The present mess that is the NHS can be substantially blamed on Patricia Hewitt. The article below appeared in The Guardian in 2005. It is well worth re-reading:
Another foot up the greasy pole
The health secretary's 'flexible' views undermine her credibility
Monday July 25, 2005
One Friday afternoon in early October 1983, Neil Kinnock and I sat, drinking beer, outside the Grand Hotel in Brighton. We were providing a "photo opportunity" to illustrate how the leader of the Labour party and his deputy - recent opponents in the leadership election - would work in perfect harmony. We had more in common than the assembled journalists realised. Neil Kinnock had just read me a letter that Patricia Hewitt had sent him earlier in the week. It expressed the devout hope and profound conviction that he would lead the party and offered her services as his press secretary. I had received an identical letter.
Ms Hewitt got the job so, during the next nine years, I had a grandstand view of her modus operandi. Not once, in good times or bad, did I doubt that she possessed outstanding ability. As she made her irresistible progress into the cabinet, my judgment about her talent was confirmed. Only one thing - apart from her patronising manner - stands in the way of her achieving even greater success. The "flexibility" that enabled her to pledge allegiance to both Kinnock and me undermines her credibility.
The quality that facilitated her journey across the whole social democratic spectrum was on display this week in an interview she gave to the New Statesman. Only an idiot - which she is not - could honestly reject "the proposition that we would have been safer if we had not done what we did in Iraq". It is possible to argue that the threat of terrorism should not have deterred Tony Blair from a war that he believed to be right. But the contention that the bombs are not the consequence of coalition membership is clearly absurd.
However, having got the officially sanctioned nonsense out of her system, Ms Hewitt produced some freelance wisdom that made me glad that she is secretary of state for health. Labour, she said, has an opportunity to "put a core proposition of policy beyond attack". The government has won the argument about public expenditure. The promised reduced taxes in return for lower investment in health and education no longer wins votes. If the money is wisely spent, "we can win again to assert the argument over the role of the state".
Ministers' unscripted comments should not be examined with the textual care that was once afforded to the Dead Sea Scrolls. And Ms Hewitt's reference to the "role of the state" - reasserted after Labour "wins again" - is far from precise. But by using a word that New Labour usually regards as pejorative, she was acknowledging that the community as a whole (which is all that the state amounts to) has duties that transcend meeting the demands of the vocal and influential middle classes.
Then the self-adjusting mechanism that keeps Ms Hewitt on message kicked in again. The state, she argued, has a duty to diminish the power of the community to meet need and replace it with the ability of individuals to compete for public services. For that is what "choice" - the mantra of all good Blairites - amounts to. It is why, as she rightly said, "social democrats have never liked choice in the public services".
It must be admitted that she set out the case against choice with great distinction. "There were fears that it would be exploited by the middle classes, that it would lead to a two-tier service." On the assumption that she holds regular advice bureaux in her Leicester constituency, she must know that to be true. Surely, for example, she meets small groups of self-confident parents who argue their children's way into "better" schools for which they were not originally destined.
Only the knowledge that she is talking nonsense can explain the fatuity of her arguments against the social democratic view. It is, she says "patronising". Perhaps. But it is also accurate. Then the secretary of state for health sank to even greater depths of absurdity. Believe me, she really said: "The more people say: 'I might go somewhere else', hospitals which aren't up to scratch will have to improve or risk losing patients." That is the argument for the market economy applied, without amendment, to the provision of public services.
Of course, it would not work. What would happen to the hospitals that "lose patients"? Would they close down like a bankrupt supermarket or stagger on half-empty, short of staff, increasingly inefficient and with continually diminishing esteem? Would it not be better for the Department of Health to bring pressure to bear for their improvement?
Perhaps even now, Ms Hewitt regrets that she talked such rubbish. She cannot believe what she said makes sense. Because of her obvious ability, it is generally assumed that her "flexibility" is a product of her ambition. Ironically, that assumption will stand in the way of her progress. Perhaps I ought to write her a letter offering my help in her attempts to climb another foot up the greasy pole.