A Blairite before Blair?
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《英国医生杂志》
The new health secretary, Patricia Hewitt, is prepared to take forward the New Labour agenda but should not be seen as anybody's poodle. Nick Timmins reports
In Patricia Hewitt, the new secretary of state for health, the NHS gets a good brain capable of fierce analysis, allied to a public manner that her critics describe as headmistressy or nannyish. It also gets a battle hardened survivor.
Such skills look likely to be needed if, as Hewitt has indicated, she intends to see through the government's market based reforms of the NHS to their logical conclusion.
Her first move was bridge building: the weekend of her appointment saw phone calls to, among others, James Johnson (the chairman of the BMA's council), Dame Gill Morgan (chief executive of the NHS Confederation), and Dave Prentis (the general secretary of the trade union Unison), asking them what they saw as the key issues and expressing a desire to work with them.
The first indications, however, are that Hewitt will work to an unchanged government agenda, with Hewitt picking up Tony Blair's language of a patient centred NHS, one where services are organised around the patient and for their convenience, rather than around the convenience of the organisation itself.
She wanted, she said, to carry on the "direction and pace of reform" as set by her predecessors John Reid and Alan Milburn, with the tenure of Frank Dobson, the vigorous opponent of foundation hospitals, the NHS market, and the greater use of private providers quietly airbrushed out of Labour's recent history.
Patricia Hewitt, is, however, a formidable politician. She is a survivor of the Kinnock years, when she was the then Labour leader's press secretary from 1983 to 1987 and subsequently a policy coordinator when the really hard work was done to drag Labour back to being a party that was electable. She had a bruising time at the hands of the parliamentary lobby, who did not take kindly either to her lack of journalistic experience or to the fact that she was a clever woman. She fought through, however.
And she has just survived for four years in her most recent post as secretary of state for trade and industry, a job where it is difficult to cover yourself in glory but awfully easy to foul up. As she herself notes, she was the longest serving minister at the Department of Trade and Industry (and its equivalents) in almost 50 years.
This, quite rightly, suggests a certain grittiness to go with the laughter lines, the big wide smile, the occasional sudden flash of temper, and a fierce intelligence. Born in Canberra in 1948, the daughter of Sir Lenox Hewitt, a civil servant who was the equivalent of the British Cabinet secretary, she went to Australia National University in Canberra and then did an MA at Cambridge, worked for Age Concern, and for almost a decade was the general secretary of the National Council for Civil Liberties, a post where she was seen as sufficiently left wing for it to be said that MI5 held a file on her.
After her time with Kinnock, when she was, in a sense, a Blairite before Blair, her brain was put to use as the founding deputy director for the Institute for Public Policy Research, the think tank set up to provide for the left the inspiration that the Tory think tanks had delivered for Margaret Thatcher.
She was also deputy chairwoman and a driving force behind Labour's Commission on Social Justice. Appointed by John Smith, the then Labour leader, to "think the unthinkable" about welfare state reform, the commission's findings were dismissed at the time as no new Beveridge report. In hindsight, many of Labour's themes of rights and responsibilities and welfare to work can be found in it. Between 1994 and 1997, when she entered parliament, she was head of research for Andersen Consulting, the management consultancy that is now Accenture, a job that gave her an insight into global business.
During that period, in 1995, she was deputy chair of the controversial Healthcare 2000, an examination of the NHS financed by the pharmaceutical industry that was chaired by Sir Duncan Nichol, the former NHS chief executive who had joined the board of the healthcare company BUPA. Among other options, it canvassed the idea of a reduced "core" NHS, with patients able to pay extra for faster treatment and non-core services.
Last week, she said, "That is not a position that I ever personally supported." At the time, she said, plenty of analysts argued that funding was too tight and that no government would ever raise the taxes needed to fund the NHS properly. "The debate was, `could the NHS survive?' " She argued that Labour has shown it can. That extra money and reform can indeed "create a tax funded NHS, free at the point of care, that really meets the needs and wishes of patients."
Patricia Hewitt: "I am not going to force patients to choose services they don't want"
Credit: MAX NASH/PA/EMPICS
And that is her starting point. Her opening moves have been to confirm that the already promised fresh round of independent treatment centres will go ahead, along with other contracts worth ￡3bn ($5.5bn; 4.4bn) over five years and treating an extra 1.7 million NHS patients. With contracts already announced, the private sector is now set to gain at least ￡6.6bn of business from the NHS over the next five to six years.
Hewitt had the courage to confirm these promises in public at the NHS Employers conference in her first week in office—and take some fierce criticism from union representatives there that the money should instead go into clearing NHS deficits. And yes, she said, if NHS hospital services cannot compete, then her view—like John Reid's—is that they may close. "I am not going to force patients to choose services they don't want."
But if Hewitt was in some ways a Blairite before Blair, it would be a mistake to view her as merely her master's voice. She differs, for example, on identity cards. She has the intellect and technical ability to grapple with payment by results and its implications. She recognises the training claim on the private sector. And her relationship with Gordon Brown—she was a Treasury minister in Labour's first term—are sound.
