Glimpses into the future
Authors: W. Russell
Journal: BMJ (1980)

The reorganisation of the NHS presented the Opposition with something of a problem when it came to deciding how to react to Mr Patrick Jenkin's statement on his consultations about the proposals in Patients First. The difficulty is that Labour agrees that the NHS reorganisation carried out in 1974 by Sir Keith Joseph was a disaster and has to be changed. They even approve of the Government's plan to remove one of Sir Keith's three tiers. But if the end is acceptable, the means are not. Mr Roland Moyle, the former Health Minister, told me that one of the major reasons for wanting a reorganisation was that it would improve the morale of NHS staff. That, however, was just what the Government was not doing.  was refusing to give the staff the protection they were asking for. At the moment we are heading towards turmoil, he claimed. It is a very great pity that they have missed the opportunity to democratise the NHS. They also keep talking about the large sums of money being made available for patient care as a result of reorganisation, whereas in fact not much is going to be released. The Opposition is also critical of the Government's refusal to set up a staff commission to assist in the smooth transition for NHS staff from one job to another. So far as the Opposition is concerned, there is not much political capital to be made out of the changes to date. If, however, they do not  out as planned they will seize their chances with enthusiasm.  looks as if a rousing, indeed angry, debate on the NHS is on the cards for this year's Labour Party conference to be held in Blackpool at the beginning of October. The signs are all there in the resolutions published in the conference agenda. They show that feeling at the grassroots is running high, particularly over such issues as pay-beds and prescription charges. The resolutions actually go beyond present party policy and will, if approved, toughen it up considerably. Though Labour usually ends up debating a composite motion, it is based on the resolutions tabled in the agenda and the ingredients available are fairly potent. On prescription charges, for instance, the recent draft manifesto issued by the National Executive Committee simply promised that charges would be abolished progressively. The constituency parties, however, want immediate withdrawal and a return to a service free at the point of use funded by taxatiom The feeling on this issue is probably best summed up by the resolution submitted by Barking Constituency Labour Party, which complains that the latest increase will cause the needy to resort to self-doctoring. Harlow CLP's resolution says that as a result of the increases many will not be able to afford the medicine they need. On pay-beds the mood is the same. They want abolition forthwith. The party is committed to action, but it has still to be decided whether they will go for a quick chop, phase them out over a  short period without agreement, or seek agreement on a timetable with doctors. The resolution from the Confederation of Health Service Employees is critical of the NEC for spending so much of its time on the squabble about the reforms to the party's constitu tion instead of getting on with a new plan for the NHS. COHSE says that relatively little work has been done and calls for