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- guardian.co.uk, Sunday May 11 2003 10.21 BST
- The Observer, Sunday May 11 2003
We know the Government is committed to the NHS as Labour's flagship policy and that it has taken the political risk by raising taxes to invest in its reform. The unions have played their part by signing up to Agenda for Change.
Until now, I have been perplexed and frustrated by the fact that the most fundamental reform of the NHS since its creation has merely appeared in a Bill without any previous consultation with NHS stakeholders, without a Green Paper setting out the ideas, and without a White Paper inviting comments on how to refine the principles. Neither was there a Labour Party manifesto commitment to establish this new breed of hospital enterprise. Party members have not debated these plans in detail and the proposal is conspicuous by its absence from the NHS Ten Year Plan.
Yet a policy without constitutional legitimacy and consultation becomes a fully-fledged Bill that, with Labour's overwhelming majority, is virtually guaranteed to become a legislative reality. Given the potential public and political backlash, why pursue a policy that, while not unleashing an overnight revolution in our NHS, is likely to be the catalyst for its greater marketisation?
The answer comes with a ransom note to be found in the latest edition of the European Central Bank's Monthly Bulletin. Having studied the ECB report, I understand why this policy on foundation hospitals is being bounced through. The most credible explanation is that they are preparatory for early UK euro entry. And it will not stop here: membership means handing over control of welfare policy in its entirety, from child benefit to old age pensions.
The ECB leaves little room for doubt that membership of the euro comes at a sky-high cost: that is, the retreat from universal health provision and the reining back of state investment in favour of the unfettered advance of the free market. No longer would healthcare be delivered to meet the needs of the people, but tailored to fit private sector priorities. For taxpayers now picking up the increased bill for NHS renewal, this report is the harbinger of doom because the NHS they fund today may not be there tomorrow.
The report calls on eurozone members to reform their health systems so that 'public health and long-term care systems should focus on providing core services for healthcare prevention while leaving individuals to provide for non-essential expenditure'. Put simply, do not expect the state to provide any more than healthcare basics. What you should prepare yourself for is a double dose of taxation in the form of the private health insurance you will be forced to take out if the ECB nightmare scenario becomes a UK reality.
The report also argues that public health and long-term care arrangements are best reformed by 'limiting the public sector's exposure' and 'enhancing private funding'. It then suggests that the best means to achieve this is through an enhanced role for 'market forces', citing that Prime Ministerial favourite, 'patient co-payments'. In other words, patient care carries an extra price tag; those who cannot pay may get a voucher.
So as well as laying bare the social costs of euro entry, the report indirectly performs another important function - to expose a motivating force driving the foundation hospital reforms.
Hasty and ill-judged membership of the single currency in this Parliament would mean hello euro, goodbye NHS. But no country and no Government should ever base its social policy programme on the demands of an ECB crying out for reform that meets behind closed doors with closed minds and whose policy remit is framed by an overly rigid stability and growth pact driven by economic absolutism without any concern for social justice
The ECB's ransom note has been delivered and the price demanded of the British people is the sacrifice of their beloved NHS for a single currency. The choice is simple - you can keep the NHS or you can choose the euro. With the bare-knuckle crunching of Labour MPs to support foundation hospitals, it is beginning to look as if the NHS is the price the Government is prepared to pay for the single currency.
My union's position has been to rule out any referendum on the single currency in the lifetime of this Parliament. But, if we have to choose between the NHS and the euro, then my faith is with the people: to keep the NHS and rule out the euro.
I still believe that the heart of Europe is where Britain should be and that the euro may one day be right for this country. However, for the sake of the NHS and the stability of the economy, the Prime Minister should show political courage and rule out a referendum for the lifetime of this Parliament.