The challenge is formidable—to take NHS staff with her into a world that will be even more challenging to some of its institutions and many of its employees than even the past few years have been. It will test her analytical abilities and her presentational skills, as nothing has before. This time she is really in the spotlight.(Nick Timmins, public policy editor)
In Patricia Hewitt, the new secretary of state for health, the NHS gets a good brain capable of fierce analysis, allied to a public manner that her critics describe as headmistressy or nannyish. It also gets a battle hardened survivor.
Such skills look likely to be needed if, as Hewitt has indicated, she intends to see through the government's market based reforms of the NHS to their logical conclusion.
Her first move was bridge building: the weekend of her appointment saw phone calls to, among others, James Johnson (the chairman of the BMA's council), Dame Gill Morgan (chief executive of the NHS Confederation), and Dave Prentis (the general secretary of the trade union Unison), asking them what they saw as the key issues and expressing a desire to work with them.
The first indications, however, are that Hewitt will work to an unchanged government agenda, with Hewitt picking up Tony Blair's language of a patient centred NHS, one where services are organised around the patient and for their convenience, rather than around the convenience of the organisation itself.
She wanted, she said, to carry on the "direction and pace of reform" as set by her predecessors John Reid and Alan Milburn, with the tenure of Frank Dobson, the vigorous opponent of foundation hospitals, the NHS market, and the greater use of private providers quietly airbrushed out of Labour's recent history.
Patricia Hewitt, is, however, a formidable politician. She is a survivor of the Kinnock years, when she was the then Labour leader's press secretary from 1983 to 1987 and subsequently a policy coordinator when the really hard work was done to drag Labour back to being a party that was electable. She had a bruising time at the hands of the parliamentary lobby, who did not take kindly either to her lack of journalistic experience or to the fact that she was a clever woman. She fought through, however.
And she has just survived for four years in her most recent post as secretary of state for trade and industry, a job where it is difficult to cover yourself in glory but awfully easy to foul up. As she herself notes, she was the longest serving minister at the Department of Trade and Industry (and its equivalents) in almost 50 years.
This, quite rightly, suggests a certain grittiness to go with the laughter lines, the big wide smile, the occasional sudden flash of temper, and a fierce intelligence. Born in Canberra in 1948, the daughter of Sir Lenox Hewitt, a civil servant who was the equivalent of the British Cabinet secretary, she went to Australia National University in Canberra and then did an MA at Cambridge, worked for Age Concern, and for almost a decade was the general secretary of the National Council for Civil Liberties, a post where she was seen as sufficiently left wing for it to be said that MI5 held a file on her.
After her time with Kinnock, when she was, in a sense, a Blairite before Blair, her brain was put to use as the founding deputy director for the Institute for Public Policy Research, the think tank set up to provide for the left the inspiration that the Tory think tanks had delivered for Margaret Thatcher.
She was also deputy chairwoman and a driving force behind Labour's Commission on Social Justice. Appointed by John Smith, the then Labour leader, to "think the unthinkable" about welfare state reform, the commission's findings were dismissed at the time as no new Beveridge report. In hindsight, many of Labour's themes of rights and responsibilities and welfare to work can be found in it. Between 1994 and 1997, when she entered parliament, she was head of research for Andersen Consulting, the management consultancy that is now Accenture, a job that gave her an insight into global business.
During that period, in 1995, she was deputy chair of the controversial Healthcare 2000, an examination of the NHS financed by the pharmaceutical industry that was chaired by Sir Duncan Nichol, the former NHS chief executive who had joined the board of the healthcare company BUPA. Among other options, it canvassed the idea of a reduced "core" NHS, with patients able to pay extra for faster treatment and non-core services.
Last week, she said, "That is not a position that I ever personally supported." At the time, she said, plenty of analysts argued that funding was too tight and that no government would ever raise the taxes needed to fund the NHS properly. "The debate was, `could the NHS survive?' " She argued that Labour has shown it can. That extra money and reform can indeed "create a tax funded NHS, free at the point of care, that really meets the needs and wishes of patients."
Patricia Hewitt: "I am not going to force patients to choose services they don't want"
Credit: MAX NASH/PA/EMPICS
And that is her starting point. Her opening moves have been to confirm that the already promised fresh round of independent treatment centres will go ahead, along with other contracts worth ￡3bn ($5.5bn; 4.4bn) over five years and treating an extra 1.7 million NHS patients. With contracts already announced, the private sector is now set to gain at least ￡6.6bn of business from the NHS over the next five to six years.
Hewitt had the courage to confirm these promises in public at the NHS Employers conference in her first week in office—and take some fierce criticism from union representatives there that the money should instead go into clearing NHS deficits. And yes, she said, if NHS hospital services cannot compete, then her view—like John Reid's—is that they may close. "I am not going to force patients to choose services they don't want."
But if Hewitt was in some ways a Blairite before Blair, it would be a mistake to view her as merely her master's voice. She differs, for example, on identity cards. She has the intellect and technical ability to grapple with payment by results and its implications. She recognises the training claim on the private sector. And her relationship with Gordon Brown—she was a Treasury minister in Labour's first term—are sound.
The challenge is formidable—to take NHS staff with her into a world that will be even more challenging to some of its institutions and many of its employees than even the past few years have been. It will test her analytical abilities and her presentational skills, as nothing has before. This time she is really in the spotlight.(Nick Timmins, public policy editor)