I started my career in the National Health Service almost at the same time as Margaret Thatcher became Prime Minister in 1979. I saw her preside over chronic staff shortages, rocketing waiting lists, and the closures of wards and hospitals. I also witnessed first hand the beginning of the politics of dismantling the NHS and abandoning the principle of universal healthcare.
Thatcher repeatedly looked at replacing the NHS with a health insurance system, but each time was told that such a move would raise costs and be politically suicidal. She managed to introduce the internal market – doubling administration costs – and promote widespread contracting out of support services. But it was in fact under Blair and Brown that engagement with competition, market structures and supplier diversity grew, though the NHS was still identified as the preferred provider of healthcare.
Ultimately, Thatcher failed to realise her vision of ending the NHS as a publicly provided, publicly financed body. But it appears that David Cameron is about to fulfill it for her.
Read my full article which first appeared in Tribune, here.
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