Blairism with a smartphone

Labour’s NHS plan is just reheated Blairism

• The Government’s 10-year plan for the NHS is almost identical to a document from 25 years ago
• Keeping up with developments in healthcare policy is like watching Groundhog Day
• Revitalising old agendas for reform will never sort out the issues facing the NHS

Yesterday, the Government published its policy paper ‘Fit For The Future: 10 Year Health Plan for England‘, which announced:

[I]nvestment has to be accompanied by reform. The NHS has to be redesigned around the needs of the patient. Local hospitals cannot be run from Whitehall. There will be a new relationship between the Department of Health and the NHS […]

A Modernisation Agency will be set up to spread best practice. Local NHS organisations that perform well for patients will get more freedom to run their own affairs.

Or actually, it didn’t. That quote is from ‘The NHS Plan: A plan for investment. A plan for reform‘, published almost exactly 25 years ago today, during Tony Blair’s first term.

The whole piece is well worth reading as another indication that reforming the NHS has never been on any political agenda. Tinkering yes, reform no. Politicians still rely on technology and bombastic rhetoric to supply something they can sell as progress – smartphones in this case.

There are good things in the plan, even if they are not genuinely novel. The NHS App, which was useful enough during the pandemic, has largely been lying dormant since, because there was not much that one could do with it. The 10-year plan wants to add extra functions to the app, so that it becomes a tool for conveniently choosing healthcare providers, and a source of information about them. NHS Trusts will be given greater autonomy over their budgets, and payment formulas will be changed, to strengthen the principle that the money follows the patient. When patients are strongly dissatisfied with the care they receive, it will even be possible to withhold a part of the payment from the provider. These are all sensible extensions of Blair-era reforms.

And that is, perhaps, the most generous reading of ‘Fit For The Future’: it is a revitalisation of an earlier reform agenda, combined with some evergreen topics that, within the current system, never truly get sorted out.

In the current context, this is probably as good as it gets. But it comes nowhere near justifying the Government’s bombastic rhetoric of ‘transformational change’ or a ‘break with the past’. It is Blairism with a smartphone, nothing more, nothing less.