“A decent society looks after its people” is the moralising title of Labour’s latest celebrity election broadcast about the NHS, starring comedian Jo Brand.
That Jo Brand is a loyal supporter of the Labour Party hardly comes as a shock – the comedian was a supporter of the People’s Assembly anti-austerity coalition, and performed at the Stand Up Against Reality Austerity gig organised by that group last year. And credit where credit is due: she puts her time and money where her mouth is, supporting a cause she believes in. But unfortunately, in the case of Labour Party scaremongering about the NHS, that cause is a blatant falsehood.
Brand opens Labour’s latest celebrity ad with one of those “oh! fancy seeing you here” introductions, as though we were the last people she expected to encounter as she exercised on a lone cross-trainer slap bang in the middle of a brightly lit TV studio:
“There’s an election coming up. You might know that. And we all have our own personal axes to grind. Mine is what’s gonna happen to the NHS. Not because of my undeniable status as a national fitness icon, but because once upon a time I used to be a nurse.”
Establish credibility? Check.
When debating healthcare reform in Britain, nothing sweeps away logical debate and replaces it with hushed reverence more effectively than uttering the words “I’m a nurse”, or “I’m an NHS doctor”. Suddenly the speaker becomes an oracle, imbued with deep and mystical wisdom about national healthcare policy thanks to their selfless occupation on the front lines of clinical care.
If you are employed by the NHS, that huge organisation, the largest employer in Britain and fifth largest in the world (just behind McDonald’s), is there not the slightest possibility that working for such a vast branch of government – with a bureaucratic life of its own and a very strong survival instinct – and relying on it for your pay cheque just might skew your judgement when it comes to changing structures and working practices? Apparently not.
Regardless, Jo Brand then whips out the first of her many personal axes to grind:
“And by the way, I’m sick of the way nurses get slagged off all the time in the press. I mean, come on! The vast majority of them are hard working, committed, amazing human beings. Because to my mind, a decent civilised society looks after its people when they are ill, and doesn’t present them with a bill at the end of it.”
Nurses being “slagged off” in the press – is that a thing? This blog struggles to remember a serious spate of anti-nurse pogroms roiling Britain since David Cameron became Prime Minister, though many people did raise sensible objections when it turned out that some nurses – now affectionately known as Jane Pilgrims – take a full time salary from the taxpayer while spending all their time doing union business, and no nursing.
As for the horrifying spectre of receiving a bill after getting treatment, this is a favourite dystopian scenario of the British left, who love to present healthcare reform as a binary choice between “our NHS” which is to be worshipped and venerated at all times, and the “evil American” system where road traffic accident victims supposedly have to swipe a valid credit card before the paramedics will scrape them off the pavement and cart them to hospital.
Of course, in truth the NHS is not as wonderful as its hagiographers claim, and the American system (for all its many, many flaws) is not quite as dystopian as the British left like to imagine. But let’s not let the truth get in the way of a good left wing scare story.
Now we come to the meat of the broadcast, and the moment when Jo Brand finally takes leave of the realm of facts, or even conjecture, and enters left wing fantasyland:
“But what I’m seeing now is little by little the NHS being pulled apart. By whom, you might ask. A clue: it’s not the Labour Party, they started the whole thing. If you’ve tried to get an appointment with your doctor, or been to an A&E recently, you’ll know. Things are in a right mess. What’s that mess all about? For a start, a ton of money wasted on a reorganisation so big you can see it from space, and so hard to understand you’d have to be Professor Stephen Hawking to get your head round it.
I give you: the Tory party. Let’s be honest about it. If they get back in, the NHS as we know it wouldn’t survive the next five years. Why? Because they’re planning even more extreme cuts, we know that. They don’t want to talk about it, but it’s not hard to guess.
What it boils down to is this: do we want a government that’ll back our NHS or not? I want to see our NHS make it to its hundredth birthday and get its telegram from the queen. Because that’s what it is, by the way, the NHS. It’s ours. It belongs to us all. We paid for it with our taxes. And we want to keep it safe in our hands, not theirs. And that’s why I’m choosing Labour.”
Now hold on just one moment. The Evil Tories did not invent the idea of private sector involvement in the NHS. Its use first exploded under the New Labour governments of Tony Blair and Gordon Brown, both through PFI initiatives to build new infrastructure and outsourcing of various support services.
The Conservative MP John Redwood made a good rebuttal when he wrote in 2013:
Whilst no recent government has and no future government after the 2015 election will seek to introduce charges or want to change free at the point of use, not all NHS care is delivered in NHS-owned establishments by directly appointed staff.
Again, the irony is that the accusers over privatisation, Labour, have in office bought in private sector care for NHS patients themselves, sometimes preferring a private sector contractor to their own in house staff. All major parties accept that it may be sensible to outsource catering, cleaning, legal work or even some clinical and medical services.
There is also one huge elephant in the room for those who claim to be against all private involvement in the NHS. That is the General Practitioner (GP) service.
