Leading article: A justified critique of a blinkered Health Secretary

Related Topics

Sir Roger Boyle leaves his post as the NHS's National Director for Heart Disease and Stroke with a bang – and a most unwelcome one as far as Andrew Lansley is concerned. In his interview with this newspaper today, Sir Roger presents an extensive charge sheet against the Health Secretary.

He argues that Mr Lansley has deliberately downplayed the NHS's successes in improving health outcomes over the past decade in order to justify a revolutionary structural overhaul. Sir Roger also accuses the Health Secretary of packing the NHS Future Forum – which was set up earlier this year to review the NHS and Social Care Bill – with individuals who would ultimately give him what he wanted. Despite the Future Forum's modifications of the Bill, Sir Roger argues that 80 per cent of Mr Lansley's original plan has been retained.

Sir Roger also thinks that the plan itself is fundamentally flawed, pointing out that impressive improvements in his own area of cardiovascular care have come not from the introduction of private sector competition, but from enhanced collaboration within the NHS. He argues that there is a lack of evidence to support Mr Lansley's contention that private-sector involvement in the NHS will drive up efficiency and quality. The US market system, with its spiralling costs, he suggests, is not a model that Britain should seek to emulate. He also predicts that increased competition will simply cause costs to rise.

So is this blistering critique justified? Up to a point. Sir Roger seems to underestimate the extent to which the NHS is failing to deliver value for money for taxpayers and patients. It is true there have been some impressive health outcome improvements in Sir Roger's domain of heart disease. Waiting times have been slashed and the death rate has halved over the past decade. But half of these improvements are judged to be attributable to changes in lifestyles, in particular falling smoking rates. Moreover, there are other areas of the NHS, such as orthopaedics, where private-sector involvement has helped to drive down waiting times. And there is evidence to suggest that an increasing role for private-sector providers in some areas would drive improvements in outcomes.

Yet Sir Roger's broad criticisms of Mr Lansley's approach are, sadly, all too accurate. The Health Secretary has rushed into a hugely ambitious reform programme in an ideologically blinkered manner. He has not assembled a compelling evidence base to justify particular structural changes such as transferring commissioning powers to GPs. And he has manifestly failed to make a convincing case to either the public or the medical profession for what he is attempting to do.

The NHS must, as Mr Lansley often argues, become more efficient if it is to deliver the same quality of outcomes over this Parliament and beyond. And the introduction of the private sector is undoubtedly a way of helping to achieve that goal. But there is a balance. The private sector must be used judiciously, not regarded as a panacea. And the design of regulation to accompany increased competition is of vital importance. The open question is whether Mr Lansley, after his dreadful year in office, can be relied upon to strike that balance.

React Now

Latest stories from i100
iJobs Job Widget
iJobs General

Recruitment Genius: UI / UX Designer

£25000 - £35000 per annum: Recruitment Genius: This firm are focussed on assis...

Recruitment Genius: General Processor

£7 per hour: Recruitment Genius: A vacancy has arisen for a General Processor ...

Recruitment Genius: Outbound Sales Executive - B2B

£18000 - £22000 per annum: Recruitment Genius: A great opportunity has arisen ...

Recruitment Genius: Online Sales and Customer Services Associate

£14000 - £16000 per annum: Recruitment Genius: Full time and Part time positio...

Day In a Page

Read Next

i Editor's Letter: Our representatives must represent us

Oliver Duff Oliver Duff
MP David Lammy would become the capital’s first black mayor if he won the 2016 Mayoral election  

Crime, punishment and morals: we’re entering a maze with no clear exit

Simon Kelner
War with Isis: Iraq's government fights to win back Tikrit from militants - but then what?

Baghdad fights to win back Tikrit from Isis – but then what?

Patrick Cockburn reports from Kirkuk on a conflict which sectarianism has made intractable
Living with Alzheimer's: What is it really like to be diagnosed with early-onset dementia?

What is it like to live with Alzheimer's?

Depicting early-onset Alzheimer's, the film 'Still Alice' had a profound effect on Joy Watson, who lives with the illness. She tells Kate Hilpern how she's coped with the diagnosis
The Internet of Things: Meet the British salesman who gave real-world items a virtual life

Setting in motion the Internet of Things

British salesman Kevin Ashton gave real-world items a virtual life
Election 2015: Latest polling reveals Tories and Labour on course to win the same number of seats - with the SNP holding the balance of power

Election 2015: A dead heat between Mr Bean and Dick Dastardly!

Lord Ashcroft reveals latest polling – and which character voters associate with each leader
Audiences queue up for 'true stories told live' as cult competition The Moth goes global

Cult competition The Moth goes global

The non-profit 'slam storytelling' competition was founded in 1997 by the novelist George Dawes Green and has seen Malcolm Gladwell, Salman Rushdie and Molly Ringwald all take their turn at the mic
Pakistani women come out fighting: A hard-hitting play focuses on female Muslim boxers

Pakistani women come out fighting

Hard-hitting new play 'No Guts, No Heart, No Glory' focuses on female Muslim boxers
Leonora Carrington transcended her stolid background to become an avant garde star

Surreal deal: Leonora Carrington

The artist transcended her stolid background to become an avant garde star
LGBT History Month: Pupils discuss topics from Sappho to same-sex marriage

Education: LGBT History Month

Pupils have been discussing topics from Sappho to same-sex marriage
11 best gel eyeliners

Go bold this season: 11 best gel eyeliners

Use an ink pot eyeliner to go bold on the eyes with this season's feline flicked winged liner
Cricket World Cup 2015: Tournament runs riot to make the event more hit than miss...

Cricket World Cup runs riot to make the event more hit than miss...

The tournament has reached its halfway mark and scores of 300 and amazing catches abound. One thing never changes, though – everyone loves beating England
Katarina Johnson-Thompson: Heptathlete ready to jump at first major title

Katarina Johnson-Thompson: Ready to jump at first major title

After her 2014 was ruined by injury, 21-year-old Briton is leading pentathlete going into this week’s European Indoors. Now she intends to turn form into gold
Syrian conflict is the world's first 'climate change war', say scientists, but it won't be the last one

Climate change key in Syrian conflict

And it will trigger more war in future
How I outwitted the Gestapo

How I outwitted the Gestapo

My life as a Jew in wartime Berlin
The nation's favourite animal revealed

The nation's favourite animal revealed

Women like cuddly creatures whilst men like creepy-crawlies
Is this the way to get young people to vote?

Getting young people to vote

From #VOTESELFISH to Bite the Ballot