One could be forgiven for thinking that the Health White Paper will inaugurate a completely new dawn. It doesn’t. Many of Lansley’s initiatives are resuscitated Labour policies: taxes on alcohol and tobacco and incentivising healthy living through choice are tried and tested formulas that have had limited past success in every field bar raising revenue.
Lansley’s White Paper is not a testament of radicalism, but it is quietly revolutionary nonetheless. Of all government ministers, Lansley has the best lines in the language of decentralisation. His actions realise his words. He has already taken GPs commissioning from central NHS Trust managers. Now he has decided to take responsibility for public health from the NHS and give it to local councils. Alas, the money is to be ring-fenced, so there is no immediate incentive for local government to improve both delivery and efficiency. ConHome’s Councillor Harry Phibbs bemoans this state of affairs.
There is the age old irony that Lansley has had to centralise to decentralise; and the fundamental structure of British healthcare remains sacrosanct. But, essentially, the Department of Health is embarking on what used to be termed the post-bureaucratic age.