A political football

Almost since the moment it came into being, back in 1948, the National Health Service has been something of a political football.

Labour has always claimed the NHS as its own. They claimed at the time to have defended the NHS from Mrs Thatcher's free-market instincts, and Tony Blair poured billions into reviving what had become a failing institution.

In the run up to last May's General Election, the Conservatives stole Labour's thunder. David Cameron was able to draw on his own experience of the Health service and express his gratitude for the way in which the NHS had served his son Ivan. The Conservatives became trusted to protect and nurture the NHS.

During the election campaign, the Tories gave us a poster of David Cameron saying he would "cut the deficit not the NHS", and promised not to bring in "major top-down reorganisation of the NHS."

Labour accuses the Coalition government of breaking that promise, but the government HAS ringfenced NHS investment which will continue to grow (though real-terms growth will depend on what happens to inflation), and claims the current re-organisation, seen by many as the biggest since 1948, is not "top down" but "bottom up", giving more power to doctors than ever before.

The fear, expressed by the British Medical Associaiton, The Royal College of Nursing, The NHS Confederation, the Royal College of Midwives and others, as well as the big unions including Unite and Unison, is this: That what we are seeing is a kind of creeping privatisation, that groups (called consortia) of GPs making decisions about spending will inevitably have to consider cost, and that private companies will enter the market, undercut costs, and trigger a price war - and that that will be at the expense of quality.

The language being used is draconian, with words like "disaster" and "chaos" being bandied around, and dire threats that all of this will lead to hospital closures and the end of the NHS as we know it.

The government, however, insists that the quality of patient care comes first and, Health Secretary Andrew Lansley told me this morning, it always will.

Mindful that Tony Blair regretted, in retropsect, not doing enough to reform public services in the two years after he was first elected PM in 1997, Mr. Cameron seems loathe to make the same mistake.

In his speech at the Royal Society of Arts (of which yours truly is a member!), Mr Cameron offered a future of greater choice, greater indepence for public institutions, and greater competition, and he said this: That he wants "one of the great legaciesof this Govrnment to be the complete modernisation of our public services."