Patients are being betrayed. Don’t retreat from reform

Published in The Times (May 11th, 2011)

For those of us forced to deal with the daily realities of healthcare in Britain, Nick Clegg has been an admirable figure. He was one of a tiny group of politicians with the courage to demand that the NHS serve the needs of patients rather than doctors or accountants.

Despite heading a party stuffed with public sector workers, Mr Clegg showed steel on health policy. He was behind his party’s Orange Book, which correctly identified that patients were treated as “passive recipients of a second-rate state monopoly service”, and he bluntly declared that the NHS had to be broken apart because it was so unresponsive to its users. “Should the debate be taboo? Absolutely not.”

Quite right. But brave words in a country where the cheapest way to win political applause is to rail against NHS privatisation even after two decades of buying in care from private providers. Last year the English health service spent more than £4 billion in the private sector. Meanwhile in Europe, even in Sweden, market-led reforms have transformed services.

As the parent of a teenager with profound multiple learning difficulties, I have seen the shortcomings of the NHS in the starkest light possible. Like many long-term carers, I can offer a litany of disturbing anecdotes from minor inefficiencies to mistakes that could have proved fatal. We have dealt with doctors who lied, nurses who ignored emergencies and bureaucrats who always know best. Our experiences of arrogance and incompetence are far from unique.

The core problem remains a top-down service in which control is in the hands of everyone except the users. Too often this leads to mistreatment of those most in need. This is how we end up with scandals such as the recent one in Staffordshire, when hundreds died in grotesque squalor and no one noticed. The bureaucrats in charge? Incredibly, they were promoted.

The Government’s woefully presented NHS reforms were not perfect but offered several steps in the right direction. Mr Clegg signed the foreword to the White Paper, defended it passionately in public and told people privately it was the most exciting thing he had done in politics. Now a man who said that Britain should consider social insurance thunders against “backdoor privatisation” to appease the professionals.

In his current political panic, Mr Clegg has shed his brave stance on health to join all those other MPs drifting along on waves of public sentimentality. He appears to have abandoned liberal radicalism for the conservatism of the crowd. And in doing so, he has betrayed patients along with his principles.

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