Maybe Labor and Tory are playing good cop/bad cop, with both looking toward destroying the system. This talking radical and acting conservatively sounds so DLC,
Labour initiatives 'overwhelm' NHS
Thinktank warns against well-meaning directives
John Carvel, social affairs editor Friday April 12, 2002 The Guardian
The NHS is being overwhelmed by a torrent of well-meaning initiatives from an over-centralising government, according to a report today from the King's Fund, an independent thinktank with close links to Labour ministers.
It said health policy in Labour's first five years in office left "an overwhelming impression of relentless, almost hyperactive intervention".
Although the NHS was enjoying a record increase in resources, the government "has not yet developed a coherent and principled set of criteria to guide its decisions", the fund said in a progress report on Labour's first five years.
Ministers have frequently been accused by the Tories of excessive meddling in NHS management, but they are likely to regard criticism from this more friendly quarter as considerably more wounding.
Julia Neuberger, the fund's chief executive, said: "Labour has a lot to be proud of. It has shown real commitment to a publicly funded NHS and to improving people's chances of living healthily.
"But investment and reform have been a double-edged sword. The NHS is overwhelmed with well-meaning policy directives, must-do targets and structural changes. Primary care trusts in particular are struggling to meet all of the policy imperatives Labour has set them."
She said it would be remarkable if Labour could halt the long term trend of increasing health inequalities. "But it is already evident there are conflicting tendencies in Labour's health policies, not least those between investment in the NHS and investment in health improvement, and between central control and local autonomy. Those tensions must be resolved if Labour is to avoid storing up problems for the future."
The report, edited by the fund's senior researchers, John Appleby and Anna Coote, said the government had unleashed "a torrent of new policies since 1997, trying to iron out health inequalities, raise care standards, improve NHS productivity, increase responsiveness and extend services".
The government's commitment to a national health care system available according to need and funded through taxation was beyond doubt. There was an unprecedented drive to put more resources into the NHS by increasing funding, tackling longstanding staff shortages and making increasing use of the private sector.
"However, Labour has not yet developed a coherent and principled set of criteria to guide its decisions. Its rhetoric is often radical, but its actions, however plentiful, are essentially conservative. The government's reforms of long term care have failed to mend a rickety system, leaving both users and carers dissatisfied. It has entered into a massive hospital building programme with the private sector, without a clear assessment of how future needs will be met, and without transferring any substantial risk," the report said.
Too much store had been set on structural solutions to problems caused by decades of under-investment and over-centralisation, it added.
The fund said the government should:
· Keep the money flowing, but dispel any remaining illusions that money alone would save the NHS.
· Stop the incessant flow of orders from the centre, build morale and confidence of the workforce, and enable them to take ownership of the reform process.
· Have fewer, broader targets for the NHS, costed and funded appropriately.
· Give a higher priority to improving health and reducing health inequalities.
· Prepare the public for the long haul: stop making heroic promises and buckle down to the unglamorous detail of building a good enough health system for the 21st century.
The criticism followed a report from Alan Milburn, the health secretary, on Wednesday, claiming big reductions in waiting times for in-patients and out-patients. He said a target to stop patients waiting more than 15 months for admission to hospital was all but met, with two people waiting over the limit at the end of last month, compared with 10,400 a year before.