Free-market sticking plaster for NHS care

The National Health Service is set to usher in a new era when it announces that patients finally get the right to be customers. Gordon Brown’s government will give us the choice about where to get heart surgery, radiotherapy, or treatment for diabetes. Under its Patient Choice agenda, from April the Department of Health will allow NHS-funded healthcare to promote their services to patients.

In a controversial move, the Government has, however, decided not to cap the spend on marketing and advertising and the NHS Trusts with precious little resources could be digging into their tiny pockets in order to compete with each other to entice patients.

The foundation of the Health Service in 1948 post-war Britain was the realisation of a socialist dream under Clement Attlee’s Labour government, and therefore everyone should have had access to a universal health service that is superior in equal measures. Having a choice only means that one NHS provider is better than another, a premise that the competing hospitals will be fighting on to lure more and more customers.

The power of choice, is of course, an effective tool for making things better and delivering better services. It was Tesco’s Sir Terry Leahy, who opened his famous speech on the Power of Choice three years ago, with these words. Leahy at the time said that one crucial difference between retail and the NHS is that the “customer chooses what he wants to buy” and therefore becomes the centre of the universe for the retailer. What he was primarily pronouncing was that private sector experience cannot be translated by those delivering public service.

The neo-liberal views of New Labour has always been more than keen to provide market-based solutions as the answer to all our problems, almost espousing the notion that the government, as opposed to the private sector, is inherently limited in what it can do to serve its people.

The white-paper on Patient Choice agenda was kick-started by Blair babe Patricia Hewitt, the former health secretary. The same health secretary who lost her post last summer when Brown reshuffled his front bench following the controversial Modernising Medical Career initiative, leaving parts of the NHS in open revolt. And prior to Hewitt, Alan Milburn has called for turning the “old style monopolised nationalised” health service into a “patient-driven service” in order to shift the balance of power in the favour of patient.

But the concern will be that the NHS, which is already at capacity, will be endorsing its services but obviously without the guarantee that services can be delivered to a universally high standard. There will be no requirement for hospital marketing to carry “health warnings” similar to the “wealth warnings” that financial services companies must add to their advertising.

Sources suggest the Government is also yet undecided if celebrities will be allowed to promote NHS services. Now that would be worth waiting for. Imagine Lulu telling us where she got her hip replacement from. But the question to ask is whether any of this would create a world-class healthcare system? Surely not. When it comes to improving standards, choice is no substitute for clinical excellence.


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