NHS Heresy, Part 2


It takes real courage to speak out against the Cult of the NHS, particularly for people on the political left who are expected to be the biggest cheerleaders of all

From a brave commenter at Left Foot Forward, reacting to the same piece of sentimentalist NHS idolatry which prompted my article here:

I am disabled and faced horrendous treatment on the NHS when I unfortunately required help, I never once criticised staff individually but still every time I tried to talk about what I faced I was shouted at, told I hate the NHS, that I want to copy the US… I’ve seen the same thing happen to NHS staff whistleblowers. At this point it seems protecting “our NHS” from any and all criticism (that is not crouched in “don’t get me wrong, I love the NHS”) is more important than the wellbeing of both the patients and the staff and the functioning of the healthcare system.

I have since moved elsewhere in Europe to my husband’s country where the PUBLIC healthcare system (health insurance and private doctors are not a common thing here either), though it has flaws as everywhere does, functions as a healthcare system much better. If you want to change the pressures the NHS is under then it needs to become socially acceptable to talk about the NHS without referring to it as the “envy of the world” constantly or being accused of hating it and the staff working for it.

Heretic! Heretic!


This statement takes courage, perhaps particularly from somebody who is clearly on the political left herself, and so is expected to be a particularly enthusiastic priestess of the Cult of the NHS. I admire her bravery – I fear that she (and others like her) will continue to be demonised for daring to acknowledge glaring reality.


Postscript: An alternative vision for healthcare in Britain, penned back in 2008 by Professor Karol Sikora, former chief of the World Health Organisation Cancer Program.


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Mark Serwotka’s Emotional Blackmail On Behalf Of The NHS Industrial Complex

In a piece for Left Foot Forward, Mark Serwotka plays the “I’m on the waiting list for a heart transplant” card to heap even more uncritical praise on the NHS:

This is something I honestly think Jeremy Hunt and the Tories will never fully grasp, or don’t want to. They don’t have a genuine sense of how the whole NHS is run. Or our other public services, for that matter. They see them as bureaucracies, first to be vilified, the better then to be cut down to size.

I don’t know how long I’m going to be in here before my transplant, but my stay so far really has hardened my resolve to ensuring we defend our NHS with everything we’ve got.

That means defending the services from budget cuts and privatisation. And it means defending the health workers who have been treated appallingly, with their pay and pensions slashed, their contracts ripped up and even hints now that foreign doctors won’t be welcome in the UK in the future.

This last point makes me particularly angry because from day one, when I first started having problems in 2010, I’ve been looked after by fantastic and dedicated doctors and other professionals from all over the world.

We really can’t say it often or loud enough — our NHS is very special. The greatest achievement of a time of political optimism, when national pride meant public investment. Our health service is the envy of the world, and we can’t afford to let the Tories grind it down.

Really, we can’t say it often or loud enough? It certainly seems as though uncritically praising the NHS from dawn to dusk is all that some of us ever do, whether we are childishly painting the NHS logo on our faces, propelling a mediocre song to #1 in the Christmas charts or flaunting our virtuous NHS-love on social media.

The envy of the world? Tell that to the thousands of people whose cancer wasn’t spotted until it was too late or who could not benefit from the latest treatments, the people who died of hospital superbugs or the families of those left to starve in dysfunctional hospital wards run by psychopaths.

Mark Serwotka’s hymn of praise to the NHS mirrors every other piece of leftist propaganda designed to aid the NHS Industrial Complex. The template goes something like this:

  1. Talk about current or past grave illness to elicit sympathy
  2. Praise the “amazing care” received, as though heart transplants or chemotherapy are uniquely British
  3. Wax lyrical about how the unending bureaucracy of state healthcare and the fact that the NHS is the world’s fifth largest employer is actually a good thing, somehow
  4. Historical amnesia, where every other significant or inspiring British contribution to the world is forgotten or diminished while government-run hospitals are put on a pedestal and worshipped
  5. Attack the Evil Tor-ees for being insufficiently devout in their observance of Britain’s new national religion

One certainly wishes Mark Serwotka the very best, that a suitable new donor is available soon and that his upcoming transplant is a success. But as a people, we really need to stop being so gullible and open to emotional manipulation that we allow ourselves to be swept along by these “but the NHS set my broken arm / cured my case of Ebola / saved my premature baby” testimonials.

