Stephen Hawking vs Jeremy Hunt: The Insidious Cult Of The NHS

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Stephen Hawking vs Jeremy Hunt, a beloved national treasure going up against somebody who actually knows a thing or two about healthcare systems – in NHS-worshipping Britain, this could only end one way

If your car breaks down in the middle of the desert, who would you rather have come to your aid – the world’s most famous and accomplished concert pianist, or a fully equipped mechanic with a bit of a bad reputation?

Unless you particularly want to die of dehydration amid the sand dunes you pick the dodgy mechanic every time. At least he has some experience with the subject matter at hand, after all. And would you listen to angry protestations from other people who said that the concert pianist was equally entitled to tinker with your car, just because he has been driven around in many cars throughout his career? Of course not. Making use of the functions of an automobile is not the same as understanding how a vehicle works or being able to diagnose technical faults with the engine.

And yet as soon as the national conversation turns toward Our Blessed NHS, this kind of common sense goes out the window. So desperate are many British people to receive confirmation bias-affirming propaganda about “Our NHS” that when theoretical physicist Stephen Hawking got into a debate with Health Secretary Jeremy Hunt on the subject of healthcare, people essentially chose the concert pianist over the mechanic. Proudly and unequivocally.

This is the mental poison spread by the Cult of the NHS. It warps thinking, is impervious to reason and transforms what should be a measured, rational and unemotional debate about how best to provide healthcare services to a country of 70 million people into a frenzied orgy of emotionalism and unconditional praise for government bureaucracy, combined with a seething intolerance of anybody who dares to question the status quo.

Most unbecoming for a scientist, Stephen Hawking leaned heavily on emotional rather than empirical arguments to make his case, writing in the Guardian:

Like many people, I have personal experience of the NHS. In my case, medical care, personal life and scientific life are all intertwined. I have received a large amount of high-quality NHS treatment and would not be here today if it were not for the service.

The care I have received since being diagnosed with motor neurone disease as a student in 1962 has enabled me to live my life as I want, and to contribute to major advances in our understanding of the universe. In July I celebrated my 75th birthday with an international science conference in Cambridge. I still have a full-time job as director of research at the Centre for Theoretical Cosmology and, with two colleagues, am soon to publish another scientific paper on quantum black holes.

Whereas in France, Germany, Australia, Canada or Japan he would have been left to die in the street? This is misleading, emotionally manipulative balderdash of the first order. Newsflash, Stephen Hawking – the NHS did not save your life. Doctors and nurses and technicians and administrators did. And all of these professions can be found outside of our own creaking nationalised healthcare system.

Universal healthcare and treatment free at the point of use are not innovations unique to the United Kingdom. Other countries manage to do it too, using a variety of different delivery models – many of which achieve better healthcare outcomes (ultimately the only thing that matters to patients) than Our Blessed NHS.

And Stephen Hawking knows this full well. Yet he is happy to take advantage of the British public’s sentimentality for the NHS and lack of awareness of healthcare in other countries to create a false impression that motor neurone disease patients such as himself – indeed, people suffering from any disease or injury – are somehow left to die on the street in other countries, and that it is only in socialist Britain that people enjoy modern healthcare. This is the kind of dishonesty and low skulduggery that belongs in the field of politics, not science. Hawking should be ashamed of himself.

But he isn’t done yet. He continues:

Last year my personal experience of the NHS and my scientific life came together when I co-signed a letter calling for healthcare policy to be based on peer-reviewed research and proper evidence. The specific issue addressed in the letter was the “weekend effect”. Jeremy Hunt, the health secretary, had claimed that thousands of patients died unnecessarily because of poor hospital care at the weekend, and used this to argue that we needed to implement a seven-day NHS. I had mixed feelings about the issue. Having spent a lot of time in hospital, I would like there to be more services available at weekends. Also, it seems possible that some patients spend more time in hospital than is necessary because certain diagnostic tests can only be done on weekdays.

However, as we showed in the letter, Hunt had cherry-picked research to justify his argument. For a scientist, cherry-picking evidence is unacceptable. When public figures abuse scientific argument, citing some studies but suppressing others to justify policies they want to implement for other reasons, it debases scientific culture. One consequence of this sort of behaviour is that it leads ordinary people to not trust science at a time when scientific research and progress are more important than ever.

