We have now had 2 national TV debates between the leaders of the three main parties and surprisingly the also ran third party leaders is coming out in front making the other two parties and their leaders worried about what this means for them. They have adjusted their delivery and rubbished the third party policy content but still the novelty of the untried is appealing to the voters. This may mean that the landscape in British politics is about to shift as it did when Labour moved into the opposition role at the beginning of the 20th Century only time will tell, however what is certain is that the next government whichever colour will bring with them profound shifts in funding to the public sector and health in particular. Can the NHS remain a national service in terms of coverage not just of the population but also of the treatments it provides or will some treatments have to be "privatised"? We will not know for a little while yet but conversely as the pressure mounts to control such costs we can expect some evidence of both a tightening of control from the centre and perhaps at the same time the casting off into the sea of supply and demand some NHS services.
Healthcare is of interest to the whole population and some sections can express this interest louder than others, but not always those in greatest need, we only have to look at the fiasco that is currently social care to see what the effects of private responsibility are, costly, unfair and unjust. If we have any doubts about the way we run things and what alternative options we have, it is interesting to remember that both the USA and Australia are now flirting with forms of universal coverage which is not only the most compassionate way to run things it is also the most economical, and moves provision from the chaotic to the complex. So lest we forget the ranting hysteria of interest groups in the US which made the passage of the Obama bill to provide coverage such an unpleasant spectacle, we must remember we are still two nations separated by the same language, and cultural differences may be more profound than they appear; a further and more immediate example of this difference is an american colleague recently stranded in the UK on University business with VAT (Volcanic Ash Trauma not Value Added Tax) who had no insurance cover, this is a situation which could not happen in the UK where Universities have employer responsibilities under various legislation to ensure coverage. In the language of Cynefin making assumptions about the ability to transpose from one domain to another may be more complicated than it appears which ever way you are moving.........
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