But I was pleased to see the leadership defeated in the health debate in Sheffield today. Nick Clegg's statement after the vote - "Yes to reform of the NHS. But no to privatisation of the NHS" - is fine with me. And if the movers of the amendment were simply defending professional interests or the status quo, I would not support them.
For me the key point against the government plan for the NHS was made in an article by Andrew George in this morning's Indpendent:
It hands extensive powers, and most of the NHS budget, to a narrow group of private contractors – GPs, some of whom are horrified at being turned into NHS managers.Exactly so.
Incidentally, I don't find the point that these plans were not included in the Lib Dem manifesto or even the Coalition agreement quite as damning as the proposers of the motion expect us to. It is early days, but being in government throws up all sorts of unforeseeable events and problems. Governing cannot be a Bennite process of implementing a previously agreed programme come what may.
Nor do I have an instinctive dislike of private providers in the NHS. But there must be democratic oversight of health. That surely is the point Liberals should insist on.
Do we have any effective democratic oversight of the NHS with the present way of organising it? I don't think so, but I do know that, in my metropolitan area, its hinterland, and the regional work done here, there have been great improvements in the last 10 years. At the same time, the NHS has suffered from the usual problems of a centralising bureaucracy (in particular its hugely expensive and fumbled IT project), so maybe we don't need the radical surgery proposed. Cameron's proposed 'bonfire of the Whitehall Depts' frightened me, because there was no plan to bring in anything better - the localising plan for the NHS is, as so many people point out, foolish when many local managers don't have the necessary expertise, and, as you point out, Jonathan, it also doesn't have local democratic accountability.
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