Yes, we wouldn’t want to cherry pick evidence now, would we Stephen? Like resolutely pretending that the only alternative to the NHS is “a US-style insurance system”, conveniently ignoring the wealth of other examples out there?

But even more asinine than this is Hawking’s assertion that healthcare policy should be based on “peer-reviewed research and proper evidence”. This is all well and good as far as it goes, but we are talking about designing complex human organisations here, not conducting a controlled physics experiment.

The only peer-reviewed research and evidence that can possibly be brought to bear on the question of how to design an optimal healthcare system for a medium-sized advanced economy will come from the social sciences, which are inexact and often unquantifiable by their very nature. What’s more, in academia the social sciences are populated almost exclusively by leftists and are effectively locked into a self-perpetuating purity spiral. When there is no diversity of perspective or political thought in the field, how can one have the slightest confidence in the outcome of the resulting studies?

Do you really think that scientists check their political opinions at the door of the library or laboratory? If so, where were all the economists during the EU referendum declaring in TV interviews that Brexit might be bad for the economy but still worthwhile overall? They were nonexistent. Why? Because they all started from a place of liking the European Union and wanting Britain to remain a member. Facts and evidence which contradicted this desired outcome were determinedly pushed aside, again and again.

Oliver Norgrove gets it right on this point:

The other issue I have with Professor Hawking’s comments is that they essentially capture the nauseating emotional connection that Brits have with healthcare provision. It is odd because healthcare needs are, by their very nature, private and oughtn’t represent bargaining chips for politicians at election time. ‘Groupthink’ surrounding the NHS is rife and poisonous. I particularly loathe the term ‘our NHS’. In using it we promote unhealthy tribalism, which blockades against meaningful debate about how we improve a stagnant system of healthcare. Diluting this poisonous emotional attachment is perhaps the first step to achieving a market-based system, similar to those seen all around the continent.

Notice also the reliance upon using the American healthcare system as some kind of stick with which to beat free marketeers in Britain. It is as if there are only two structures globally, and we must protect one from becoming the other. Professor Hawking, a clever man, knows full well that by instigating comparison with the United States he can more aptly generate support for the maintenance of the NHS. Which I believe, given changes to demographics, life-expectancy and population-induced strains, is bad for our healthcare outlook.

Increasingly, academics believe that, almost by right, they are entitled to transfer their authority in a particular field to other fields, often for the sake of making noise and boosting their own public profile. This became especially apparent during Britain’s referendum on European Union membership. Of course, I am not saying that academics should not have the right to speak and be heard. Nobody values the importance of free speech more than I do. The issue is that by association alone they are afforded disproportionate exposure and their words a special (and often unwarranted) significance. This is damaging to debate as it promotes laziness and useless conventional wisdom.

And besides, Stephen Hawking doesn’t really want to design an optimal healthcare system. No, he is attached to the present system for emotional reasons, and is busy corralling facts and figures which confirm his own biases and preferences. A rational scientist would start with a blank sheet of paper, not a crayon drawing of the NHS logo with girlish hearts scribbled all around it, à la Hawking.

Yet Hawking preposterously claims to be a dispassionate observer in all this:

A physicist like me analyses a system in terms of levels of approximation. To a first approximation, one can see the situation facing healthcare in this country in terms of forces with different interests.

Quite. So let’s talk about the NHS Industrial Complex, that byzantine and interconnected web of special interests from pharma companies to suppliers to logistics providers to medical schools to clinical staff on the taxpayer dollar, to the army of administrators and bureaucrats required to run what is – astonishingly – the fifth largest employer on the face of the Earth. All of these actors have a vested interest in the current system perpetuating itself – it’s how they get their pay cheques and make their profits. Disruption to steady-state operations is therefore unwelcome and to be resisted at all costs, even if there are potential windfalls for patients.

But these are not the malevolent forces that Stephen Hawking wishes to discuss. He wants to go on a generic leftist rant about the “multinational corporations, driven by their profit motive” – forgetting that the profit motive he so despises helped to spur the development of many drugs and healthcare technologies which save lives every day. He also takes the economically illiterate view that there is a fixed amount of money in the economy and healthcare system, and that shareholder profit necessarily means less funding available on the front line. This is nonsense, as any sixth-form economics student could have explained.

