David Green

Cameron must defeat Clegg and break the NHS’ monopoly

‘NHS good, private health bad’. ‘State good, market bad’. ‘Four legs good, two legs bad’. Whenever political leaders get into a tight corner they have to find allies fast. There is no time for reasoning to work its gentle magic. Basic sentiments need to be stirred and the popular favourite is usually hate.

Yesterday Mr Clegg used this classic strategy to rebuild his support base. The cold-hearted Tories were at it again, dismantling that icon of compassion the NHS. In public they were declaring their undying love for it but out of sight they were promising fat profits for ‘health care corporations’ once the new law was passed.

Mr Clegg even resorted to another child-like contrast. The new regulator, Monitor, should not promote competition but rather ‘collaboration’. As any thinking person knows, the opposite of competition is not collaboration, but monopoly. Mr Clegg disapproves of any comparison with utilities, but even he could see the absurdity of defending BT’s monopoly of telecommunications by calling for collaboration not competition. And the NHS is not ‘just like’ a utility as he reminded us in his speech, but it does have something in common. As most other European countries discovered long ago, mixed public-private systems with competition lead to better health care than public sector monopoly.

Can Mr Clegg honestly say that the most vulnerable people in society receive a worse standard of care in France, Germany or the Netherlands than in the UK? Older people who have become ill as time takes its toll are by far the biggest group of NHS patients. Isn’t it more true to say that the NHS provides a notoriously bad service for older people? American health care is the usual hate symbol of NHS partisans, but the Americans have Medicare, which provides their older generation with the best that money can buy.

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