Simon Stevens: the NHS boss with a plan – Deborah Orr???? Come Again Debs?

Of course we have been here before, only this time is becoming a reality and we are only one step away to losing the NHS. Cameron and Osborne would have made Thatcher proud. They achieved what she couldn’t.

Margaret Thatcher secretly tried to press ahead with a politically toxic plan to dismantle the welfare state even after a “cabinet riot” and her famous declaration that the “NHS is safe with us”, newly released Treasury documents show.

The plan commissioned by Thatcher and her chancellor Sir Geoffrey Howe included proposals to charge for state schooling, introduce compulsory private health insurance and a system of private medical facilities that “would, of course, mean the end of the National Health Service”.

The CPRS paper had been partially leaked and she was only able to quell the subsequent furore by famously pledging the “NHS is safe with us” at the October 1982 Tory party conference. Downing Street briefed that the toxic plan had been “shelved”.

But Howe’s Treasury private office papers released by the National Archives on Friday confirm that not only had that special cabinet meeting taken place to discuss the plan but that two months later, far from being buried, Thatcher was still secretly trying to press ahead with it.

I wonder what prompted this apologia – while still having sympathy for Stevens in trying to do an impossible job, some of the arguments here are daft. No amount of physiotherapy would have helped me to treat my cataract, which is one of those operations that now loses the 18 week target – “routine surgery”, they say; but it wasn’t because it went wrong: all put right again but you make it sound a trivial procedure and it wasn’t. No amount of physiotherapy is going to help an arthritic hip or knee – are you SERIOUSLY suggesting otherwise? If not, what the hell are you suggesting?

There’s understanding an issue and trying to put the case for the person lumbered with resolving it, and there’s writing an article which reads as if you’re doing a mate a bit of a favour, and this article veers too close to the second. You’re right of course that executives in the NHS get the blame for the consequences of irresponsible government parsimony, to the extent you made that case at all: the chief executive of my local NHS Trust has just, in the jargon, “stepped down” ahead of a CQC report likely to place the hospital in special measures, and Facebook’s kindly reaction has been, in general, “good riddance”: it would be instructive to see if those who criticize her could do any better or even half as good a job as she has done over 4 years. But this was a result of crisis – Stevens’ proposals are a response to crisis, even to the potential collapse of the NHS: that is the central issue here, not woolly homilies about our expectations of a health service. The NHS is not centralizing services only because there’s a logic to doing so, which there is, but because it’s not got the resources to sustain the service which people have come to know and expect. The NHS in short is undergoing crisis management, not a planned, logical process of reorganization – cost-driven decisions because funding has been cut in real terms, not rationalization of services because that’s a good idea in itself.

Trying to conceal this does Stevens, and the NHS, no favours at all. The next time the Guardian criticizes Corbyn, however justly, for failing to hold the government to account, it might like to take a look at the beam in its own eye – it’s supposed to be the mission of a free press, and perhaps particularly the Guardian’s, to hold power to account: not to soft-soap it.

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One Response to Simon Stevens: the NHS boss with a plan – Deborah Orr???? Come Again Debs?

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