No, the NHS did not save your life. Doctors, nurses and modern technology saved your life. And guess what? In other countries, the systems that they wrap around those doctors, nurses and technologies often deliver better healthcare outcomes for their people than Our Blessed NHS (genuflect) is able to produce.

But what really damns Mark Serwotka and his NHS-loving amen chorus is the fact that they will not even allow the British people to look at the benefits of other healthcare delivery models. The NHS Industrial Complex has the British Left (and whole swathes of the Right) so wrapped around its fat little finger that to even question whether the NHS model should remain the One True Faith of these islands is to invite potential excommunication from political life.

And all it takes to perpetuate this nauseating Divine Office of praise for the National Health Service is for occasional feel-good stories like this one to make us wipe away a tear, lean back with a smile and know that we benefit from the Best Healthcare System In The World. So good, in fact, that it is replicated by jealous rivals in precisely zero other countries.

A reading from the book of St. Mark Serwotka.

Thanks be to Bevan.


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NHS Heresy, Part 1


Instituting a new feature on this blog, highlighting those rare, brave souls who dare to stick their heads above the parapet and suggest that Our Blessed NHS (genuflect) is no longer a sustainable model for delivering top quality healthcare to the British people

The Telegraph’s Jeremy Warner says the unsayable:

In a tax-funded health care system, the normal, self-limiting rules of supply and demand don’t apply. Where the service is perceived to be essentially “free”, demand can never be sated; it will just keep on growing until it breaks the system.

Three new elements have entered the equation in recent years to make an already grave situation much worse. One is the advent of mass communications. As people become more aware of potential threats to their health, and what treatments might be available to counteract them, they expect better and demand more.

Second, society is ageing. Most health care costs are incurred in the latter stages of life. Current demographics are delivering a double blow; more people are both moving into the high cost cohorts, and once in, they are surviving much longer than they used to.

And finally, there is the ceaseless march of technology, including the advent of “personalised medicine”, procedures and or treatments tailored specifically to the patient’s individual genome. Over time, this approach to medicine ought to become cheaper. It also already promises to make some existing and extremely expensive, treatments obsolete. But right now, it only piles on the costs. A personalised service is also quite alien to the NHS’s culture of uniformity. Even applying it will require radical change, never mind the small matter of how to pay for it.

Warner concludes, hopefully:

If the NHS was ever the “envy of the world” described by popular myth, it has long since ceased to be so. None of this is to denigrate those who work selflessly against the odds in British health care for the betterment of the UK public. It is merely to point out that the post-war model of funding no longer works and needs a radical overhaul. It would be a brave Prime Minister who questioned this sacred cow, but with meaningful Labour Party opposition all but vanished and the challenges and opportunities of Brexit likely to force change across the policy landscape, there could scarcely be a better time for some radical thinking than now.

This blog has no such optimism. Theresa May has earned her reputation as a somewhat traditionalist authoritarian for a good reason. She is already making noises about opening more grammar schools, thus establishing the new prime minister as a reinforcer of traditions rather than a slayer of sacred cows.

And the NHS, having passed its 68th birthday, is not just a British tradition – it is the British tradition, more integral to who we think we are as a people than Wimbledon, red telephone boxes or the Queen. You will see the monarchy abolished in this land before you see a system of private healthcare replace Our Precious NHS, at least under this government.

More to the point, Theresa May’s government already has its semi-competent hands full coming to terms with the scale of the challenge presented by Brexit. Unlike some of the cowboys in Vote Leave or Leave.EU, this blog never pretended that Brexit would be easy, and Theresa May’s Foreign Secretary and ministers for trade and leaving the EU are just now beginning to realise this fact.

Successfully negotiating the scoping of Britain’s negotiating position and then managing the initial two-year secession negotiations following the triggering of Article 50 will, whether Theresa May likes it or not, expend just about all of the political energy and capital that her government possesses this side of a general election, even if the Labour Party manages to continue being a slow-motion car crash right through til 2020. There simply will not be enough energy left for the fundamental restructuring of British healthcare, especially in the face of howling opposition from the NHS Industrial Complex, that vast web of vested interests which grows around the world’s fifth-largest employer like ivy on a crumbling building.