Hawking ends his cri de coeur with this rousing message:

If that all sounds political, that is because the NHS has always been political. It was set up in the face of political opposition. It is Britain’s finest public service and a cornerstone of our society, something that binds us together. People value the NHS, and are proud that we treat everyone equally when they are sick. The NHS brings out the best in us. We cannot lose it.

Isn’t it funny that if you want to make an establishment leftist sound like a frothing-at-the-mouth Ukipper all you have to do is whisper the letters “NHS”, at which point they will immediately start ranting about British culture and values, the importance of our unique island history and our unquestioned superiority over every other country.

And yet we see smug, superior headlines from the likes of the Independent, sardonically declaring “It’s brave of Hawking to take on an intellect like Hunt“, as though Stephen Hawking’s brilliance when it comes to physics somehow automatically translates to the complex political and organisational considerations involved in healthcare reform. This is basic, superficial thinking of the first order – and yet nearly every newspaper clapped along like trained seals, without stopping to think whether Hawking really has any credentials to be pontificating on the future of the NHS. He doesn’t.

Stephen Hawking is little more than an NHS Ukipper, with no more right to meddle in British healthcare reform than your garden variety Ukipper should be allowed to go up against Michel Barnier in the Brexit negotiations. But his ignorance and emotional manipulation are given cover by a bovine public raised to worship the NHS unquestioningly, and by a sycophantic media who prefer to make smartass headlines about Jeremy Hunt’s intellectual deficit rather than stopping to question who makes the better argument.

And as it happens, both men are wrong. Stephen Hawking is busy trying to reanimate the mortal remains of Aneurin Bevan, while Jeremy Hunt is tinkering around the edges of a failing system which needs redesigning from the ground up.

This is what passes for a debate about healthcare reform in this country, and the cost of all the virtue-signalling, NHS-worship and half-hearted reforms can be counted in human lives.

 

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Did The Russians Just Hack Our NHS?

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Our NHS is under attack – and not by the Evil Tories, for once!

Newspaper and television news networks are now reporting a major cyber attack targeting NHS England hospitals – apparently all systems are down and an emergency has been declared to initiate backup/recovery processes.

From the Guardian:

A number of hospitals have been hit by a large scale cyber attack, NHS England has confirmed.

Hospitals across the country appear to have been simultaneously hit by a bug in their IT systems, leading to many diverting emergency patients. NHS England said it was aware of the problem and would release more details soon.

Meanwhile doctors have been posting on Twitter about what has been happening to their systems.

A screen grab of a instant message conversation circulated by one doctor says: “So our hospital is down … We got a message saying your computers are now under their control and pay a certain amount of money. And now everything is gone.”

This is obviously potentially very serious, with possible impacts on patient care – apparently local NHS hospitals are reverting to pen and paper, while tweeting that patients should avoid going to A&E.

Was this a coordinated attack by a foreign power, or is it simply the case of a dozy NHS office admin clicking a dodgy link in an email and falling prey to a traditional money-grubbing scam?

(The answer is almost certainly the latter – this time. NHS Digital itself has confirmed that the generic ransomware attack was not specifically targeted at the health service, as a number of other organisations in multiple regions and sectors are affected; so the outraged NHS priests and priestesses on Twitter calling for the execution or maiming of these hackers can probably stand down now).

But since politicians and armchair pundits have been quick to blame Russia for everything else that hasn’t gone their way lately, I’m sure that Vladimir Putin’s name will be put forward as the man behind this craven attack on Our Blessed NHS.

But Putin should be careful – while Britain and the international community will apparently sit on our hands and dither while he invades Ukraine and drags his country ever further backward toward nationalist authoritarianism, provoking a fight with the NHS might be a step too far.

Even Jeremy Corbyn’s Labour Party election manifesto reserves the right to use nuclear weapons, with great cautionin extremis. Well, since the National Health Service is the closest thing we now have to a religion in secular Britain, attacking Our Blessed NHS may be the one hostile act by a foreign power that could still rouse half the country to press the red “launch” button and fire off some Trident missiles.

But when the dust settles, it may be worth considering that yet another drawback of having a monolithic national healthcare system serving all 65 million people in Britain is that it represents a singular target for mischief-makers and hostile foreign powers alike.

Presumably GCHQ and other agencies are constantly on the case protecting Britain’s national energy grid and other core infrastructure. But as a country have we been so busy singing endless hymns of praise to “Our NHS” that we neglected to realise that it has also potentially become our national security Achilles heel?

