Phoney Choices between Phoney Choices

Workers' Daily Internet Edition: Article Index :

Phoney Choices between Phoney Choices

Tony Blair took the government’s anti-social programme of "investment with reform" a stage further on June 23 when he set out his vision for the "recasting" of public services. He claimed that the consequence of "investment with reform" is that a change to the quality of public services can become "transformational". "People," he said "want a different relationship with the state today. It is about equity and excellence."

"Equity and excellence" is one of a range of formulas from Downing Street which are supposed to bring out differences between Labour’s vision for the health service and that of the Conservatives.

The Conservative health policy includes a pledge to abolish all central targets imposed on hospitals, including the star rating system and waiting lists targets. The Tories attempt to distinguish between the "phoney choice" offered to patients by Labour and their promise that patients can opt to go to any hospital within the NHS. In addition, people may be able to choose the private sector subsidised, with provisos, by the government. The Labour government defines the distinction as "the right to choose rather than the right to charge".

What is covered over in this "battle" are the matters of principle. Both "sides" vow that the issue is not that health care is a right and the government, as the representative of society, has the duty to provide it to all at the highest standard without discrimination. This is the principle of public services, and the state has the duty to provide them. In the "battle" between whether Labour or Conservative gives genuine "choice", it is taken as read that the private sector must be involved in public services, and that the laws of the market place be allowed to operate. This is the criminality of the proposals.

It is significant that the Prime Minister speaks of "equity" and not "equality" of excellence. There is an inbuilt discrimination in that the poor are not guaranteed a healthy environment, with adequate housing and equal opportunities, and even in terms of excellence the government’s goals remain a policy objective. Meanwhile, genuine choice whereby the people have control over the decisions over the healthcare they receive, and health workers and professionals participate in setting the agenda for the NHS, is missing.

When the Prime Minister speaks of accelerating reform to develop a "new generation of personalised services" he flies in the face of what is required of a modern health service, which is that the right of the people to health care must be guaranteed, and that health services must be provided when and where they are needed by the people. This is what is lacking in society, and this is what the people are demanding. They realise that the choice between the "choices" the two big parties are offering is itself phoney, and that indeed both are based on providing "equity with excellence". In other words those that are able to access excellence will do so whether by ability to pay or through their conditions of life, while there remain those who do not have that opportunity.

High quality, all-round, free, publicly provided health care must be guaranteed for all.