Introduction

In some ways, New Labour has presented a tale of two health policies. Inopposition, and in the early years of government, the general line was thatimproving the NHS required the abolition of the internal market rather thana major injection of extra resources. However, as the Conservatives found,claims of improved statistics of health policy failed to convince thepublic, who perceived that the service was getting worse. The mostsignificant evolution of New Labour’s health policy came not with theWhite Paper of December 1997, The new NHS: Modern,dependable (DoH, 1997), but two years later. The decision bythe Chancellor of the Exchequer and the Treasury to “stick to theTory spending limits” for the first two years of the New Labourgovernment meant that structural tinkering (as promulgated by the December1997 White Paper) did not materially change the public’s perceptionof the NHS. It was arguably an ‘evaluation’ in January 2000 bythe independent-minded Labour peer Lord (Robert) Winston in the NewStatesman that the NHS was in a worse state than the healthservice in Poland, and that New Labour had failed to keep its promises(including the abolition of the internal market) that prompted the secondphase (cf Timmins, 2001). Although some of this was later qualified, themessage was clear: the jewel in New Labour’s crown, the NHS, requiredsignificant polishing. This came in the form (first) of the PrimeMinister’s announcement of new money in February 2000 and (second) ofthe NHS Plan, announced in July 2000. This clearly shows that the contextfor New Labour’s health policy, and consideration of the future ofthe NHS, is the background environment of political economy (Paton, 2000,2001).

At one level, the key political objective for the NHS (Paton, 2001), in NewLabour’s eyes, is its preservation. However, at another level, thefact that New Labour claims that it had largely achieved its pledges onhealth before launching its NHS Plan (DoH, 2000) suggests that, in healthpolicy, New Labour may have met its more limited objectives yet failed toachieve much.