The first, run by BPP will expand it’s courses to include the training of healthcare professionals such as nurses.  NFR welcomes this move as evidence that the Government are following yet more of our policy ideas, for we have long believed that nurse education and the definition of what constitutes being a nurse should be set free from government and the Nursing and Midwifery Council.  It is imperative that this new university is allowed to set its own curriculum for nurse training and set it’s own standards.  I am sure that Foundation Trusts and hospitals from the independent sector will be more than happy to work with an institution that has high standards and that trains nurses who provide high quality patient care.

The unions that are decrying this initiative are peddling pure fallacy when they say that:

“Encouraging the growth of private providers and making it easier for them to call themselves universities would be a disaster for the UK’s academic reputation. It would also represent a huge threat to academic freedom and standards.”

For in truth, if this university wants to survive it will have to provide and maintain exceptional standards to retain its reputation and to continue to attract the best students.  Just as the pioneer of private universities in the UK,  The University of Buckingham has done for many decades.

Not only will the Government have gone back on its promise of abolishing Quangos, but it will also have fallen soundly at the first hurdle in its bid to reform the NHS.  For this move will send out signals to Strategic Health Authorities (SHAs) and Primary Care Trusts (PCTs) that if you make enough noise to justify your existence and roll with the punches to reinvent yourselves,  you will be saved.

One can imagine the mutterings in the SHAs and PCTs about being seen to support the changes as long as they do not go so far as too get rid of any “our” jobs or layers of bureaucracy!

It is vital that Andrew Lansley and his health team recognise the forces that they are up against.  They have lost the first battle against the FSA, they must now regroup and begin to close down all avenues that could allow the SHAs and the PCTs to have any chance of survival.  Otherwise all talk of reform and the ‘Big Society’ will be dealt a blow from the outset.

It is now vital that trade unions welcome this more market based approach to healthcare and step up to the plate of supporting greater plurality of provision – including worker ownership, co-operatives and mututals.  It is vital that Britain’s private hospitals do not repeat their memorable and disasterous tactic of the early noughties; when faced with the prospect of Blair’s independent foundation hospitals they actually worked alongside an unholy alliance of Frank Dobson, left wing MPs, trades unionists and a cabal of opposition Tories to undermine the legislation. Britain’s private hospitals have long talked the talk of consumer competition, it will soon be time for them to walk the walk of a paradigm-shifting and wholly privatised market. For while NFR wants the abandonment of national collective pay bargaining, and therefore does not believe that simple regionalisation of pay goes far enough, we can be sure that the government’s proposals represent a shift towards health privatisation on the provision side. By initially putting the vast majority of the NHS budget in the hands of general practitioners, whom the patients are themselves free to choose, the government is setting up a shadow voucher scheme.  Once the money follows patients through GPs, and it can be spent in a diverse and open market of non-State provision, the next step will be to allow all providers to sell, if they choose, their own local insurance products.  For many years private health cash plans such as H.S.A. Simply Health have sold their wares giving a proportion of their profits to local NHS hospitals. In future, NFR envisions a deregulated world in which local independent health providers, both large and small, are able to advertise and sell whatever health coverage or insurance products are desired.

Today, health is so important no-one should have to go in to any hospital, surgery, or clinic owned or directed by the state.  No health professional should be tied to out-of-date and Sovetised pay scales that demean their integrity and professionalism. As such, the future is clear. The NHS is being soundly re-engineered as a funding mechanism. Provision is rightly going the way of a freer market and professionals are being tentatively liberated from the shackles of top down direction.

In time, a more open, competitive and private funding revolution must follow. So too must the private training of all health professionals and the opening up of state monopolies such as the General Medical Council and the Nursing and Midwifery Council.

NFR has long believed that Strategic Health Authorities and Primary Care Trusts should be scrapped. NFR also believes that the NHS should be a funding mechanism but that no hospital, care home or clinic should be owned or run by the state.  While initial reports of the white paper are positive it is vital that it spells out that the state will never build another hospital again and that our existing stock embrasses diverse forms of ownership, including cooperative and not-for-profit, and that all provision is independent.  No-one in this country should ever have to go to a state run hospital again, moreover, the staff who work in these hospitals should be similarly denationalised.  National collective pay bargaining should be replaced by a more dynamic and responsive labour market and monopoly authorities such as the General Medical Council (GMC) and the Nursing and Midwifery Council (NMC) should face stiff competition from a raft of competitors offering competing standards and ways of doing things.

In this context Andrew Lansley’s white paper is unlikely to go far enough.  Still trying to make socialism work NFR suspects that he will chicken out of necessary labour market reforms and will remain on side with elite legislative favour so beloved by the GMS and the NMC.  As such NFR is only likely to give next week’s white paper 3/10

For many years there has been a dialogue of the deaf between the UK and the US.  While we believe that they have a totally private system that will leave people dying in street if they do not have private insurance, they believe that we have this wonderful state system that gives everyone everything they want. Nothing could be further from the truth.

Both systems are badly flawed and in dire need of more market oriented reform.

I do believe that this could be an effective way of the NHS measuring patients outcomes but only with the following provisos:

1. First, that the NHS is no longer a care provider. All NHS hospitals should be removed from State ownership.  They  must be owned and run by private companies, mutuals, cooperatives and other for and not-for-profit organisations.
2. The NHS will then become an institution that funds and sets minimum standards for healthcare provision.
3. Contracts for care must be awarded to these independent hospitals and their performance measured against the Health Secretaries’ minimum standards
4. If the hospitals are not achieving the standards stipulated then contracts must be removed.

The final point is vital.  By introducing the system outlined above healthcare providers will become truly accountable for the care that they give their patients because if they do not provide high quality care for all patients they should be taken over by those who can turn them around or they will go out of business.

The Hoover Institution is one of the United States most prestigious academic think tanks and closely affiliated to Stanford University.  The institution greatly influences public policy development globally  with its ongoing research agenda and I am very honoured to be asked to write for them.

NFR believes that the Coalition Government should not just stop at schools, hospitals should be next in line.  As I have written before, local planning laws must be changed to allow much greater diversity of provision.  Hospitals could be set up for example by private companies, mutuals, charities, patient groups etc and they should also be able to take over failing NHS hospitals and to compete for care for and treat NHS patients.