Neither has Theresa May shown any great interest in touching the super-charged third rail of British politics in any case. She kept Jeremy Hunt on in his role as Health Secretary, hardly a bold marker of intent to pursue a radically different course of action. Neither does a parsing of May’s past speeches reveal a yearning desire to enact healthcare reform bubbling beneath the cold, authoritarian exterior.

After the 2020 general election and in a post-Brexit environment, things may be different. This blog sincerely hopes that this is so – that Britain, buoyed by the fact that Brexit has (hopefully) been achieved without ushering in the apocalypse, might be in the mood to tackle other big challenges. But here we are on extremely flimsy ground – when nobody can comfortably predict the next month in British politics, it is foolish to daydream about what might possibly happen in four years’ time.

Yet everything that Jeremy Warner writes is true. At best, any government – even an NHS-worshipping Labour government under Jeremy Corbyn- could only paper over the cracks in our healthcare system. Relative performance on key metrics (like cancer survival rates) will continue to drift downwards, further away from our continental rivals, while NHS cheerleaders continue to point to value for money studies which suggest, on paper, that their idol is still the “envy of the world”. And the British people will continue to heap unending, unthinking praise on the NHS, literally killing themselves with their devotion to that giant bureaucracy.

It would nice to be able to write something more optimistic, but at this time there are absolutely zero grounds to expect that the situation will change for the better, short of a major crisis or unexpected political shock.


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Stik’s Street Art, Like His Life Story, Is Moving. But This Worship Of The NHS Is Dangerous

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In secular Britain, the only things left to worship are ourselves, government and the NHS. And boy, do we do it well

Here is an interesting variant on the usual deification of the NHS we are used to seeing and hearing from the organisation’s cult-like defenders.

From the Hackney Citizen:

Stik, the once-homeless graffiti artist, whose stick-like figures adorn the streets of East London and beyond, has announced that a full set of his NHS Sleeping Baby print is to be auctioned at Christie’s later this month.

The prints, expected to sell for £2,000 to £3,000 as a set of four, will raise money for the Homerton University Hospital NHS Foundation Trust Art Charitable Fund.

This is not the first time Stik has used his art to help the hospital. The original ‘Sleeping Baby’ mural can be seen in the garden of Homerton Hospital itself, and last year Stik sold £50,000 worth of prints of the image with all the proceeds going to the Homerton Hospital’s art room.

The iconic image of a sleeping baby, painted in Stik’s usual style of block colour and thick-black lines, has since been adopted as a symbol by NHS workers. “It represents the vulnerability of the NHS and the feeling of fondness we have for it. The NHS is our baby and we have to protect it,” Stik says.

During the recent junior doctors strikes, the image was printed on placards with slogans such as ‘Hands off our NHS’ and ‘The NHS is our baby’.

To be clear: doing anything to raise money for hospitals is a selfless and noble act, to be applauded. That much is great. What is troubling are the sentiments expressed which accompany the philanthropic act – in this case, an almost slavelike devotion not to the idea of healthcare, hospitals or the work of medical professionals, but rather to one specific organisation, government department and method of healthcare delivery.

Speaking about the NHS as a vulnerable infant, almost like the Christ child, is not healthy behaviour. Nor is placing ourselves in the position of loving parents to this baby, charged with protecting it from all harm (though it does make a refreshing change from portraying ourselves as the children, being tended to by the watchful parent of big government).

Equally offensive is the way that NHS cultists presume to speak for everyone in the country, and routinely pontificate about things like “the feeling of fondness we have for it”. Oh do we, now? I’m fairly certain that NHS-loving drones are indeed in the majority, but I would also wager that there is a not insignificant number of people who fully support the idea of universal healthcare and are very grateful to doctors and nurses, but who have very little attachment to Britain’s unique model of centralised, government-owned delivery.

And yet the NHS cultists, much like the Princess Diana cultists nearly two decades ago, have the nerve to speak on behalf of us all. They declare on our behalf just how much we love the NHS and will fight to protect it from change, just as the Diana cultists wept into every passing television camera, sang along to Elton John and declared the entire nation to be in mourning.

Stik is a gifted artist, and many people find his murals poignant and beautiful. But we should not allow our respect for an artist and sympathy with his powerful life story to cause us to unquestioningly swallow NHS propaganda, hook, line and sinker. Other countries, without an NHS of their own, manage to build and operate hospitals too. Many of them provide their citizens with healthcare free at the point of use. Many also help the homeless, or indeed anyone in urgent need of medical care. Believe it or not, generosity, compassion and public spiritedness are not uniquely British values.

