I didnâ€™t get a chance to speak last night in the NHS debate at full council. In my speech I wanted to explore the policy background to Shaping a Healthier Future (SaHF). A bit wonkish maybe but if you look at the history of this project and the policy environment it becomes clear quite how venal Labour has been over the future of our hospitals.
Anyone with any knowledge of NHS finances knows that the SaHF programme is being driven by the Nicholson challenge â€“ a programme put in place in 2009 by the then Labour Secretary of Health, Andrew Burnham. It is designed to take out Â£20 billion in efficiencies and put it back into new services in order that the NHS can deal with new demand within a flat real terms budget.
It is quite easy to prove that this is Labourâ€™s policy â€“ they wrote it down on page 4:3 of their 2010 manifesto:
This is the Nicholson Challenge in black and white in the Labour manifesto.
It easy is to show too that this is the driver for Shaping a Healthier Future. Go to page 17 of the consultation document where it says:
So Labourâ€™s own policy has led directly to NHS NWL needing to find Â£1 billion of savings in North West London and hence this programme.
Now you might well say that the Conservatives didnâ€™t have to keep Labourâ€™s policy and that is a fair criticism. I might add though that Labour isnâ€™t proposing to find Â£20 billion to make Nicholson go away and that this sum is not far short of all council tax collected every year or all business rates collected every year. It is a truly large sum of money.
What is clear though is that if Labour had been in power the overall financial settlement for the NHS would not have been any better, indeed it might have been worse as the Conservatives have made keeping overall NHS spending rising in real terms into a totemic promise. SaHF would probably not have looked very different under a Labour government as it would have been the same set of managers working to the same set of constraints.
If it wasnâ€™t hard enough for the health service managers designing a response to Nicholson they also had to contend with the fact that Labour’s Alan Milburn signed off on a 35 PFI deal for the West Middlesex Hospital in 2001. Against that fixed constraint Ealing Hospital for one was always going to lose out.
So Labourâ€™s â€œTories close your hospitalsâ€ line is pretty much upside down. It is rare that a policy is so clearly and easily traceable from its effects on the ground back to the original decision. The stage was set by Labour and the only person listening to our borough is Jeremy Hunt.