Thankfully, David Cameron’s proposed changes to the way the NHS operates will only affect England (unless, of course, the Attorney General decides that ‘human rights’ demand that we are given the same ‘opportunity’ to ‘enjoy’ a free market health service!). The substance of what he said is not therefore relevant in Wales; but the words he used do have a degree of resonance.
He talked about the need to ‘modernise’ the health service, and to ‘transform’ it. These are two words which we hear a lot in other contexts as well. They’re words with positive connotations, of course – who wouldn’t want to ‘modernise’ something, for example? It’s only when he starts to spell out what he means by modernisation and transformation that any doubts start to arise.
The point is that both modernisation and transformation are processes, not outcomes; it’s an important distinction but not always a clear one. Modernising something, and transforming it from one state to another, sound like an offer of radical change – and it may well be exactly that. But change, even radical change, isn’t always the same thing as improvement. We need to see the substance behind the rhetoric – and politicians aren’t always willing to reveal it.
We’ve had a classic example in Wales in recent years. The Welsh Government’s plans for ‘Transforming Education’ sounded like a good idea; but the plan turned out to be something of a euphemism for encouraging county councils to close schools, abolish sixth forms, and ignore the demand for Welsh medium education. Similarly, Cameron’s plans for ‘modernising the NHS’ seem to be a euphemism for privatising large chunks of it, and extending the internal market which is the legacy of Thatcher and Blair.
Words with a nice positive feel to them make for great political rhetoric, especially when worked on at length by the spin doctors; but Cameron’s announcement yesterday underlines that we need to ensure that we understand what they are really planning and aren't simply swayed by the words.
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