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Last Updated: Friday, 23 November 2007, 13:53 GMT
Rolling back the NHS reforms?
David Thompson
The Politics Show

MRI scan
Scans form part of the services offered by independent centres

Is Gordon Brown ditching Tony Blair's NHS reforms? If he is, will the service get worse? We assess the situation...

You would not want Gordon Brown's Lottery numbers right now - if you saw him betting on black, you would put your Northern Rock mortgage on red.

To say the Prime Minister is having a bit of a run of bad luck at the moment could put you in line to win "Understatement of the Year".

And if this week was not bad enough, there are signs that, under the radar, a new set of thorns are being sharpened up for Mr Brown's side.

Some of the ultra-Blairites, the MPs, activists and blue-sky thinkers who really would have taken a bullet for Tony, are beginning to grumble.

At the moment, they are keeping their powder dry.

If you ask them to go "on-the-record" with their complaints, they say things like, "it's too early", "we'll have to wait and see", or "it's not the time - yet".

If you are feeling charitable, you might conclude that is because they want to give the Prime Minister a fair crack of the whip.

Breaking cover on health

If you are feeling cynical, you might think it is because they want to wait until he is well and truly down before they crack that whip across his shoulders.

Where some of the more upfront and plain-talking of Gordon Brown's critics are breaking cover is on the subject of public service reform - particularly in the NHS.

Alan Johnson and Gordon Brown
Alan Johnson has scaled back plans to expand the private sector's role

Recently, Alan Johnson, the Health Secretary, announced that plans to expand the use of the private sector in carrying out routine operations and scans were to be scaled back.

He said it was because a number of the proposed projects were either no longer needed to tackle waiting lists or because they did not represent value for money.

However some people in the private healthcare industry - and some senior Blairites - read it differently.

For them, it was an unfortunate step back from the reforming agenda driven through by Mr Blair in order to shake up public services, particularly the health service, and make them relevant to the 21st Century.

Pressure for reform

Lord Warner, the former Minister who was, to put it crudely, hired by Tony Blair to put a rocket up the NHS and make sure it stayed lit, told the Politics Show he was concerned at the change of direction.

"I think many people in parts of the NHS and certainly in the private sector, have been concerned there has been a change of direction; people do feel the foot has been taken off the accelerator, a little bit, in terms of contestability and choice, particularly contestability," he said.

"What we don't want , or what I don't want anyway, is a kind of second-rate Blairism, Blairism with the edges removed.
Lord Giddens

"It was always part of the message that the NHS needed to be gingered up a little bit with a wider variety of providers and that innovation often came from the providers who came from outside the NHS as well as inside the NHS.

"I think some of that commitment has been lost in terms of the signals that have been given," he told the Politics Show.

Lord Giddens, the academic who is seen by many as the "Godfather" of Blairism, is even more direct.

"I think at the moment we've got too much government by report and therefore many important decisions are being deferred until reports are made.

"I have to say that I expected Gordon Brown to come into government with a much more articulated programme than so far he's delivered and we're waiting to see what that programme will be, so I don't think we really know in any detail what his view of the future of the NHS or indeed the education system is," he told the programme.

He went on: "What we don't want , or what I don't want anyway, is a kind of second-rate Blairism, Blairism with the edges removed."

Changing language

But there are Blairites who disagree with that analysis - and not just because they are currently serving under Mr Brown.

Ben Bradshaw, the Health Minister, said that what is happening is not a change a policy - just a change of tone.

Ben Bradshaw

The policy is still the same... I think personally we are using a language that is more accessible to people and that means more to people
Ben Bradshaw, Health Minister
He told the Politics Show: "I think what a lot of people may have noticed is that, rather than talking about 'reform reform reform' for reform's sake, we're talking about waiting times, quality of care, performance and giving people better care. That doesn't mean we've changed the policy. The policy is still the same... I think personally we are using a language that is more accessible to people and that means more to people."

This may seem at first glance like a pinhead debate by two sides of the same coin, but it is important outside the Westminster bubble because, ultimately, it will decide how this government delivers on schools and hospitals - and that matters.

It may, however, be a debate the Prime Minister feels that, right now, he could do without.

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