The battle of the NHS

Nick Clegg is at risk of being challenged by party rebels at the upcoming Liberal Democrat conference.

It’s a sentence that’s been used before over the last five years, during which Lib Dem activists uncomfortable with the direction of Coalition policy, and the role of Lib Dem ministers, have attempted to reposition party policy. This time, according to an article that appeared in Sunday’s Observer, party activists will challenge their leader on health policy and will attempt to engineer a situation in which the Lib Dems back a repeal of the Coalition’s NHS reforms and challenge the increased competition and opening up of the NHS market in an effort to outflank Labour.

The activists face an uphill battle and it’s worth remembering that similar efforts to scupper the Health and Social Care Act, the legislation behind one of the biggest ever restructurings of the NHS, were ultimately unsuccessful. But their efforts are noteworthy and a demonstration of how the health service will be one of the main and most contentious issues ahead of the general election next May.

The outcome of the general election will fundamentally affect the health service, both in terms of how it is funded and to what extent the private sector will have an opportunity to provide NHS services. If the Lib Dem activists are successful, then the party will stand opposed to increased private sector involvement – claimed by critics to be the privatisation of the NHS. Even if they are not, it is likely that the Party’s position will be less supportive than the Conservatives of the private sector delivering NHS services. For their part, Labour will likely retain Andy Burnham’s position of accepting some private sector involvement, but with the NHS as the ‘preferred provider’ of services.

It is going too far to suggest that, in the event of an outright Labour victory or a Lib-Lab coalition, the NHS will become a market closed to the private sector. The ever-increasing demands on the health service will continue to require a growing level of private sector involvement, particularly given the threat of a £30 billion funding gap in the NHS that will not be solved by simply increasing its budget year on year. But there will be implications for the private sector companies currently delivering, bidding for or planning to bid for NHS services after May 2015.