Calling time on the NHS as a political football

Chris Bailey explores the politicisation of healthcare in the context of the General Election.

There is a painful truth about health and UK elections: the NHS is political. It is a standard-bearer issue from which battle lines are drawn and ideologies are differentiated. Concerns it has simply become a ‘political football’ remain and every election presents an opportunity to demand more from a public service that affects almost every single one of us.

From the very start, the NHS faced tough decisions over how best to allocate scarce resources. The NHS of 1948 was unlike anything seen before, established (in part) as a response to tackling five ‘giants’ that threatened post-war reconstruction (want, disease, squalor, ignorance & idleness). But it soon faced a now well-recognised problem: increasing costs of healthcare vs financial restrictions. In the decades that followed, changes caused by financial constraints became inevitable and a process of reform has been ongoing ever since.

But should we accept the NHS as another issue for politicians to scrap over? Fast forward to GE 2015 and a ‘weaponised’ NHS looms large, much to the concern of healthcare professionals and civil society. With the management of the NHS consistently topping the polls in terms of voter concerns for this Election, it’s no surprise that the health service is once again at the centre of a fraught political debate. Labour correctly sees trust on the NHS as a key strength for the Party, as evidenced most recently by Andy Burnham’s quick move to capitalise on the New Year’s spate of A&E ‘major incidents’ and position this as a direct consequence of Government mismanagement.

The privatisation debate has ignited and will likely escalate. Arguably, it moves discussion away from important areas, such as how the NHS can meet demands and continue to improve the nation’s health. Last week’s update on privatisation from the Kings Fund epitomised how a politicised NHS can distract from essential issues. It found that:

  • Yes, there has been growth in non-NHS providers, but there has been “no wholesale privatisation of the NHS.”
  • Approximately £6.5 billion was spent in 2013/14 on private providers, in the context of a total NHS budget of £113 billion.

Provider competition is important and can bring benefits for NHS patients, but must be managed to ensure standards are maintained, avoid cherry-picking of lucrative contracts, and guard against the double-agent dilemma (commissioners who have a vested interest in commissioning their own services!).

Last year, the New Statesman suggested the Left had become obsessed with ‘smartarse debunking’ on welfare and immigration. As we get closer to this highly contested Election, that sentiment will ring  true for all parties and their approach to the NHS – politicians will be more tempted to throw around statistics, accusations and recriminations about the best way to manage our health service in order to gain even the slimmest electoral advantage.

The NHS will continue to be characterised by arguments over how best to use public resources – meaning that it will always be subject to political debate. But beyond the point-scoring, voters with the NHS at front of mind will need to see through the bluster and unpick the real story behind what is best for our health and this wonderfully British institution.