The primary care GPs were never nationalised in the first place. To this day they remain as a collection of small businesses, running their own practises, with payments from the NHS under contracts for services they provide.
So the NHS has never been entirely state owned, with a core part of the overall healthcare service (general practitioners) staying as private contractors, and Labour introducing outsourcing – and good thing too. Labour – and apparently Jo Brand – are obsessed about who signs the pay cheque of the person delivering care, while conservatives are more concerned that the person deliver the best possible service, whether they happen to be employed by the state or a private company.
And will the Labour Party ever let us forget that they were the ones who founded the NHS back in 1948? Of course not – they have vanishingly few other significant accomplishments to their name since then, hence the need to continue banging on about their great triumph 67 years later, well into the twenty-first century.
Just because nationalised, state-provided healthcare was the best, most effective and humane method of healthcare delivery when a battered Britain was picking itself up from the ashes of war and the rubble of the Blitz does not mean that the same centralised, government-owned system – preserved as though in aspic – remains the best option in the year 2015.
It’s amusing that the political left instinctively recoil at the very mention of British exceptionalism in any sphere other than that of healthcare, whereupon they immediately adopt a holier-than-thou attitude to the rest of the world (but really America), refusing to learn from best practice around the world while cheering on mass public spectacles in praise of the NHS of a style that would pass muster in North Korea.
But this unthinking attitude can itself be dangerous, as the journalist Ian Birrell argues so effectively in his criticism of the NHS-worship during the London 2012 Olympics opening ceremony:
There is something strange in sanctifying a system for delivering health care. We do not venerate the schools that educate our children, let alone the Tube trains that transport us to work. If Paris had won the Olympics, there would have been no dancing doctors and giant baby in its opening ceremony, even though its insurance-based service is often judged the world’s best.
Unfortunately, Britain’s misty-eyed myopia over the NHS — which will intensify now it is an official part of our island story — is a delusional, self-defeating national tragedy.
As he sought to repair the damage done by his idiotic tweets, [Conservative MP Aidan] Burley insisted we all love the NHS. Wrong again. For some of us who have seen its underbelly, there is little love for this anachronistic institution. As the father of a child with profound learning difficulties, I have seen too many blunders, too much insensitivity and too little care for the most vulnerable to share the national religion any longer.
In the words of the father of another disabled child, it is sickening to endlessly hear the mantra of what a great institution the NHS is from people who don’t rely on it and are therefore not engulfed in a near-daily struggle against its inertia and ineptitude.
Inertia and ineptitude? Why, that almost sounds like characteristics of a government department.
But these real-world stories of people failed by NHS bureaucracy don’t fit in so nicely with Labour’s narrative of a plucky, hard-pressed but well functioning service threatened by the Evil Tories. Neither does the fact that while the NHS remains very impressive in emergency care, detection and treatment of serious conditions are verging on becoming a national disgrace.
And while people who love the NHS (you know the ones I mean – they change their profile pictures on social media to incorporate the NHS logo, an act we would call Orwellian were it any other government department) may hate Nigel Farage with a burning passion, the UKIP leader is not wrong when he spoke passionately last month about his own personal experiences:
In the NHS, the system is so battered and poorly run that unless you are really lucky, you will fall through the cracks. The NHS is, however, astonishingly good at critical care. But what testicular cancer taught me is that the NHS will probably let you down if you need screening, fast diagnosis and an operation at a time that suits you.
I know how sacred the NHS is to the people of Britain; everyone is frightened that it will be taken away. But the cost of that fear is that the political classes are terrified of even criticising it. The standard of debate about the NHS on programmes such as Question Time is risible. No one — whether Tory, Labour or Liberal Democrat — will have anything but praise for the doctors and nurses of the NHS. Then they get a round of applause and that is it. It is as if you cannot support something and criticise it at the same time.
Here’s the rub. Wouldn’t it be great if once, just once, we could actually debate healthcare during a general election campaign, as opposed to just reflexively praising “our NHS”? If we started with a blank sheet of paper and lifted our gaze to look at other prosperous first-world countries manage healthcare before sitting down to design a system, might we not come up with something better than the NHS, that cumbersome ball and chain tethered to our ankle by a well-meaning but short-sighted post-war government?
In the cheesy “behind the scenes” preview of Jo Brand’s anti-Conservative attack ad, Brand has this to say:
It wouldn’t take that much longer for the NHS to be almost completely dismantled by the Conservatives, and that could happen I think easily within the next five years, and I find that the most depressing thought ever.
I’m not a big fat liar! Well, I’m fat, but I’m not a liar [laughter]. Honestly, I’m telling you the truth.
Unfortunately, Jo Brand is a big fat liar. The big and fat part is absolutely fine – more power to her. But she will have to live with the fact that she has allowed herself to be used as a willing pawn in Ed Miliband’s shameless campaign of misinformation and fearmongering.
For whipping up unfounded public fear about “our NHS” – which will continue to exist and monopolise healthcare in Britain, for good or ill, just as long as the sun rises in the east – Jo Brand should be ashamed of herself.