Absolutely the most important thing to do about the NHS, far more important than GP commissioning, internal markets and all the rest, is to break the national pay awards.
We do have regional and local labour markets, with different prices in them. That the NHS runs a national labour market means that high cost areas cannot get the staff they need: yes, this does kill people.
There are also plans for hospitals to become mutuals, adopting a John Lewis-style model where a medical centre would be owned by the staff. However, such a move would be fiercely resisted by trade unions as new employees would be shut out of the NHS pension scheme and the plan would introduce variable pay schemes across the NHS. Some have pointed out that the one-size-fits-all model has cost lives. Recent research shows that not being able to vary pay has meant that hospitals \”in tight labour markets\” have higher death rates and lower productivity.
However, simply announcing the end to national pay bargaining would produce a national strike.
Which means that Lansley\’s being rather clever here. If hospitals are to become mutuals, something which every lefty seems to desire in other areas of the economy, then the end of national pay bargaining comes as a side effect of that. Which sets up an interesting tension for those who would protest about it really.
So, you prepared to give up 1.4 million people getting control of their working lives, ownership even of their workplace, purely to oppose the end of national pay bargaining?