Nurses for Reform Blog

This is a fantastic article by my friend and colleague Stephen Pollard welcoming David Cameron’s announcement that the Conservative Party, if they win the forthcoming general election, will allow public sector workers to run the services that they work in as co-operatives.  In truth this project will probably start in education but is likely to very quickly spread to healthcare services.

This is a real step in the right direction as far as Nurses for Reform is concerned.  As regular readers of this blog will recall, we have always championed the rediscovery of the UK’s wonderful history of mutual and co-operative funding and provision of healthcare and we are so happy that David Cameron and his Conservative Party are taking on our policy ideas (here, here and here).

For NFR the saddest part of this is that the people who should be welcoming the empowerment of their members more any other are against it Unite, the largest public sector union have been publicly condemning this move.  Well, shame on them.  They have now demonstrated that they are far more interested in playing politics than really looking after the interests of their members and the workers that they claim to represent.

Unite and indeed the Labour Party must welcome this policy, they have to see this as a triumph for their ideas.

Since the recent meeting with David Cameron Nurses for Reform has attracted a vast amount of media attention. Perhaps most importantly we have also picked up lots of new support from registered nurses who have decided to formally sign up and support the organisation. Appalled by the horrific realities of state run healthcare many nurses have clearly been relieved to finally find an organisation that spells out some home truths about the NHS and campaigns to put the long term interests of patients first.

On the media front, NFR has been reported in The Daily Telegraph.  We have also been reported in The Mirror, here, here and here .  And we have been reported on major UK political blogs – such as Samizdata and the Adam Smith Institute .

There have been numerous other blogs about the organisation – including Liberal Conspiracy, Labourlist , and Tom Harris MP’s blog (to detail just a few) – and early this week I was interviewed by the Nursing Standard (readers will be able to see the result of this when the NS gets around to publishing it in a few weeks).

The really heartening thing about this episode is the dozens of nurses who have signed up to support NFR and what we stand for. Their emails and messages of support characteristically represent a profession who are tired of being gagged by politicians and misrepresented by the usual political class types at Unison and the Royal College of Nursing.

On the down side, NFR is mindful that many people in the UK and Europe still do not get how hostile the organisation is to American state healthcare. In failing to understand that the US government spends more on Medicare, Medicaid and S-Chip than the Pentagon spends on the military, it would be helpful if some of our detractors at least read this NFR article on why America does not have a free market healthcare system and therefore why NFR is hostile to the American healthcare system.

I am pleased to confirm that earlier this week I had an interesting hour with Tory leader David Cameron in his private office in the House of Commons. I had been invited by him to discuss NFR’s ideas on the future of health policy and presented a range of ideas. Amongst others, these included the end of national collective pay bargaining for nurses and doctors, the view that the state should not own or have any of its agents manage hospitals, a world of widespread health advertising (to overcome problems of patient ignorance through trusted brands) and a dramatic liberalisation of hospital planning laws. On this latter point, central government should have no say in when and where any hospital is opened or closed. If he becomes Prime Minister I have no doubt NFR will meet with him and his policy team again. But whatever happens, he can rest assured that NFR will remain very much on the outside of his – and any other party political – tent. As a libertarian organisation, NFR has a profound mistrust of all politicians. As such, we will remain dangerous and continue to think the unthinkable.

This article in the Daily Mail picks up some very interesting points from David Cameron’s speech about the NHS last week.  Of course there was the inevitable waffle about NHS spending, that did not tell us very much at all, but for me the crucial sentence was:

The Tories would allow “any willing provider” – including more private firms – to supply quality care to NHS patients.

Regular readers of this blog will know that I do not think this goes nearly far enough.  As I have written here, I believe that all NHS hospitals and care facilities must be put in to the independent sector and that the NHS should become a funder of care and a minimum standard setting institution.

However, as we get closer to the next general election I will look forward to what else Mr Cameron has to say about the use of the independent sector in UK healthcare.   I know that he has a copy of the Institute of Economic Affairs book ‘Towards a Liberal Utopia’, in which I co-wrote the chapter on health, so maybe he does consider that NFR has some good ideas!

This article in the Daily Mail announces that David Cameron will make a speech today stating that the Tories are the best party to look after the NHS and that they do have plans for its improvement.  Well I hope that this is true because the UK’s healthcare provision is in need of not only some ‘big plans’ but some action too, to ensure that it really does become an ‘envy of the world’.

To begin with my suggestion would be that all NHS institutions and facilities must be removed from the state sector, whether it be through management buy outs, sales to for-profit or not-for-profit organisations or the setting up of independent charities to run them. In the future, all hospitals, clinics and community services etc., must be independently owned and run.

Then then next action can be to de-nationalise the staff.  All doctors, nurses, therapists and other health professionals should no longer be employed by the state or be paid according to national collective bargaining processes.  Instead, these decisions should be decided by a diverse, competitive and consumer-led market. 

It is the belief of NFR that only when these basic actions have been implemented we will start to witness the benefits of a dynamic health market that can then be more substantively reformed on the funding side. By allowing nurses, doctors,  hospitals and clinics etc., to openly advertise their wares patients will start to benefit from a flourishing range of brands that they can trust. It is in this world that finally state regulation can give way to market-borne, bottom-up, reputation.