Andy Burnham once again repeated his promise to “repeal the Tory Health and Social Care Act” if Labour win the next election.
Burnham was speaking from the platform at the 6 September Trafalgar Square rally of the People’s March for the NHS. It is good that Burnham makes the promise to repeal the Act publicly, but it is not enough.
When Burnham was Health Secretary under the last Labour government he backed the recommendations of Sir David Nicholson, the chief executive of the NHS, to make £20 billion “efficiency savings” by 2015.
Burnham’s opposition to Lansley’s plans boils down to not letting “market forces rip right through the system with no checks or balances”, but he is at pains to stress that “without the contribution of private providers, we would never have delivered NHS waiting lists and times at historically low levels”.
Burnham is in fact quite the fan of private provision within the NHS, albeit with the proviso of not letting it go “unchecked”. Labour’s own manifesto pledged to give Foundation Trusts more freedom to expand private services.
The problem with market forces is that they have a dynamic of their own. Allowing Foundation Trusts to expand private provision led Labour to accept proposals to raise the private patient income cap (meaning trusts can derive more of their income from private patients, so diverting resources to private services over NHS ones).
The promise starts to sound more empty when you think of the cuts that have already taken place, about which Burnham has little to say. A repeal of the Act would not reverse the damage already done, only serious reinvestment would address the millions of pounds of cuts already made.
Burnham has been very quiet about future funding of the NHS, whilst most agree that without an increase in funding the NHS will face a £40 — 50bn shortfall by 2020.
There is some argument in top Labour Party circles about raising national insurance contributions to cover this shortfall. The argument should be about taxing the rich and cutting the spending on the bureaucracy that has sprung up with increased privatisation.
A return simply to pre-2010 status for the NHS is not enough. Since the 1980s Tory and New Labour policies to introduce market mechanisms and PFI into the NHS to hugely increased bureaucracy, from 6% of health expenditure, 15% with the introduction of the internal market, and now an estimated 30 — 50% after the Health and Social Care Act.
Burnham should commit Labour reverse market forces and embark on large scale reinvestment in the NHS.