How hard can it be to keep hospitals clean? Well, if you’re thinking
what we’re thinking, the answer is… it’s fairly difficult if you outsource responsibility
for cleaning, erode working conditions and labour standards and provide inadequate
cleaning materials – all in the name of market-based efficiency. Unsurprisingly,
Conservative health policy is silent on the impact of commodification on the
reduction of healthcare standards. But the party’s Manifesto, launched today,
does hint at how the system of market ‘choice’ will be extended if the Party
gains office.
The Tory pledge to give all
hospitals 'the freedom to
hire staff, specialise and borrow to invest' can be read as a commitment to continuing
the (neo)liberalisation of the NHS. Although it is presented as a rebuff to
Labour centralisation and bureaucracy, this measure is little more than an
extension of the present government’s Foundation hospitals scheme, which
already undermines pay bargaining and allows for increased subcontracting to private
firms. Conservative pledges to reduce ‘radically reduce the number of Primary
Care Trusts, abolish the Strategic Health Authorities
and cut the number of quangos, inspectorates and commissions’ also follow the
logic of Foundation hospitals to their logical conclusion, since that measure
has already damaged the ability to achieve the efficient, non-market planning
of services and undermined these bodies.
What is striking here is that a measure introduced by Labour to protect
an NHS ‘free at the point of use’ (a ritual commitment which is also repeated
in the Conservative manifesto) is being used as a means to further undermine it.
The ideologically shared vision of ‘patient choice’ serves as a metaphor for
the opting-out of the system by the middle-classes, undermining the universalist
aspiration for equitable treatment on the basis of healthcare needs.
(For more on this issue, see the articles on ‘Spoiling for Choice’ here and here in
the Red Pepper archive). OR
There is a much more interesting test of public opinion on www.may5election.com.
Posted by: David Davis | Tuesday, April 12, 2005 at 05:28 AM