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Unanswered Questions on the NHS

12 February 2012

Andrew Lansley’s Health and Social Care Bill has become one of the most divisive issues in contemporary politics. And it is certainly the most stubborn.  

Despite David Cameron declaring he is ‘at one’ with his Health Secretary, the proposals have been criticised by other leading – if unnamed – Conservatives. It is feared that the amendments forced by the Lords’ risk a disruptive reorganisation that simply no longer makes sense. A ‘flagship’ piece of legislation has, it seems, become little more than a muddle.

The mind is immediately drawn to 1951, when an incoming Conservative government promised to roll back the state, foster private enterprise, cut red-tape and ‘set the people free’. The reality was, however, less radical than the Churchillian rhetoric. There were some changes: the steel and transport industries were denationalised and many wartime restrictions removed. But patterns of government and the state’s role in society remained largely unchanged. Most importantly, there was no fundamental change of on the NHS.

This tactic proved politically astute as the veneer of liberty was matched by a continued commitment to intervention and ‘fairness’. This, alongside rising living standards and a divided opposition, helped to keep the Conservatives in power for the next thirteen years. The question for today’s Government is whether it can marry the political rhetoric with such substantive improvements. And whether the ‘biggest shake up since 1948’ can be implemented without damaging the Conservative’s election pledge that the NHS would be ‘safe in our hands’ remains to be seen.

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