Time’s up for the NHS monopoly

Is it time we faced up to the fact that the NHS itself is the reason for the continuous stream of scandals? It’s not just the Mid Staffs Foundation Trust, or the ‘Nicholson Challenge’ or ‘the reforms’, or ‘the culture’. The NHS suffers from systemic faults. Above all, the regular flow of defects and failures is what you would expect from a command-and-control regime that has a monopoly.

It’s not as though making this claim is new. The last Labour Government recognized the structural flaws in the NHS nearly a decade ago. The NHS Improvement Plan of 2004 specifically denounced monopoly: There would be ‘contestability … so that patients and the public, rather than monopoly institutions, can make choices about where, when and how care is delivered.’ Giving people greater personal choice would give them ‘control … allowing patients to call the shots about the time and place of their care, and empowering them to personalise their care to ensure the quality and convenience that they want.