indeed, he pointed out that this basic concept had first been pursued by the last Labour government but that GPs in most parts of the country had not, at that stage, always managed to obtain the power from local trusts to successfully push that agenda forward.
But his enthusiasm for the government’s approach pretty much ended there. In fact, he was chillingly clear that the way in which the government was pushing the reform process carried huge risks. To begin with, he pointed out that the hefty savings targets being inflexibly forced through had the capacity to really endanger the provision of core services. And while Dr Stoate noted that there were elements of NHS provision that were highly inefficient, he also warned that the government’s approach was dangerously flawed.
He also criticised the Lib Dems for their panic-response upon realising just how damaging the Tory approach could be. It was bad enough having to cope with resources being hacked back, he pointed out, but to then have to deal with Lib Dem-inspired modifications – that did little more than bulk-up the layers of bureaucracy in the system – was making matters worse.
He also drew attention to the ideologically-driven localism agenda that the Tories were determined to hoist upon the NHS and which has the capacity to introduce even greater inequalities into NHS provision. Specifically, he said that, as things stand, and as budgets diminished, there was a real danger that local health service administrators may choose to focus on some services at the expense of others – leaving some areas without an adequately broad range of vital services.
Howard Stoate’s valuable insights should help us as Labour Party members in defining our response to the reforms. Certainly, as a progressive movement, we should embrace reforms that genuinely enhance efficiency, quality of service and patient choice. But as the party responsible for creating the health service, we also have a clear responsibility to the people of this country to defend our NHS. And a Tory-led agenda of broad and deep cuts, presented under the banner of reform, represents a risk to the NHS that we must rigorously oppose.
John Adams