Back to the 1990s

There maybe arguments as to whether it is a result of economic necessity or merely ideology, but this government is practising, as one commentator puts it, 'laissez-faire government in the purest sense'.

In the name of austerity and of promoting 'freedom' for professionals, step by step the Coalition are slowly dismantling state-delivered public services. In health care, one of the biggest early assaults has been on methods to measure (and encourage) high-quality, timely service to NHS patients. The government will argue that this is in order to reduce bureaucracy, but sceptics will argue that removing performance monitoring is all too convenient, and scrapping safeguards to prevent NHS patients being disadvantaged is an indication of an government relaxed  about the consequences of such an outcome.

So, waiting time and service delivery targets are set to be dropped, caps on private hospital incomes will be removed, NHS Professionals is the latest outfit rumoured to be under threat of privatisation (although it appears that, in line with many other public bodies, those actually working there are left in the dark). Most recently, it has been announced that Clinical Excellence Award Schemes are now 'under review'. These awards, incidentally, are designed to give financial recognition to consultants 'who perform over and above the standard expected of their NHS role'.

Now, it is true that many senior consultants have lucrative contracts, but the history of the NHS has been one of using financial incentives and generous contracts (particularly so in the large reform and investment programme in the early 2000's) to encourage key senior medical professionals to maximise their work in the state sector - of risk leaving them doing the bare minimum for the NHS in favour of more lucrative private work.

Whatever the decision on the Clinical Excellence Award Schemes are, it is clear that major efforts to encourage professionals not to prioritise private work to the detriment of NHS patients are now a thing of the past. In this area, the government is taking a step back, and it looks highly possible that Britain is heading back to the 1990s.