The Missing Link?
Edited by Christopher Pollitt
Chapter 18: The uses and abuses of historical context: a case study in the ‘mutualisation’ of public services
The Missing Link?
In 2003 a Health and Social Care bill was passed by the UK Parliament, bringing in foundation trusts that would reinforce the split between purchasers and providers of health care, and make the providers much more independent. The move was an unpopular one among Labour backbenchers, who threatened a revolt. It looked to them as if their government was going further in the same direction as the previous Conservative government had done in developing a real market for health care; semi-autonomous health trusts were being encouraged to apply for even more autonomy. The Bill was passed, and one of the deciding factors was a pro-foundation narrative that persuaded (or at least confused) the critics by claiming the reform was in fact a return to a much older Labour tradition. The legislation described the foundation trusts as being ‘modelled on co-operative societies and mutual organisations’. It was, in fact, the culmination of a deliberate process of narrative construction by the Co-operative Party, aided by some distinguished journalists and carefully timed reports from think tanks that looked to past history to justify a new policy. The argument was that we had lost something fundamental when, in the setting up of the welfare state in the late 1940s, the then Labour government had sidelined a ‘mutual’ tradition of working class self-help that had provided health care through friendly societies (Birchall, 2008).
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