At this grave time, let us all repeat the Pledge of Allegiance to Aneurin Bevan’s glorious creation, our country’s pride and joy:

I pledge allegiance to the logo of Our #NHS
The envy of the world
One health system, indivisible
With increasingly poor healthcare outcomes for all

And when NHS England has fixed the problem and we have all made ourselves feel good by cheering on the saintly people who work in the world’s fifth largest bureaucracy, maybe we can have a sensible conversation about breaking up the NHS monopoly – for the good of all patients and, apparently, our national security too.

 

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A Song For The NHS

It’s time to sing a(nother) song for Our Blessed NHS

In 2014, we were all instructed to spend Christmas Day tweeting and sharing our fawning adulation of the National Health Service and NHS workers on social media, lest the sensitive government-owned healthcare provider feel unappreciated for even a single second.

Last year, a choir of workers from the Lewisham & Greenwich NHS Trust actually stormed the charts and took the coveted Christmas #1 spot with a very pedestrian and unremarkable Ode to the NHS, after the British public were guilted and emotionally blackmailed into virtue-signalling their support for Our Blessed NHS by purchasing the recording.

At that point, this blog started to sound the alarm bells, even more loudly than usual.

But still it was not enough. Still we are apparently failing to show sufficient love for the National Health Service. Still we wretched sinners fail to give due worship and honour to Britain’s secular, socialist religion.

Step forward NHS Million, an online campaign group which exists solely to spread fawning propaganda about the health service and encourage its worship, with a call for all of us to come up with our own individual hymns of praise to the NHS:

How long, one wonders, until a formal NHS anthem is commissioned, and sung every day in state-run hospitals up and down the land? How long until there is some kind of “NHS Loyalty Oath”, different from the Hippocratic Oath, in which NHS workers are forced to pledge to defend the principle of socialised healthcare over and above all else, rather than simply doing what is best for their patients?

Do these people realise how they look and sound to anyone from outside Britain? Simple-minded adult babies singing childish simple songs for a government they take active pride in depending on 24/7. It would be hilarious if it were not quite so gut-wrenchingly pathetic.

I look forward to trying (again) to explain this national NHS mania to my in-laws and American side of the family when we travel to Texas for Christmas this year. I look forward to the looks of blank incomprehension on their faces when I patiently explain to them that no, it is quite normal for otherwise independent-minded, adult-looking British people to suddenly whip out the guitar and croon a sappy love song to a money-hungry government department. I cannot wait to hear what they say when I suggest that they should follow our lead and found a national movement encouraging American citizens to write songs in praise of the IRS or the US Postal Service.

Fortunately, the one thing for which British people can be relied on even more than reflexively loving the NHS is the way in which we tend to make fun of any effort to make us give due deference to authority. And I am pleased to report that NHS Million received far more snide comments in reply than genuine song contributions.

Here are some of the best:

This inspired person managed four suggestions in one tweet:

Then there were the earnest-but-dim contributions:

And the perennially confused:

While others were a year behind the times:

Fix you? Really? Been there, done that.

Oh, and my own contribution:

Unfortunately, some people did take the request seriously and actually produce a song:

“RIP Our NHS” is a punk/ska-sounding number, only the rebellious element has been lobotomised and everything one would expect from the genre – angry contempt for authority etc. – has been replaced by a petulant, foot-stamping tantrum for more government interference in our healthcare. 80s kids for less freedom and bigger government!

Nobody wants an acute healthcare crisis to unfold in Britain. But if that is what it will take for us to finally stop singing childish ditties to the fifth largest employer in the world, a vast bureaucratic organisation of immense power and with huge vested interests in the form of the NHS Industrial Complex, then what are we waiting for? Bring it on – let’s get the pain over and done with.

For what is the alternative? How many more Christmases must we otherwise spend holding hands and singing plaintive worship songs to Big Government while other nations, unencumbered by 1940s socialist dogma, continue to overtake us in the healthcare outcome league tables?

Enough is enough. NHS Million can take their NHS songs and stick them where the sun don’t shine. The service that they are performing, no matter how well intentioned, is worse than useless – papering over the cracks and encouraging people to unthinkingly support the status quo is actively harmful to the long-term health of the nation.

