Colin's Journal

We actually remembered Pancake Tuesday this year, and made some excellent pancakes. Lots of lemon juice and sugar topped them off nicely, and the tossing went well enough that there none of them ended up on the walls, floor or ceiling.

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There’s a bunch (although more than one hundred probably counts as more than a bunch) of labour MPs that are opposing the introduction of foundation hospitals. A foundation hospital is one that is not run by the government, but rather run as an independent not for profit organisation. They are, at the same time, still part of the NHS and “monitored” by stakeholder councils.

Obviously the effectiveness of the scheme will depend a great deal on the amount of control that remains with central government and the monitoring council. Too many targets and diktats from the government will eliminate the independence of the foundation hospitals, forcing them to ignore local concerns, and losing the opportunity to experiment and innovate on how provision is made. There is also the potential for abuse, especially in areas where there is no real choice as to which hospital NHS patients are sent to, and this presumably is what the monitoring councils are meant to stop.

Whether any of this will work is very open to question, but it is hard to see it being poorer than the centralised system that is in place today. The reasons given for opposition tend to focus on the fact that only qualifying hospitals will be given this independence, so leading to a “two-tier” hospital system where the independent hospitals can set their own wages and, the presumption is made, deliver better care. The obvious answer would be to make all hospitals independent, and while the government claims to have this aim, it seems unlikely to happen quickly. The opposing MPs however are against any differentiation in the service, still holding the ridiculous belief that all hospitals across the board can be brought up to the same level. This has never been achieved in the private sector (even when the product is identical, like the telephony market, there is still differentiation), and I can’t think of a public sector service that is of uniform quality across the board.

While MPs waking up to their responsibility of questioning the government is to be welcomed, it seems to me that they have picked a poor subject to do this over. Hopefully this new assertiveness will also be applied to those issues where the government is truly heading in a poor direction.

(Inspired by Why Do They Call Me My Happy?)

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