Unhealthy Speculation

Patsy Hackitt, the Nurses' Friend, has hurried to calm malicious rumours that the Government means what it says. An advertisement in the Official Journal of the European Union invited private companies to enter "competitive dialogue" (as opposed, presumably, to entering mere sordid competition) and tender for "a comprehensive range of management services including primary care trust management and related services". Of course, this was not an accurate reflection of government policy. It was probably all Ms Hackitt's secretary's fault. In fact, they probably didn't even pay for the advertisement.

Nevertheless, Ms Hackitt has felt obliged to extrude a rebuttal of "reports in some newspapers", said rebuttal to be printed in tomorrow's Guardian, where I trust no evil-minded and irresponsible commenters will be tempted to post the words "clap ... clap ... clap" beneath the health secretary's doubtless effortful outpouring. The rebuttal repeats the mantra that the government "is committed to a publicly funded health service that is free at the point of use and available to all, regardless of means." Leaving in charitable abeyance the question of whether any sane, bribe-free adult can believe anything the government says, it is noticeable that the mantra does not commit the government to anything so exotic as quality of service, meeting the needs of communities, or treating staff like human beings. It matters little that the NHS is publicly funded if the public funds are being channelled into PFI hospitals with swishy corporate logos outside and no particular interest in the people they are supposed to be serving. It matters still less that the NHS is free at the point of use if the point of use is understaffed, overworked, and pullulating with corporate middle-management Grins of Reassurance™.

Ms Hackitt further states that "there is no question whatsoever of 'privatising' the NHS," and the inverted commas are immediately noticeable. If there is no question of privatising the NHS, why not say there is no question of privatising the NHS? Does Ms Hackitt have her own special definition of "privatise", like Condoleezza Rice with "torture"? If so, do we get a prize for guessing what it is? If there is no question of "privatising" the NHS, what precisely is it that there is no question of doing?

Not much, it appears. Ms Hackitt says that primary care trusts, the local bodies responsible for purchasing health care services "can never outsource this responsibility, or ask others to make these decisions for them", but on the other hand, will be able to "buy in outside help to improve their commissioning role". Perhaps they will be permitted to consult multinational companies as philanthropic as the one owned by Riley Bechtel CBE, or as dedicated to the country's best interests as the foreign conglomerate which owns Thames Water.