Reform Scotland


New Reform Scotland Advisory Board member says we need reform in the interests of consumers, not producers

Tom Harris, the former Labour Minister who served under the Prime Ministerial tenures of Tony Blair and Gordon Brown, has called for the Labour party to take a fresh approach to healthcare reform.

In a Sunday Times extract of his chapter for Reforming Scotland, a forthcoming publication from the independent think tank Reform Scotland, of which he has become an Advisory Board member, Mr Harris wrote:

“The deference with which the health service is regarded by politicians, media and citizens is its greatest strength and weakness. Strength because it is unassailable; no party would dare undermine or threaten the central concept of free health care at the point of use, paid for from general taxation and available to all irrespective of income.

“Yet after 30 years of knocking on voters’ doors and speaking to them about their actual experiences as patients, of 14 years listening to constituents’ complaints about their treatment at the hands of NHS staff, I am only too well aware that the NHS’s perception as a “religion” is also its greatest weakness. For its critics are too often reviled as apostates and heretics.

“Because of its historic role in founding the NHS – a role of which its members are rightly proud – it is Labour that finds itself in the most difficulty when it comes to reform. And too often it sides with the vested interests of the producers, rather than the consumers.

“When David Cameron, flush from his unexpected victory at the polls in May, proposed a seven-day NHS, Labour’s over-cautious reaction reflected its reluctance to take on the BMA and the health unions. While the party was hesitantly scratching its head, the public were scratching theirs in bewilderment: You mean there isn’t a seven-day service already? How on earth did that happen…?

“Reforms that Labour should feel relaxed about include the dreaded word “private”. Because we’re all private healthcare users. Every one of us. And that is not the result of any new Blairite or Thatcherite innovation; it’s been the case since the NHS was born. Your local doctor is not an NHS employee. He or she is a business person, contracted by the NHS to provide a service – a service from which your doctor makes a tidy profit. No-one cares. And no-one is calling for that system to be replaced by one in which GPs are directly employed by the NHS. Nor should they.

“Since devolution, ministers of both parties have enshrined a form of conservatism when it comes to public service reform. While Scotland peers with contempt at academies and free schools south of the border, at the growth of private health providers within the NHS, it further entrenches the ultimately doomed philosophy that the answer to every problem is more cash, not reform.”

Geoff Mawdsley, Reform Scotland’s Director, said:

Reforming Scotland will contain chapters written by people from a range of political backgrounds and none. It will examine the reform agenda and how it could be applied in different areas of public policy. We are excited about Tom’s contribution in the area of healthcare, which is very much in line with our approach of empowering the users of public services.”