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Brown is the new Blair

Lynn Young
Primary Healthcare Adviser for the RCN

The summer of 2007 brings a brand new Prime Minister in the form of the Right Honourable Gordon Brown. He is well known to us as Chancellor of the Exchequer, but now has a golden opportunity to imprint his legacy upon the nation. At the time of writing this article Patricia Hewitt remains the Secretary of State for health, but most of us in the health world anticipate that Mr Brown will quickly appoint a friend as a replacement. Rumours are currently spreading like a contagious virus about who this may be. I imagine that by the time this article is in print all rumours will have ceased as we will know the name of the new Secretary of State.

So, in the meantime, let us speculate on what life might be like in healthcare under the control of Gordon Brown. In the short term, Mr Brown will not preside over a happy and contented NHS. Nurses are still losing their jobs - many of them senior and specialist posts. Today, newly-qualified nurses struggle to find - not the job of their dreams - but any job that carries the title of nurse. Many of you will have heard Mr Brown recently announce his passion for improving education opportunities "for all" and that the NHS is his "immediate priority". Although he is quick to acknowledge the great improvements that the NHS has achieved since Labour took office in May 1997, Mr Brown is keen to point out that "we still have a lot to do to show people that the NHS is going to move into an era as a health service that is there for people when they need it".1

Brown and Blair hold completely different ideological views on how the public sector should be organised. Both gentlemen hold true to the notion that services must continue to be state funded at the point of need, but Mr Blair is certainly more willing to embrace competition and market forces in the public sector than Mr Brown. Indeed, Mr Brown has publicly stated that "the NHS is not easily subject to market solutions and there are limits of markets in healthcare for both finance and provision."2
Alternative providers have been moving into primary care for a number of months now and while we do not envisage a policy change to slow down competition and the tendering process, the pressure may come off once Mr Brown is in charge. But, on the other hand, maybe not. It is not unusual for politicians to hold a certain view when not in office, and then for it to change when power and control come knocking on their door.

It is an important time, though, to remember the measures taken by Tony Blair and New Labour to offer new opportunities to nurses. Way back in 1999, GP fundholding vanished to be replaced by primary care groups, where nurses took their place and then became members of the professional executive committees of primary care trusts. Mr Blair announced the introduction of the role "nurse consultant" at a Nursing Standard Nurse of The Year award ceremony in 1998, which took us all by surprise, and so did the introduction of the modern matron in the NHS Plan and community matron in the NHS Improvement Plan. Nursing has certainly developed and expanded in the last decade, making the current cuts in nursing posts and education budgets even more difficult to comprehend.

We need to look forward with hope and a spirit of optimism, in the belief that times will change, and that in the not too distant future the nursing profession will be in a fit state to travel into the promised land of improved health and healthcare, alongside diminished disease, suffering and premature death.