There can be nothing more terrifying than the Liberal Democrat Spring Conference. In action – for it is rarely inaction – the conference makes its Leader bow, scrape and tug his forelock. This week was no different. The unusual combo of Evan Harris, lately MP for Oxford West, and Shirley Williams, lately one of Harold Wilson’s James Callaghan’s Cabinet ministers, pounced upon the Cleggites with the strength and ferocity of an enraged puma. The conference voted, practically unanimously, to express what could charitably be described as concern at the Tory plans for the National Health Service.
Why does it matter? Settle down, little dears, and I’ll tell you. The Coalition agreement specified that nothing really would be done on the NHS. The two parties did not agree, so nothing would change. But almost immediately upon taking office, the Tories announced that, far from nothing happening to it, the NHS would see its biggest change in sixty years. Central planning would be abolished. Power would be devolved to GPs, who would control budgets. The old structure of state-maintained layers of bureaucracy would be SWEPT ASIDE and replaced with effectively private providers.
Now, say the Liberals, this won’t do. It has little to do with the fact that they don’t like the plans. Neither do they like a lot of things the Tories are doing. But whereas in many cases they have agreed on the need to compromise, in this instance the plans directly contradict the Coalition agreement. So obviously the Lib Dems have a right to protest them. That is why Nick Clegg has been ordered by the conference to negotiate with Cameron about watering down the proposals.
This is a new era for this blog. So I’m not yet certain about the extent of personal conviction we’re permitted in its treasured folds. My opinion, though, is as follows. The Tory plans are insane and must be stopped at all costs.
Elements of them are good. Devolution of power is always good. So is making the NHS more efficient, which stripping out bureaucracy will probably achieve. But by allowing anyone to bid to run bits of the health service we are not only dismantling a gloried institution in the name of private profit. We are utterly, utterly ruining any semblance of an organised, incentivised health system. We will not end up with an American system, because nobody will have to pay. But if the organisation of the thing degenerates into bloody, capitalist farce like the plans will let happen, we may as well give up and move back to Alabama. And if provision of healthcare is based- as it might be – on whether or not you can make profit for some worthless fat cat in another continent, I for one would merrily get quite cross about it.
I’d imagine the system will only be half-introduced: perhaps with less of a private element, perhaps with less decentralisation. The level of opposition is so irredeemably vast it seems hard to expect otherwise. All the same, the re-organisation needed to mop up the spatter from the previous re-organisation will cost the taxpayer billions of pounds. And whether or not you agree with the plans in the first place, that is political reality, and that is what will win through.