Free at the point of delivery

The Tony Blair Institute for Global Change has produced a report which suggests a greater role for the private health sector. Wes Streeting, Labour’s shadow health minister seems to be in tune with this line of thinking although he claims he doesn’t want to see patients being forced into paying for healthcare. We’ll have to wait and see how long that resistance survives. Blair writes of the benefits that will come from each of us having a personal NHS account, which it seems will grant us more choice—indeed autonomy over health services and from whom we get them. This idea has been around for quite a while. Weren’t we supposed to be able to choose our own, preferred doctors and consultants under previous reforms? The idea that patients are well informed players (aka patients) in a properly functioning market place? This is one way the service would be enabled to draw in more private operators—all in the worthy pursuit of ‘freedom of choice’ - and who’s against that?
 
But a ‘personal NHS account’ (made possible according to Sir Tony by the marvels of digital technology) reminds me of something the Tories were bent on introducing into the education system back in the 1990s. Their 1997 manifesto said:
 
‘We will give more talented children, from less well-off backgrounds, the opportunity to go to fee-paying schools by expanding the Assisted Places Scheme to cover all ages of compulsory education, in line with our current spending plans. We propose to develop it further into a wider scholarship scheme covering additional educational opportunities. The freedoms and status of fee-paying schools will be protected.’
 
In other words, the Assisted Places Scheme would have been the foundation of a personal education account, allowing the consumer to enjoy the benefits of fee paying schools at the taxpayers’ expense, importantly maintaining the principle of ‘free at the point of delivery.’ But I’m sure that the consumer would be enabled to buy little extras, which in the case of the NHS could be a private room for example (and for starters).
 
It seems that digital technology has an unseen power to make our two main political parties speak the same language. Back in the somewhat pre-digital days of 1997, Labour’s famous ‘Five Pledges’ card, bearing Tony’s physog pledged, numero uno, to scrap the assisted places scheme and use the money saved to reduce class sizes. It did, and it did. Let’s see how in the digital age the parties, despite rhetorical differences, continue to merge. (N.B. I touched on this subject in an article in Lobster 86 at https://www.lobster-magazine.co.uk)