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David Walker: The corridors of power ...

Labour MPs are pinching themselves. The government has raised taxes and lived to tell the tale, the Tory press are nonplussed, people tell pollsters they like the Budget and higher rate taxpayers say they will grin and bear it, for the sake of the NHS.

Even the naysayers of the business sector, who are carrying the can, are muted in their opposition. It would be wrong to call the mood one of optimism, but after the lassitude of recent months, backbenchers have a spring in their step. But now comes the hard part, translating the loot into visible improvements. The key word is visible.

Gordon Brown is said to be keen on independent data so he can make an objective appraisal of where the money is going. Alan Milburn, health secretary, is not so keen on letting auditors tell the public whether his targets are being met and wants to keep control.

Some MPs say that as soon as the public sniffs the new coat of paint and sees the new defibrillators they will think things are improving.

In other words, subjective impressions will be most important, politically speaking. If you see the doctor’s receptionist typing into a computer, they won’t mind having to wait to see a doctor. (For suppliers of equipment to the NHS a bonanza is on its way: the spend on ICT alone over the next five years will be of the order of £13bn.)

Whether they are listened to by the politicians or the public, the bean counters are going to enjoy a boom. If Enron has caused a bout of anxiety among private sector auditors, the Blair government’s faith in the auditing function in general reaches new heights.

Health’s regulatory apparatus is being rejigged, leading to the creation of a new Commission for Healthcare Audit and Inspection to do value for money and clinical rather than financial audit (which will continue to be the province of the Audit Commission). All ways there will be more jobs on the fringes of health care provision. And more grateful Labour voters?

  • David Walker writes for The Guardian.

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