Health off the shelf

Be it healthcare or hard boiled eggs, we, the public, are urged to take responsibility for our own health.

According to current Tory wisdom, it is our role as consumers to act in our best self-interest, and the role of government to ensure that a choice of goods and services is provided cheaply and efficiently. This is the scenario behind the recent white paper on the NHS: by creating an internal market within the health service, providers of healthcare will be encouraged to compete to ‘put patients first’ An injection of market principles and all will be well.

Mrs Thatcher believes ‘there is no such thing as society’ She lives in a world where people go into hospital ‘on the day they chose, at the time they chose.’ In this world – the world also of the white paper – there is no need to consider the collective priorities of the community as a whole. Delivering healthcare to the nation becomes little more than ensuring that our national chain of hospitals is always well stocked with the most popular medical lines.

But the fact remains that in the real world it is the most vulnerable in our society who have the least ‘purchasing power’ – and the greatest need for healthcare. What incentives are there in these proposals for providers of healthcare to ensure that ‘less profitable’ services such as geriatrics or mental health – services that have traditionally come a poor second to high-tech acute care – are provided adequately?

The recent debacle of the great egg affair did not inspire confidence in the market’s ability to protect the nation’s health. It seems the more we heard about the controversy, the less we actually knew. But it is clear that the bewildered consumer was relatively powerless in the fact of the vested interests of the food industry. As businesses compete with each other to give us the best (ie, cheapest) deal, and to maximise their own profits, health issues are simply not taken into account.

The cost of producing food we can eat without risking our health is likely to be passed on to the consumer. The government’s reluctance to regulate the food industry is entirely in line with its own philosophy; we will have to choose whether we want to – or can – spend more on safer food. This is the philosophy of consumer choice on which the white paper is based.

Our right to healthcare is more important than giving patients the same rights and guarantees as Sainsbury’s shoppers.

The government must be told we want a health service that meets our needs, not suits its pockets. We must tell it loudly and clearly.