This is a time for serious people and bold new ideas to end the dark reign of the NHS Industrial Complex, the nostalgic socialist dreamers and the fawning, childish sycophants who unwittingly do their bidding.

 

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Love Our NHS? Prove It With Your Vote In The EU Referendum, Continued

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If you are deciding how to vote in the EU referendum based on what the rival campaigns are telling you is best for the NHS, you’re doing it wrong

The stupidity and incompetence of the Vote Leave  campaign reached such desperate lows today that at this point, I can no longer really blame anyone who has not been paying much attention to the EU debate thus far if they end up voting Remain. Heck, if I hadn’t been writing about politics every day and following the debate for years, I might well do the same.

After all, why put your trust in the Leave campaign, the people proposing a departure from the status quo, when the leaders of Vote Leave are conducting their campaign with all the political aptitude of the slow sibling from a well-connected family whose parents were grasping around trying to find something productive for them to do with their lives, and gave them the fate of our country to play with.

And so today we get this much-trumpeted open letter from “more than fifty” healthcare workers, telling us that only by voting Leave can we Save Our NHS.

The letter reads:

Dear Sir,

The NHS is a great British institution that families rely on in times of need. But as it slips into financial crisis the NHS itself needs some urgent attention.

The NHS is being asked to make huge cuts at a time of rising demand. Patients are having to wait longer for treatment, hospital deficits are increasing and doctors are on strike after being told they must take a pay cut. The Government must accept responsibility for this – they have starved the NHS of necessary funding for too long.

If we Vote Leave on 23 June we will be able to spend more on our priorities like the NHS. If we put the billions that currently go to EU bureaucrats into the NHS instead it would hugely improve patient care. For example, the £350 million a week we hand to Brussels is similar to the entire yearly Cancer Drugs Fund budget.

As healthcare professionals who have worked for the NHS for years we believe that the best choice in the EU referendum is to Vote Leave on June 23rd and save the NHS.

List of signatories

Well, I suppose it’s marginally better than the ludicrous suggestion that we use the money we supposedly save to whack up a brand new fully staffed hospital every week until there are ten mega hospitals in every town and ninety percent of us are employed by the NHS.

But still, what a bunch of utter nonsense this letter (and the decision to campaign off the back of it) is. Not only does this fail the “common sense” test, it fails the “does anyone at Vote Leave have any measurable brain activity at all” test.

The NHS is one of the largest organisations in the entire world, and the fifth largest employer with over 1.7 million people on the payroll. Rounding up fifty NHS workers to put their names to a letter supporting either Brexit or the Remain campaign means absolutely nothing – one could just as easily circulate a letter and get fifty signatures from NHS employees who believe they have been abducted by aliens, demanding a massive budget appropriation to build space lasers to keep us safe.

Furthermore, it would be utterly naive to base a geopolitical and constitutional decision like Brexit on the gut feeling of a bunch of people who not only work in an entirely unrelated field, but who toil for an organisation so large and all-powerful that it positively screams “vested interest” and “deeply ingrained bias in favour of the status quo”.

Besides, a bunch of predominantly conservative politicians and activists not known for their doe-eyed devotion to the NHS suddenly going prancing around the country acting like the health service’s greatest defenders is not going to fool anyone. By a huge majority, the most committed devotees of the NHS are the same people who will unthinkingly vote to stay “in Europe” come hell or high water. Worshipping at the altar of Nye Bevan doesn’t do great things for one’s critical reasoning skills, after all.

All of this time spent repeating the risible notion that only by voting Leave can we Save Our Blessed NHS is time that could be spent – oh, I don’t know, maybe promoting a comprehensive plan for a safe Brexit with the minimum of disruption. A plan which would instantly negate 90% of David Cameron’s fear-based Remain campaign and really bring this campaign to life.

But why do that, when Matthew Elliot and Dominic Cummings are more than happy presiding over their children’s finger-painting exercise of a campaign, preaching to the already converted and singularly failing to tackle any of the counterarguments quite rightly thrown in their faces by David Cameron and Britain Stronger in Europe?

Fortunately there is another shadow Leave campaign – an underground resistance, if you will – who are intent on fighting this referendum with facts, and who understand that the public rightly expect those who advocate for Brexit to have put some thought into what Brexit should look like.

