The Changing Politics of New Labour: From ‘Reintegration Without Reorganisation’ to Retreading the Market Road

Abstract

Paton shows how New Labour began by claiming that it was going to ‘abolish the internal market’ but defined the latter in narrow terms as GP Fund-holding only rather than the purchaser/provider split per se. In 1997, New Labour promised to reintegrate the NHS without reorganisation but by Blair’s retirement in 2007 could be argued to have done the opposite. The chapter traces evolving policy, from the so-called Third Way’s rhetorical application to the NHS through the era of central targets to Labour’s own version of the market in 2002 and subsequently its re-launched ‘health reform programme’ in 2005/6. It traces the political crises and policy confusions caused along the way by policy overload, and shows that some solid policy achievement was cloaked in confusing and repetitive structural reform, especially in a vain attempt to make sense of ‘primary care commissioning’. Choice became the watchword, but after devolution in 1998, the UK other than England abandoned ‘market reform’ and yet there was no appreciable difference between patient choice in England and elsewhere in the UK.