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Cameron must defeat Clegg and break the NHS’ monopoly

18 May 2011

11:08 AM

18 May 2011

11:08 AM

‘NHS good, private health bad’. ‘State good, market bad’. ‘Four legs good, two legs
bad’. Whenever political leaders get into a tight corner they have to find allies fast. There is no time for reasoning to work its gentle magic. Basic sentiments need to be stirred and the popular
favourite is usually hate.

Yesterday Mr Clegg used this classic strategy to rebuild his support base. The cold-hearted Tories were at it again, dismantling that icon of compassion the NHS. In public they were declaring their
undying love for it but out of sight they were promising fat profits for ‘health care corporations’ once the new law was passed.

Mr Clegg even resorted to another child-like contrast. The new regulator, Monitor, should not promote competition but rather ‘collaboration’. As any thinking person knows, the opposite
of competition is not collaboration, but monopoly. Mr Clegg disapproves of any comparison with utilities, but even he could see the absurdity of defending BT’s monopoly of telecommunications
by calling for collaboration not competition. And the NHS is not ‘just like’ a utility as he reminded us in his speech, but it does have something in common. As most other European
countries discovered long ago, mixed public-private systems with competition lead to better health care than public sector monopoly.


Can Mr Clegg honestly say that the most vulnerable people in society receive a worse standard of care in France, Germany or the Netherlands than in the UK? Older people who have become ill as time
takes its toll are by far the biggest group of NHS patients. Isn’t it more true to say that the NHS provides a notoriously bad service for older people? American health care is the usual hate
symbol of NHS partisans, but the Americans have Medicare, which provides their older generation with the best that money can buy. We still have to wait for our hip operations, while many of
America’s senior citizens confidently expect to have two such operations before their days are numbered, perhaps one in their sixties and another in their eighties.

The UK’s record of care for the most prevalent diseases is inferior to that in most similar countries. Whether it is cancer, heart disease, or stroke, the UK lags behind the leaders.

All civilised countries aim to provide good medical care for every citizen, whether they can pay or not. All have tried different systems for achieving the same ideal. The NHS method of
‘double’ public sector monopoly is the worst of the lot. The last Labour Government recognised that it was not necessary to monopolise both funding and provision of care and Mr Blair
famously said that, so long as care is free at the time of use, it does not matter whether the hospital is public or private. That is the majority view in most other developed countries, but Mr
Clegg doesn’t seem to have noticed.

Mr Cameron has made support for the NHS the test of his compassion but Mr Clegg is trying to paint him as a callous Tory in disguise. GP commissioning is an administrative distraction that can be
dropped but promoting competition is vital to improving British health care. Mr Cameron should stick to his guns.

David Green is director of Civitas 


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