Politics

21 July 2007

Beneath the dynamic surface, Brown is dismantling Blair’s public service reforms

The closer one studies the detail of Mr Brown’s proposals in the last few days, the clearer the unionists’ cause for celebration becomes. While providing spectacular entertainment, from Tory defections to the scrapping of the Manchester supercasino, he has been silently and systematically working his way through Tony Blair’s public service reforms and stealthily undermining each one. His work has been technical, as understated as one of his Budget footnotes — but no less deadly. The result is a significant shift in government policy.

To understand what the Prime Minister is up to, we must go back to the root of his conflict with Tony Blair. Around the time of the 2001 election, Mr Blair had concluded that central government diktats did not work, and the surest way to improve public services was to have schools and hospitals compete with each other for the custom of the parent and patient. He wanted independent schools and hospitals to enter the state system, to generate this competition. His principles were sound, simple — and, of course, Conservative.

For equally solid Labour reasons, Mr Brown opposed him. Now and again, he would recite his creed: that the ‘consumer is not sovereign’ in healthcare, and that the laws of the market don’t apply to public services. He was happy for companies to compete and to do disgusting capitalist things to each other — but he did not want the public sector so defiled. His Treasury resisted the public service reform agenda from the top, while local health and education authorities resisted from below. By the time Mr Blair finally left office, his achievements were nugatory.

Today, less than 1 per cent of the NHS budget is in the hands of outside medical companies. Of Britain’s 3,300 secondary schools, just 47 are City Academies. This falls substantially short of the critical mass which the ‘choice agenda’ needs to work. So Mr Brown does not have to kill something which Mr Blair scarcely brought to life. He knows that if no more outside competition is brought to bear on the local authority cartels, the fledgling reforms will wither and perish by themselves. He need not wield a knife.

First, health. Mr Blair’s idea was to bring in a new breed of mini-clinics called Independent Sector Treatment Centres. They would be privately run, but carry out operations for the NHS. Mr Blair’s hope was that they would one day account for a tenth of the market. But it now seems that the NHS Trusts, which long resented the new clinics, have already started to edge them out.