Health Policy Insight
Healthcare management online analysis and intelligence
The home of UK health policy

Editor's blog Thursday 10 March 2011: Oh dear - Health Minister Paul Burstow interview worsens matters

Publish Date/Time: 
03/10/2011 - 22:35

Oh dear. Oh dear, oh dear.

Liberal Democrat Health Minister Paul Burstow has made scant impression thus far, policy-wise.

A trend that continues with his dreadfully wet and at points misleading interview with Guardian political editor Patrick Wintour.

As well as a drab reassurance that Monitor would not promote competition regardless of the needs of patients or the health service (which would quite simply the most stupid concept imaginable), Paul 'Who?' Burstow reportedly vowed to quit the government if he thought he was "part of a project to bring in a US-style health service".

Oh, for fuck's sake. Almost the instant that health policy debate starts to include US comparisons, you can generally be mildly certain that you are not going to be listening to anything that adds value.

'Who?' Burstow told Wintour, "I am not going to the conference to lecture people, but to listen, reassure and persuade". Damp, damp, damp.

Likewise, he suggested that Labour has been attacking "a phantom bill, a caricature. It is like a hall of mirrors with all kinds of distortions. Occasionally, they scrutinise the actual legislation". Which is of course true, and clearly the reason why the Government was amending their own legislation's reference to tariff as a maximum price.

'Who?' also reportedly said, "For instance, I have never advocated red in tooth and claw price competition inside the NHS. There is at the moment an awful lot of price competition brought in by Labour through its independent treatment sectors. As a result of the policy changes we are bringing in there will be less price competition".

Which is horseshit.

ISTCs do not compete on price. They were built to do the kinds of straightforward elective care for which the tariff was made.

ISTCs were originally subsidised above tariff to 'incentivise' their market entry; and were associated with stunningly crap legal arrangemenets at the end of the contract period, forcing the NHS to buy the buildings back if contracts were not renewed.

On the 'less price competition' point, you can - just - construct a Jesuitical argument that as tariff is extended to more of the total range of NHS services, then, yes, there is less competition on price.

It's not really the point, though - and moreover, a more complex, more extensive tariff will require more management, which GP consortia won't be allowed to have. It's also in context of the plans to reduce the total NHS management spendby 45% by 2014-15.