A new dawn?

Man, as John Le Carre famously wrote in his novel The Russia House, is not equal to his rhetoric. Let us hope that this is not true as we embark upon a new era of politics and, with it, healthcare policy. The last 13 years have been morale-sappingly bad for the NHS - any new funding notwithstanding - and the two opposition parties, now wedded in coalition, have consistently damned the architects of this demise with strong words and lengthy speeches. But it is one thing to oppose, quite another to dismantle. Just like the higher earners who watched their tax-free allowance silently vanish in the last Budget and who will doubtless not see it reappear even though the measure was opposed by Her Majesty's then Opposition, so we now wonder whether the new administration has the courage, energy and drive to dismantle the rotten, creaking structure of the Health Service and replace it with a slimmer, healthier organism.
Not just the culture of targets and the cottage industry of clipboard carriers that surrounds it; not just the glut of managers with little to do and even less idea of what they are supposed to be running; not the plethora of needless quangos that wield disproportionate power over situations their members are not qualified to understand - and in these I include the Strategic Health Authorities that act only as non-visionary bars to progress and should be closed forthwith; not even just the appalling culture of 'counting hours' that has reduced the profession to clocking in and out of an ever more monitored workplace. No - even the utterly wasteful internal market itself, the mechanism that sets doctor against doctor, speciality against speciality and wastes the money that we are told is so very precious right now: a new way to govern the NHS must be found, perhaps even one that puts it, in part, outside the whims of the government of the day. Health, unlike government now, is not a fixed term event and should not be solely run by those who are shackled by this constraint.
Mr Lansley has apparently secured himself a Cabinet post within the new coalition. Let us hope that he and his colleagues in the Department of Health - itself in need of a reform diet - can live up to the many election promises of the two parties (and go further) to treat this once bejeweled public service to the lifestyle change it so desperately needs.