A fig leaf for privatisation

PATRICK GRAY argues that the Co-operative Party has been fooled into supporting foundation hospitals.

I fear that cooperators will come to regret that the Co-operative  Party has been fooled into lending respectability to the government’s wrong-headed plans for foundation hospitals.

The will o’ the wisp promise of community control is completely meaningless. Mutuality may well be applicable to primary care, where a well-defined user group exists, but this proposal is not addressed to primary care. It is aimed at precisely those hospitals which in five or ten years time will be most attractive to American health corporations and the people who destroyed the building society movement.

Many of the hospital trusts are already heavily overspent. What will happen to foundation hospitals when they face bankruptcy? It isn’t hard to guess!

The ambiguity is no coincidence. The Institute of Directors, recently described in the Financial Times as “Britain’s leading right wing pressure group”, and a relentless critic of public provision and employment rights, has recently decided that abrasive attacks on the Labour Party are no longer productive (Financial Times, 28 October 2003). Switching to a softly, softly approach, it has seized on the notion of mutuality as a convenient fig leaf for dismantling the welfare state.

Anyone who doubts this should skip the summaries published on various occasions in Co-operative News and read the full text of the IoD’s research paper on the NHS (reprinted July 2003), where its plans for the future of health care are set out for all to see.

In reality, the NHS serves our members very well. A recent study by the World Health Organisation (WHO) ranked it among the four best health services in the world. It costs far less per head than the systems in the USA or Germany, and yet people in the UK live longer than in either of these countries.

Of special importance to us as co-operators, it has proved particularly good at directing care to those most in need, which is one reason why we live longer than Americans despite the huge expenditure in the USA on high-tech medical machinery and drugs.

The IoD paper simply ignores these achievements. It makes no attempt to discuss the cost of NHS care or its results in terms of the length and quality of life. Instead, in a classic right-wing fantasy, it conjures up a vision of an imaginary world where almost everywhere, including Brazil and the USA (and Britain before 1947), “local people are beavering away to help their neighbours by running the local hospital”, while people in the NHS are infected by “corrosive cynicism”.

The problems faced by other systems. The dedication of NHS staff and their record of service, and the need for more resources are largely or completely ignored. Instead, from a jumble of bureaucratic detail, anecdotes and sneers, the paper arrives at the predictable conclusion that the NHS has to be “reformed”.

The way to do this, the IoD argues, is to break it up, hand its assets over to private (or, as a first stage, mutual) ownership, increase private finance, stop it completely from treating patients and reduce its role to that of “funder and regulator”.

In other words, do to health care what Mr Major did to public transport with such disastrous results.

The strategy may be wicked and dishonest, but it certainly isn’t stupid. The electorate will never be asked, and Labour MPs will never be embarrassed by being called to vote for abolishing the NHS. The job will be done out of sight and out of mind by local managers to all intents and purposes accountable to no-one.

The IoD has already announced that its next target is local services. If this game of political grandmother’s footsteps succeeds, schools and universities will soon be in line for a drop of mutuality and a lot of privatisation.

The Thatcherite dream of unpicking the social progress made over the last 60 years and restoring the up-stairs, down-stairs philosophy of a century ago will be huge step nearer – and all in the name of extending co-operation.