A thread on why Labour and the broader left should support the government’s leaked proposals on ending ‘some’ aspects of the Lansley Act.

I’ve not had very typical career moves but it’s involved working in managerial roles across the spectrum of post Lansley orgs, worked for regulators, on an STP, but also on other side with anti privatisation campaigns, and as a political pollster. I see a few perspectives.

The Lansley reforms were an act of vandalism on the NHS. The Conservatives and LibDem ministers who supported it should be ashamed (Grayling has nothing on this one!) and a full apology is the least required.

The most important aspect was it turned the NHS into the status of a regulated privatised utility. I worked for Monitor. One of its main roles was to promote competition. At a policy level, private and public became of equal value, or lack of value.

Privatisation seeped into the culture, in particular in primary care, CCG level. Not in the most visible areas, but community physio, support services, constantly on the table. Outsourcing became endemic at least as an option. It nearly always failed. Underbidding, over-selling

The left’s response to news the worst aspects (by no means all) of this market system will end has been a mixture, of 'don’t trust', 'we would prefer the mass of new local structures to have power than a Tory govt', to ‘now is not the right time’ for another reorganisation.

There is also massive distrust of the integrated care orgs, which will remain. These are said to be stepping stones to more privatisation. But there is nothing intrinsic which would lead to this, especially if the law has been changed to end the current tendering process.

Covid has put up a big sign up highlighting the mess of the current structures. Pressure to privatise and outsource, has left for instance, too many ‘joint ventures’ laboratories for example, and broken down and hollowed out local unified public health systems.

Rather than look for reasons to oppose the leaked proposals, politically, Labour could be capitalising on the damage that’s been done, and who’s responsible. Anything else, could see Labour and the left outflanked by the Conservatives on NHS privatisation.