Whether we are allowing Stik to lead us in worship of the fifth biggest employer in the world, childishly painting the NHS logo on our faces, wearing it on our clothes or propelling a schmaltzy NHS Choir ballad to the Christmas No. 1 slot in the charts, in each cases we are disengaging our brains and allowing ourselves to be swept up in a cult rather than thinking rationally. Maybe the NHS was just what Britain needed back when we were struggling to pick ourselves up from the rubble of the second world war. But 68 years later, even in this age of globalisation, no other country has chosen to copy our approach. Not one. Shouldn’t that tell us something?

Faith is important*, but it is generally best applied to the spiritual realm. In the temporal realm here on Earth, we are able to look at evidence, test hypotheses and innovate new solutions when old ideas and ways of working become obsolete. Nowhere is this more true than the field of medicine. If we or a loved one were gravely ill, few of us would put our trust in a faith healer or wait for a divine miracle alone to provide a cure. Indeed, we tend to scorn and even prosecute those who do so.

And yet when it comes to the system of healthcare delivery we choose for our country, we proudly spurn new information and cling desperately to the familiar, seizing on any news story which confirms our present pro-NHS biases while simply ignoring heretical contrary evidence. In other words, we act entirely through (misplaced) faith, not reason.

Of course we should all hope that Stik’s Sleeping Baby prints raise much money for the Homerton University Hospital NHS Trust when they are auctioned – nobody disputes the worthiness of the cause. But in post-religious, increasingly secular Britain, we should be very wary of what we choose to fill the void once occupied by the Church. The human urge to worship has clearly not been vanquished, and venerating the NHS as we currently do is terrible for us, and calamitous for our flailing healthcare system.


* Long-time readers will recall that I am a Roman Catholic


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The Junior Doctors’ Strike Is A Tawdry Pay Dispute, Not A Principled Defence Of The NHS

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This strike is about money, not patient safety or the future of the NHS

James Forsyth speaks sense on the naivety and arrogance behind the ongoing junior doctors’ strike:

This walk out, the first all-out strike since the NHS’s creation, isn’t over some issue of high principle. It’s about money. The main sticking point in their negotiations with the government is that Saturday shouldn’t be treated as a normal working day.

The BMA’s suggestion at the weekend that it was prepared to call off the walk out if the government didn’t impose the new contract, but instead pilot it for a while, suggests that even the doctors themselves fear they’ll lose public sympathy by going ahead with this strike.

Yes. The fact that the final sticking point in negotiations is around money reveals all of the previous lofty, high-minded concerns about public safety and “tired doctors making mistakes” to be the cynical campaign rhetoric that it is.

Forsyth hammers home the point on pay:

Under the government’s offer, those junior doctors who are on duty one Saturday in four will receive a premium pay rate of 30 per cent. This means they are, on average, getting paid more for working on Saturdays than nurses, midwives and paramedics. The proposed deal is also more generous than what firefighters and police officers get for doing their job on a Saturday. This is hardly grounds for a walkout that will inevitably put lives at risk.

Junior doctors are right that they are paid less than doctors in some other countries. But this is, in large part, because the state has heavily subsidised their education. By the time a doctor has finished their foundation training, the state has already spent a quarter of a million pounds on them.

Until doctors are prepared to pick up more of this tab themselves, they shouldn’t complain that some of those working in other health systems are paid more than them. Indeed, it would be sensible of the state to actually require medical students to commit to working in the NHS for a certain number of years before funding their training—something that it doesn’t currently do. Junior doctors should also remember that if they stay in medicine and become consultants, they will find themselves in the top two percent of earners in this country.

This blog is no fan of the current Conservative government and no great proponent of the latest NHS reforms. But for the sake of decency, this strike needs to be broken. And then we need to have a long, hard national conversation about why an advanced democracy like Britain is facing a national strike of any kind in the year 2016.

Hint: if we did not still have a monolithic nationalised health service – the fifth largest employer on the planet serving the 22nd largest country by population – we could never be in the ludicrous position of suffering a strike of all the junior doctors in the land. Doctors would not all share the same employer, patients would not all rely on the same medical service and we would all be spared this drama.

Something to mull over as the accusations and counter-accusations fly.


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