The policymakers who kept changing the prescription
Friday 07 April 1995
When Kenneth Clarke took over from Moore, he helped Lawson to scupper the plans for alternative financing of the NHS, but bought Thatcher's desire for competition between self-managed hospitals in an internal market - and injected the idea of GP fundholders buying care.
Under John Major and William Waldegrave, the language and pace of the reforms were toned down, and Waldegrave put Health of the Nation targets on the agenda. Patient's Charter objectives and centrally funded initiatives to cut waiting lists and improve services took a higher profile. But as Major's administration took a softer line, top NHS management took a tougher one. Peter Griffiths, the deputy chief executive of the NHS, and Eric Caines, its personnel manager, were fiercely pro-market.
Under Virginia Bottomley, the pendulum has swung back and forth. Early encouragement of more vigorous competition - partly at the instigation of Brian Mawhinney, her health minister - has been followed by much more talk of partnership and co-operation. Duncan Nichol, the former NHS chief executive, has been replaced by the more pragmatic Alan Langlands.
Even under Nichol, however, attempts were made to reinstate planning - not just in London - following fears over just how destructive the market could be to the fabric of the NHS. Without that, London hospital closures would have been even more dramatic. The new community care arrived and Mrs Bottomley has pushed mental health up the agenda.
But as some trusts are struggling and fundholding takes on myriad different forms, no one knows whether, three to five years down the road, health authorities or GPs will be buying most care - or which should be. Ministers find themselves denying the ultimate logic of the NHS reforms - that the service could end up publicly funded but privately provided. At the same time, however, they are encouraging the private sector to bid to finance and run NHS services and even entire hospitals. Meanwhile, NHS hospitals are earning record sums from treating private patients.
- 1 President of Argentina adopts Jewish godson to 'stop him turning into a werewolf'
- 2 Doctors remove 80 teeth from boy's jaw
- 3 The 'Black Museum': After 150 years, public set to see exhibits from police’s grisly crime museum
- 4 Sir Winston Churchill’s family begged him not to convert to Islam, letter reveals
President of Argentina adopts Jewish godson to 'stop him turning into a werewolf'
The 'Black Museum': After 150 years, public set to see exhibits from police’s grisly crime museum
Downfall of Dustin 'Screech' Diamond, the 'Saved By The Bell' star charged with bar stabbing
Syrian teenager Usaid Barho reveals how he escaped from Isis using a suicide vest
Sir Winston Churchill’s family begged him not to convert to Islam, letter reveals
Millions of Britons struggling to feed themselves and facing malnourishment
British actor Idris Elba cannot star as James Bond because he is black, says shock jock Rush Limbaugh
Ukip member gets into Christmas spirit with Union Flag plea to Santa 'for our country back'
Germany anti-Islam protests: 17,000 march on Dresden against 'Islamification of the West'
Nigel Farage: Ukip leader named 'Briton of the year' by The Times
Douglas Carswell tells Ukip to stop blaming foreigners as youth poll shows Nigel Farage is even less popular than Nick Clegg
£22000 - £28000 per annum: Recruitment Genius: A fantastic opportunity has ari...
£20000 - £23000 per annum: Recruitment Genius: Our client is a global marketin...
£17000 - £18000 per annum: Recruitment Genius: A fantastic opportunity has ari...
£22000 - £24000 per annum: Recruitment Genius: An enthusiastic individual is r...