Though Cowards Flinch

Something about the Conservative tradition has been lost as time has passed, namely in that Edmund Burke was not simply against the French Revolution per se. Instead Burke was positively for the Monarchical tradition that preceded him, pleading at revolutionaries to explain why they were going to put into jeopardy a system of governance that had the benefit of tradition, for a new experimental system, benefits of which were not entirely known.

The knee-jerk opinion that Burke was simply a thorn in the side of revolutionary change has normally been the preserve of liberals, but the Conservative phobia of experimentation with evidently useful, treasured and existing elements of society has clearly been overturned by Andrew Lansley, the UK health minister, and his new health bill. So much so in fact that Liberal peer Shirley Williams declared her opposition to what she called the “untried and disruptive reorganisation” of the NHS, back in February.

Yesterday, during the Liberal Democrat Spring conference in Sheffield, party members (still able to change policy) voted for an “extensive and radical re-write of the government’s NHS bill”.

Williams, along with former MP Evan Harris, “tabled calling for proper accountability and safeguards against privatisation” which has thankfully paid off, and not without support from party leader Nick Clegg who accepted the “rebel” amendments.

What this will do in the short term is create deep ruptures within the coalition. The Liberal Democrats, and Nick Clegg – who has vowed not to let the “profit motive drive a coach and horses through the NHS” – have sent a message to the health minister saying that they do not support the inclusion of “any willing provider” in the NHS. But as Paul said recently on this blog, proposing amendments to the health bill may not stop the coach and horses so soon. The backdoor attack on the NHS:

has been in the form of the abolition (in 2013) of Primary Care Trusts, and the establishment of three waves of GP commissioning consortia, already covering 35 million people in England.

This has created the space in which most GP consortia, who have nothing like the capacity to commission their own secondary care services, will buy in what the commissioning PCTs used to provide.

This time it won’t be the PCTs who provide it, but private sector health management firms like Capita, Dr Foster and the US giants like McKinsey, who are already working with 25 consortia.

Sure, some ex-PCT staff will get jobs in these management firms, as their technical understanding of secondary care contract development and monitoring will be needed, but little will remain of the PCT’s public-health oriented, public service ethos.

Though many of us are unsure what will happen if the coalition collapses, we hope Lib Dem rebels pull something out the bag to shake things up for good. Many people I know were hoping for the floor to fall in over tuition fees, but to no avail. Hopefully enough courage from the Tories’ orange bedfellows will be plucked to tear apart this horrible political mess once and for all.

Perhaps even the British Medical Association will pass a vote of no confidence to really bollocks things up for Lousy Lansley. But amid all celebrations that the majority of Lib Dems have dealt an important split in the coalition, we must still remember that the pressure by the Tories to pursue round-the-back privatisation to the NHS extends further than this new bill.

(H/T Alex for information on the BMA)