Going their own way

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I confess that I quite enjoyed the sight of Cameron, Clegg, and their film crews being berated and told to leave by an angry doctor during their hospital visit yesterday.  There was a certain poetic justice in it, given that their visit was part of their efforts to sell their proposals to give doctors more power over what happens in the NHS in England.  ‘Be careful what you wish for…’ might just be ringing in their ears.

I’m not convinced that the much-trumpeted changes in the policy are as significant as the presentation of them might suggest.  The Conservatives want to present the changes as a result of listening to what people have to say, whilst the Lib Dems seek to present them as a Lib Dem victory within the coalition.  Labour of course simply want to be able to describe them as being a U-turn. 

The result is that all three parties have a vested interest in making out that the changes are significant – whatever the reality.  But the key principles – of extending the market approach and letting in more competition – seem to be unchanged. 

In that sense, the Tories have won.  They can always reintroduce a firm timescale later, and extend the degree of competition.  The Lib Dems have been bought off by being allowed to claim some sort of victory.  And Labour are left shouting on the sidelines, trying to oppose something which they’ve also described as being a U-turn from the original proposals.

It doesn’t affect us in Wales directly, of course.  But it is the biggest example yet that I can think of where the increasing divergence between NHS structures in Wales and NHS structures in England stems from a change made in England, rather than, as over the previous four years, from changes being made in Wales. 

It’s a clear case of ‘England going its own way on health’ (and why not, if it’s what they want), but I find it interesting that it doesn’t get presented that way.  It certainly would if it were Wales or Scotland introducing such changes.