Iestyn Williams, Health Services Management Centre

Iestyn Williams

No one will be surprised to see that Labour has put health care at the front, the back and the middle of its election strategy.  Given the prominence of the NHS in the national psyche and Labour’s status as its natural protector, they would arguably be foolish to do anything else.  And of course the Conservatives are politically vulnerable on health at the current time following the embarrassment of Andrew Lansley’s reforms, a system that is creaking at the seams, and a widespread perception of a plot to privatise what is a beloved national institution. 

It has yet to be established whether the recent tough talking from Labour is based primarily on political principles or electoral opportunism.  However the recent announcement that they would spend £750 million of any additional funds on reducing cancer test waiting times suggests that the dominant motivation is one of political popularism.  In privileging cancer wait times, Labour has shown a lack of either courage or expertise (or both). 

This is not to say that cancer care does not require support and indeed the UK’s comparatively poor survival rates suggest that more can and should be done.  And it is no surprise given the proximity of cancer to so many of our lives, as well as the terrible suffering it often brings, that we as a people are often prepared to pay a premium for cancer services.  But we also need to look at the bigger picture.  Cancer services take up a huge proportion of NHS funds (not to mention the uniquely dedicated budget allocated to funding expensive cancer drugs), and have been the subject of relentless policy initiatives in recent times. 

In a context of constrained resources the risk is that other service areas with a lower profile – witness the chronic neglect of mental health – lose out unfairly, exacerbating inequities both in the service and in wider society. We might expect the Labour party to be sensitive to such concerns but the current leadership seem content to put them to one side. 

In its response to the impending NHS financial crisis, Labour’s recently announced funding plans were modest to say the least.  And we now know that they intend to divert much of the meagre additional revenue identified away from many of the areas that need it most.  Under New Labour, in times of relatively prosperity, it was possible to pursue both principle and political expediency simultaneously.  In the current health care context, difficult choices need to be made and so far Miliband’s Labour has fluffed them. 

Iestyn Williams is a Senior Lecturer in Health Policy and Management at the Health Services Management Centre, University of Birmingham. He is involved in a range of research, teaching and knowledge transfer work and has a broad methodological experience and expertise. Current projects include an evaluation of a novel approach to public involvement in priority setting, and a national study of health care decommissioning.