I am never more excited and hopeful for the future of this country than I am when I read their work. Please follow The Leave Alliance, share their articles and (if you are able) donate to their all-important fundraising efforts. Every pound raised helps to spread the message further.

Semi-Partisan Politics will be diverting any kind contributions made to this site to The Leave Alliance from now until the conclusion of the campaign.

 

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Love Our NHS? Prove It With Your Vote In The EU Referendum

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The EU referendum meets our national religion

The major campaigns on both sides of the EU referendum are currently slugging it out in a tawdry contest for the affections of fearful, NHS-idolosing simpletons.

No British political campaign is complete without eye-rolling attempts by those without ideas or vision to trawl for votes by pretending that Our Blessed NHS (genuflect) is mere moments away from being abolished.

From Vote Leave’s latest mailshot, entitled “Save Our NHS”:

Lord Owen, the former Labour Foreign Secretary and Health Minister, today launches the Vote Leave ‘Save our NHS’ campaign with an important speech: ‘Protecting our NHS from the EU’.

He argues that the our National Health Service should not be under the control of the EU and cites serious flaws in The Transatlantic Trade and Investment Partnership (TTIP), which is a major new deal being negotiated behind closed doors between the EU and the USA.  This he says, disregards the purpose of social health care and undermines the responsibility each member state has for its own healthcare policy.  This is highly detrimental to our NHS.

And from Britain Stronger in Europe, the charmingly personalised “Love the NHS Samuel? You need to read this”:

When it comes to the NHS, you can’t listen to the people campaigning to leave Europe.

They describe the NHS as a “60-year mistake” (Vote Leave’s Dan Hannan), say there’s “plenty of room for cuts” (Nigel Farage), and think people should have to pay for services so they “value them more” (Boris Johnson).

No – instead, we should listen to the doctors and NHS workers who make our health service so special.

This week, 200 medics wrote a letter stressing that “the NHS, medical innovation and UK public health” are stronger in Europe.

They warned “Brexit should carry a health warning” – because the economic damage caused by leaving Europe would “jeopardise an already cash-strapped NHS.”

Samuel, those who work in the NHS couldn’t be clearer – we need to stay in Europe to protect investment in our health service. Volunteer for our campaign today, and help secure the NHS for future generations:

Well, that’s that then. Your friendly local NHS urologist is clearly such an expert on statecraft, diplomacy and constitutional matters that they are ideally positioned to tell you how to vote on a matter of existential importance to Britain.

The obvious, simple-minded manipulation being attempted by both campaigns would be offensive were it not so amateurish. And to think that political consultants and strategists are actually being paid money to come up with this stuff.

Vote Leave and you’ll get cancer, because Brexit is so dreadfully scary that it should come with a health warning!

Vote Leave and we’ll save so much money that we can build a brand new hospital every week. Just think of it! That’s fifty two massive new hospitals every year. In a decade, we’ll have 520 new hospitals! By the year 2036 we could have 1040 new hospitals! Enormous ones! Your descendants could live in a Britain with a humongous, fully staffed new hospital for every single person living on this island! Oh, what a paradise it will be.

What pathetic, manipulative nonsense.

Whether we vote to leave the European Union or remain in the burning building, the NHS will continue to exist. We can’t seem to shake it. And it will continue to churn out moderately priced but increasingly substandard levels of care while nearly the entire population gathers round to uncritically praise the holy creation of St. Aneurin Bevan of Tredegar from dawn to dusk. Nothing, absolutely nothing, will change.

Do you really believe Britain Stronger in Europe when they suggest that “medical innovation” will cease or be harmed if Britain leaves the political construct known as the European Union? Exactly what is it about forsaking a foreign flag, anthem and parliament which will slow down the cure for Alzheimer’s?

Or do you seriously buy this idea that Brexit means that we can throw up a brand new hospital in every major British city within a year, and keep on doing that until the NHS is not only our largest employer but our only employer?

Don’t be taken in by this execrable, manipulative, transparently idiotic nonsense from the major Leave and Remain campaigns, all of which seem to be managed by B-student politicos and all of which are operating on the hopeful assumption that you are a frightened, credulous simpleton.

Recognise that this referendum is about sovereignty, sovereignty and sovereignty. Do your own research, and then make the right decision. And whatever you decide, don’t waste your vote virtue-signalling your love for Our Blessed NHS.

 

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