OK, so how’s this for an idea. Why don’t we break the entire NHS off from government to form an independent body – state funded but not state controlled?
As I see it, an independent NHS would have the following advantages:
– Less day to day interference from government, more cohesive long-term planning
– Continuity through elections, less chopping and changing of direction and leadership
– Could be run like the BBC, using the techniques of the private sector but as a public service
– Easier for people working in the NHS to rise through the system, they wouldn’t have to be politicians to reach the top and so successful ideas could flourish internally
– Still providing services free at the point of use
– Greater public support, they could see what proportion of their taxes went directly to funding the NHS instead of being ‘lost’ in general government spending.
It might be less flexible if funding had to be set aside exclusively for the NHS, but the real problem is that politicians would never want to give up that much control because, in the short term, they’d have less influence.
We’d also have to accept that people at the top of this new organisation would not be directly elected, they’d be appointed because of their expertise. But on the other hand – do you democratically ‘elect’ the civil servants who run the NHS now? Did you decide that John Reid should be the Minister for Health? No.
I also haven’t planned out exactly how you would fund it, obviously a flat tax would be too unfair and regressive given the size of the investment. But the more I think about it, the more I’m convinced this would be the best way of preserving the values of the NHS will reforming it at the same time.
(Oh, and belated shout out to Alex Trafford, whose website is looking funkier by the day)