Alan Milburn and the NHS

The essays supposedly penned by senior Blairites that have appeared in the New Statesman recently seem to have been written with the sole purpose of pissing me off. Firstly we had David Miliband’s grim paean to the New Labour’s years which I reviewed rather acerbically here, and now we have Alan Milburn holding forth on how the left (although I have no idea what fellows like him really mean by ‘the left’ anymore- anyone not to the right of Norman Tebbitt?) should ‘reform’ the NHS. His essay is here.

Milburn is a guy who has traversed that well-trodden path in left-wing politics. He started out as a Trotskyist and is now a zealous free-marketeer, so much so that there have been rumblings in Tory circles about him being offered the health portfolio in place of the hapless and charmless Andrew Lansley. Milburn was Health Secretary from 1999 to 2003 and was a great exponent of the joys of privatization, or as it is euphemistically called, ‘competition’. He is one of the Tories favourite Blairites. Probably second only to Blair actually.

Milburn’s reign at the Department of Health was pronounced a great success by the free market right. His reforms (although he wasn’t allowed to go as far as he would have liked) made things so much better, obviously.

And there was me thinking that the NHS actually got better because of all the extra money that Labour put in………… Silly Mambo…….

The essay isn’t exactly choc-full of searing insights and new ideas. There are a number of points about preventative medicine that are perfectly fair but also perfectly banal statements of the obvious. Much of what Milburn proposes is inoffensive but designed to hide his wider arguments. Much like David Miliband’s earlier piece. The real thrust is there but you have to look quite hard for it.

The essay highlights a common theme of all New Labour thinking. For all the professed optimism and forward-thinking of the Third Way the essay is the usual brand of Blairite uber-pessimism. No challenge to the status quo and the current direction of travel can be countenanced under any circumstances. Free markets are dominant. We have to adapt to that. The left will be irrelevant if it fails to accept that consensus. It is TINA, just without the irritating acronym. 

We are living in an era of permanent austerity and must cut our cloth accordingly: “workforces and, therefore, tax revenues are sure to diminish” Are they? So we can’t tax the rich a bit more? And/or the banks? And do something about tax evasion? There is nothing at all that could reverse the trend that Milburn points to (a trend that incidentally hasn’t appeared yet)?

This so-called ‘economic necessity’ means that the NHS has to change, apparently. It has to be made more ‘efficient’. Beneath all the banal clichés Milburn is advocating New Labour’s favourite solution to everything: privatization, or in Milburn New Labour speak: “driving forward reforms that empower patients, financially incentivise outcomes, increase competition…….. an NHS where a judicious mix of levers is deployed to improve both efficiency and quality”

Of course this implies that the NHS is rather inefficient in its current manifestation. Is it?

Well not really. Efficiency is difficult to measure when it comes to saving lives, but the NHS is one of the most ‘efficient’ health services in the world. So why the desperate need to change it and introduce market forces?

Because this isn’t about ‘outcomes’. It’s about ideology and certain powerful vested interests getting their teeth into the NHS cash-cow. Private health firms are rubbing their hands with glee at the thought of the ‘de-nationalisation’ being implemented by Lansley and the Tories.

As I have stated time and again on these pages, New Labour, the Tories and Lib Dems are hypnotized by the free market. They have an almost religious faith in its ability to transport Britain to the promised land. Regardless of the facts and the constant failed experiments.

But maybe I’m being too generous to Milburn. Maybe there is another reason why he making these arguments. What could it be, I wonder………

Wait a minute…here it is! He’s also on the board of PepsiCo, bizarrely………

We may need to change the line about the taxidermist’s daughter to ‘follow the money’.

I have literally no idea why Alan Milburn is still in the Labour Party.

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