Former health secretary Alan Milburn says he cannot support measures that would fragment the NHS
The Blairite former health secretary Alan Milburn hasdisowned Tory efforts to use him as an advocate for the government's changes to the NHS, as the first signs of Tory unease about the plans emerged in the Commons.
The Conservatives have politically relied on former Labour cabinet ministers and health advisers to argue that the changes are a natural evolution of Labour policies, a claim designed to blunt the opposition's "opportunistic attacks".
But Milburn told the Guardian he could not support measures that would fragment the NHS. "It is a good idea through commissioning [for GPs] to have greater ownership of the financial consequences of their clinical decisions," he said. "But GPs do not have the ability to make innately complex commissioning decisions, and it is a profoundly bad idea to weaken the public accountability over the commissioning of �80bn of public money."
He added that Liberal Democrat policies now excised from the bill would have done more to bring co-ordination between health and social care.
Milburn also disclosed that a fortnight ago he rejected an offer by Andrew Lansley, the health secretary, to be a candidate for chair of the new NHS commissioning board. "The politics of the changes mystify me," Milburn said. "The four words 'cuts, health, privatisation and Tory' ?are always going to be bad for the Tories. Either these policies are an evolution or a revolution, but they cannot be both."
He is due to set out his views in full in the Labour magazine Progress. He said that some of the reforms ticked the right boxes, including greater freedom for NHS foundation hospitals, bringing government out of day-to-day management of the NHS, and what he calls managed competition.
Milburn's intervention may do something to clarify the issues of contention in a debate that has become increasingly polarised and distorted.
His remarks came as Lansley used a Labour-inspired debate in the Commons to tell the Lib Dem deputy leader, Simon Hughes, that he was willing to clarify the bill, but he repeatedly accused Labour of union-backed scaremongering. Lansley said he had already compromised by tabling amendments to rule out competition based on price and prevent cherry-picking by private companies.
Lansley rejected Labour claims that the bill brought the health service under European Union competition laws for the first time, saying there was no extension of the EU within the NHS.
But Lansley and Downing Street are deeply frustrated at how his proposals are being portrayed and perceived.
Compromises being informally canvassed include strengthening the planned powers of health and wellbeing boards, making GP commissioning more accountable to the public, and revising the role of the health economic regulator, Monitor.
At the end of the health debate last night 21 Lib Dem MPs did not register a vote with the government, in what seemed like a sizeable protest; it is impossible to say how many were making a protest, or how many were absent from the vote for other reasons. At its spring conference, the party voted overwhelmingly for fundamental changes to the health and social care bill.
Source: http://www.guardian.co.uk/politics/2011/mar/16/nhs-reforms-not-labour-milburn
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