The health policies of all the main political parties emphasize:**
(a) the need to reduce public responsibility for the
health of populations;
(b) the need to increase choice and markets;
(c) the need to privatize medical care;
(d) a discourse in which patients are referred
to as clients and planning is replaced by markets;
(e) individuals’ personal responsibility
for health improvements;
(f) an understanding of health promotion as
behavioral change; and
(g) the need for individuals to increase their personal
responsibility by adding social capital to their endowment.
See: What we mean by social determinants of Health. Vicente Navarro Speech to the Eighth IUHPE European Conference, September 9, 2008
The sum of all these is an ideology that will widen health inequalities, destroy the precious and vital therapeutic relationship between patients, doctors and other care-givers, make impossible the effective integration of primary, secondary and social care and massively add to the burden of suffering that presents to whatever’s left of healthcare.
This should be contrasted with the ironically ideological article by Andy Burnham’s new chief political advisor Keiran Brett: Against Ideology which argues in favour of individual empowerment and against state intervention; classic neoliberal ideology.
Will we notice when the Tories have won?
*Ross McKibbin. The London Review of Books, September 24th 2009
“Then there is the sad story of ‘choice’, from which the Tory leadership has learned little over the last 30 years. Much of the energy of recent governments has been expended on trying to create markets where markets cannot operate – particularly in education and health. One perverse consequence of this has been a huge increase in managerial bureaucracy in every sphere where ‘markets’ have been devised. Another has been to encourage a free-for-all, which favours, as one would expect, the well-connected and the well-to-do. ‘Choice’ has consistently undermined both the efficiency of the Labour government’s high levels of social expenditure and its worthy attempts to eliminate inherited disadvantages. How far a Cameron government would attempt to further marketise the NHS we don’t know, since Cameron is clearly nervous about upsetting the status quo. When it comes to education, however, Gove has been extolling choice and diversity (every man his own school). If carried out, this policy would probably wreck the state education system by shifting resources to the most energetic and best-placed parents. Since resources are finite, the result of ‘choice’ is that one parent’s gain is another parent’s loss. But the Labour Party has been almost as reluctant to admit this as the Tories. It is unlikely, therefore, that a Cameron government would make much difference. It will simply make the same mistakes; and perhaps a few new ones.”
**correct me if i’m wrong and I might vote.
**not a correction but a comment: I wouldn’t like to do privatised health care down, but much former NHS care is being moved into the third sector which Simon Antrobus, head of Addaction – a charity whivh helps individuals, families and societies cope with substance use – says a lot of commissioners just don’y understand.
I watched the process of illicit drug use services being transferred to the third sector via tendering in Cambridge. There are far less management layers, and substitiution therapies – notably Methadone – are being tied to attendance at therapeutic group work.
Just an observation.