A Rational Way Forward - the Core Values of the NHS

I was watching Andrew Marr's 'History of Modern Britain' The subject that he was tackling was post war Britain and the creation of the NHS. Beveridge's report was actually written during the war, and copies of it were dropped over occupied Europe as propaganda. When the Allied forces entered Hitlers bunker, they found a German report on Beveridge's proposed system and it said it was far superior to any social system that the Germans or any other country had thought of.

I think it's so important to understand that the NHS is first and foremost a vision. It was no coincidence that it came at the end of the war, at a time of crisis. People looked at Hitler's Germany and decided that they did not like his ideals. They did not want a society where only the strongest survived and where the poor, the sick and the old were pushed to the wall. It was set up at a time of extreme austerity. Britain borrowed heavily from America during the war, and it borrowed £4 billion from America to set it up. It only paid off the last of that debt in 2006. But it didn't matter. It was something we did, because it was the right thing to do, because to us, a civilised society was a fair society, where everyone had equal access to healthcare and where need, not wealth, was the determining factor.

This is what I like about this report. Right at the start, it calls for a return to that vision, to the core values of the NHS. It states
'The NHS should provide care that is:

1. Free at the point of delivery
2. ethically rationed by clinical priority
3. equitably resourced
4. funded from general taxation (Appendix 2)

People might be apprehensive about statments 2 and 3. But what the BMA is referring to, is how central government has really devolved a financial responsibility that should belong to government, to local trusts and private operators. For example, if you need money to build a new hospital and the only way you can get that money is to take out a PFI contract and pay the debt out of your existing clinical budget, that is not fair. Local health boards don't have the money to finance these contracts. The money should be available from the Treasury, because it is a major financing project in the public interest.Moreover, PFI is not value for money. But the government persists with this, the health board goes into debt and gets accused of mismanagement.
What should happen is the government should take responsibility for major capital projects, assessed on clinical need and it should be funded from general taxation.

Now there will be those of you out there saying this is old socialist dinosaur stuff. But the reality of PFI is that we have actually created a new national debt through this system and it will land at the government's door sooner or later. We just have to decide whether we want the debt paid off through national taxation, or paid off in kind, through the shutting of A&Es, nursing homes, day hospitals, rationing of doctors and consultants and closure of mental health services. We have to decide as the last generation did, whether we think the NHS is something worth spending money on. Your punt..