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Think tanks are hijacking health service debates

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I’ve always thought the only difference between a ‘think tank’ and some people down the pub having a chat is that the people down the pub don’t tend to have their own letterheads.

However, if someone somewhere is giving you money and a name and presumably all the biscuits you can eat there must be a purpose behind your existence as a think tank and as it can’t possibly be your ideas because those ideas are plainly absurd what might it be?

This week, ‘think tank’ the Social Market Foundation suggested that patients should be charged £20 to visit their GPs in a bid to reduce demand on NHS services and who knows, maybe make a few quid.

Obviously children or people receiving tax credits wouldn’t have to pay (these think tank people are not barbarians) but everyone else would. Now, as ideas go this one is right up there with selling your fingers so you can afford to buy a typewriter.

We spend 15 years trying to reduce the costs of hospital and long-term care by encouraging contact with GP services and then a think tank tries to undo all that with a single stroke, creating the circumstances where people have to choose to either shop or go to the doctor. That will reduce the number of people in waiting rooms but increase expenditure on hospital care not so far down the line. And one would imagine that even groups like this one - who tend to think people are essentially an irritant to the pure science of economics - know that an idea like that is absurd in itself. And so, one wonders, why do they suggest it?

One possibility is that it changes, ever so slightly, the nature of debate about NHS spending. Up until recently politicians have argued over who would be nicer to the health service in 2011 as they sought to reassure public sector workers and a worried electorate that while things are going to be difficult somehow it won’t affect patients or services all that much.

“If the NHS is under threat it needs advocates, people to defend and develop the best of it in the face of attack.”

However, they aren’t being all that convincing. So next comes an array of suggestions preparing us perhaps for cuts, additional costs, new types of suffering. They may not all happen and so maybe we will ultimately be grateful for that but slowly the agenda is being set and worryingly nurses are not contributing to it.

A day or so later two more ‘think tanks’ (I wonder if they have their own quiz nights?) The King’s Fund and The Institute For Fiscal Studies said the NHS should now start preparing for the budget deficit it will experience in 2011.

And so it should, but with think tanks queuing up to suggest how we do it, shouldn’t nursing be asking if it needs its thinking done for it by organisations like the SMF? If the NHS is under threat it needs advocates, people to defend and develop the best of it in the face of attack. Somebody to point the axe away from clinical services perhaps and at bureaucracy and micro management, for example. Surely nursing needs to be at the heart of that debate. And so the real question is: why aren’t we?

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