To what extent and why do New Labours proposals for the NHS differ from those of the previous New Right Conservative Government?

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To what extent and why do New Labours proposals for the NHS differ from those of the previous New Right Conservative Government?

The creation of the NHS saw the state take on an interventionalist role providing healthcare which was fully comprehensive, universally free for all at the point of use and funded through national insurance and general taxation (Walsh et al, 2000).  After a period of consensus, successive governments have scrutinised the sector leading to its attempted reforms but it is argued that there is considerable continuity between governments regardless of the party in power (Baggot, 2007).  This essay will consider the proposals made by New Right and New Labour for the NHS, looking first at what influenced each party’s proposals.  The key area’s the essay will focus upon are the internal market, GP fund holding, Primary Care Groups (PCG’s) and preventative health to allow the interpretation of the extent to which New Labours proposals differ from those of the previous New Right Conservative Government.

When Thatcher began her first administration, the NHS was not meeting public expectations and problems with resources and funding were becoming increasingly apparent, with furious rows erupting over the issues between politicians and the medical profession (Leathard, 1990).  Thatcher considered a move to private health insurance which never materialised as it was widely rejected by her peers.  It is argued that Thatcher only stayed true to the core objectives of the NHS only because of the political damage it could do to the party if they were challenged (Lund, 2008).  The Griffith’s report of 1983 and American market economist Alain Enhoven were highly influential in what would become the most radical reforms ever proposed for the NHS.  The Griffiths report outlined how making the sector more business like, creating competition between providers and linking funding to productivity would strengthen the sector in terms of cost effectiveness as well as managers being introduced at every level to improve the quality of management.  Enhoven strengthened these ideas and discussed ways to mimic a market to make the NHS more responsive to its consumers, a purchaser provider split would help money to follow the patients, improving quality and cost effectiveness (Renade, 1997).  Further issues with bed reductions and the escalating pressure on services lead to the focus continuing on finding new ways to allocate funding and resources (Bochel et al, 2005).  The ideas around an internal market were to be the central grounding of the proposals made in the 1989 White Paper ‘Working for Patients’.  The main aims of the white paper were to: extend patient choice, devolve responsibility and secure better value for money within the NHS.  The key proposals to make these aims happen were the purchaser-provider split to increase best value, GP fund holding meant that money would follow the patient and medical audit to promote quality (Renade, 1997).  

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The Black Report of 1980 confronted the Conservative government with the effects of health inequalities and made a number of suggestions of how to reduce not just via health policy but also through other sectors such as housing.  This was ignored by the party even in the creation of ‘The Health of the Nation’ (1992). Although it illustrates a considerable shift in public policy under the Conservatives, it ignored many of the issues raised in the Black Report (Bochel et al, 2005).  It was on the other hand, seen to be ‘rolling back’ Thatcherism and stressed health rather than ...

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