By Debbie le Quesne

Birmingham the pivot for Baroness Thatcher’s health reforms

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Love her or loathe her, one thing’s beyond dispute: Baroness Margaret Thatcher transformed Britain – with Birmingham being a trigger point for her health policy which underpins NHS reforms of today.

Our media has probably given her more airspace and column footage that any Prime Minister before and since and even in death she continues to divide a nation. She was loved as a leader and reviled as a tyrant.

The Iron Lady who ruled for 11 years imposed her will on the nation — breaking the unions, triumphing in a far-off war, and selling off state industries at a record pace.

She had achieved so much in her political career, ironically scuppered by a poll tax mutiny within her own party. Her economic policies and drive to dismantle the Midlands’ metal bashing industries touched every home in the land and still does.

She pulled the teeth of the trade unions, destroyed the miners’ stronghold on a nation and set in motion a dynamic of free market enterprise that coined its own name – Thatcherism.

But what did this unyielding leader do for the care sector? I struggled initially to bring anything to mind, but then became aware that she was a prime mover in NHS reforms 25 years ago.

We all agree that the current NHS changes are the biggest in its history. In terms of scale that is certainly true, but the course for these reforms was set in the heart of Birmingham.

It was 1988 when Baroness Thatcher announced on the BBC Panorama programme that the NHS would face a fundamental review.

The trigger was a crisis at Birmingham Children’s hospital where heart operations had been postponed for lack of funding, putting young lives at risk. Already the Government had stumped up monies to for the NHS the year before as the demand for health care outstripped supply (nothing changes).

With £100m taken from the Treasury to bale out the NHS, the Conservative MPs were pushing for change and Baroness Thatcher set about to introduce the same disciplines of privatization to the service as she had instigated in other sectors.

The NHS had lurched from crisis to crisis during the 1980s and the Government had once more been forced to seek an extra £100m from the Treasury to bale it out.

The review ushered in the NHS internal market and the mechanism for competition.

In a nutshell, health authorities ceased to run hospitals but instead “purchased” care from hospitals that had to compete with others.

Every development in the NHS and private care since has been a refinement of this market structure.

Has it improved the NHS? Are we better placed now to deliver care? These are huge questions which only a nation can answer, but I think everyone would agree the health reforms were certainly not the centerpiece of her administration.

Rest in peace Baroness Thatcher, though I doubt she will as the debate about her life and work and its social and economic implications fills our TV screens and will continue to do so until her televised funeral.


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