The NHS will be the subject of many arguments as the election approaches, and those who understand the complexities of health reform should do better than simply giving out lines that play well with their constituents

The Royal College of Nursing fired the starting gun on another familiar jog round the managers versus clinicians track on Monday, with a survey comparing the pay of nurses with the spending on NHS directors.

‘The NHS will rightly be the subject of fierce argument over the next 10 months’

This was a disappointing piece of populism from an organisation whose leadership well understands the extensive evidence that the NHS does not devote sufficient resources to effective management.

Another well worn mantra: public sector bad, private sector good (or vice versa) got a much more interesting handling by Jeremy Hunt and former NHS England chief executive Sir David Nicholson.

Mr Hunt rightly identified it as a “toxic” debate, while Sir David said it was time the NHS got over its “obsession” with the subject. Both men, who are hardly political bedfellows, called for providers to be treated on their merits and not judged on ownership.

The reason to highlight this enlightened approach is because the NHS will rightly be the subject of fierce argument over the next 10 months.

Pre-election fever

It will be easy – and very tempting – for a whole range of interest groups to go for the line that plays best with their constituency and that the media need not think too hard about.

‘The NHS has known many mistakes born out of a fevered pre-election period’

This is not a call for the hard issues to be avoided: that the private sector has anything other than a peripheral role to play in large areas of NHS provision is very much open to question, for example.

But the history of the NHS has known many mistakes born out of a fevered pre-election period, which then have to be painfully and lengthily corrected. Just one example is the undermining of clinical influence following Labour’s 1997 general election landslide. Those mistakes can be minimised if people who understand the complexities of health reform refuse to play to the gallery.

Topics