Consumerism will kill the NHS

The Department of Health may have new ministers, but there will be no change in New Labour policy on public services. The development of market mechanisms in the NHS will continue, as the government seeks to shore up middle class support by pushing the NHS to become, in effect, a national insurance company brokering access to a range of health service providers.

That much was confirmed by Tony Blair in his speech to the Fabian Society in June. ‘New suppliers, injecting new ideas, greater choice, extra capacity and best practice from outside into the NHS,’ urged Mr Blair, forgetting, perhaps, the recent deluge of fraud cases injected into the US health care ‘system’ by for-profit health care companies.

The prime minister clearly sees consumerism as the next Big Idea for public services. ‘Choice and consumer power as the route to greater social justice not social division,’ he said, arguing that people want ‘the consumer power of the private sector, but the values of the public service’.

But do they? And will the move reform not just the NHS, but a whole swathe of public services, through encouraging us to see ourselves as consumers really work – or will it, paradoxically, make matters far worse?

There are good reasons to believe that, whatever the prime minister may believe, unleashing a ‘weapon of mass consumerism’ on the NHS will ultimately prove as deadly as a dose of anthrax. A recent report from think-tank Catalyst, by Catherine Needham, sets out clearly why this is the case.

As consumers, says Needham, we act alone, without regard for others, and our relationship with services is temporary and fleeting. We seek accountability simply though complaint, or the ability to take our custom elsewhere. Rather than participate actively in debating and shaping services, we become passive and, at worst, resentful when services fail to match to heightened expectations we have of them.

Ironically, then, to encourage consumerism may be simply to encourage dissatisfaction, while simultaneously discouraging the active citizenship needed to create a fairer and more interconnected society. ‘Consumer power’, as a route to social justice, will prove to be not miracle, but mirage.