Privatisation

The Dangerous, Beguiling New Conservative Luddite Movement

Samuel Hooper9 Comments

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Conservative reform? Who needs it? Apparently the dogmas of the quiet past are totally adequate to the stormy present

Just as the prestige conservative media and a handful of prescient MPs are belatedly waking up to the need for serious ideological renewal within the Conservative Party, a reactionary new counter-movement seems to have popped up, determined to counsel complacency and inaction instead of urgency and reform.

Alex Wild of The Taypayers’ Alliance has a new piece in CapX entitled “Does the Conservative Party really need new ideas?“, in which he determines that no, the Tories can apparently do just fine by reheating the ideas and rhetoric of the past.

Not everything that Wild discusses is wrong – he does at least acknowledge that the Conservative Party’s primary political error in recent years has been their cowardly acceptance of leftist ideas and frames of reference, borne out of a pathetic and hopeless desire to be liked rather than respected. That much at least is accurate. But when it comes to diagnosing solutions, Wild seems to be under the dangerous illusion that playing the old Tory Greatest Hits album on endless repeat is a solution remotely equal to the challenge of our times. It isn’t.

Wild writes:

Instead of continually accepting the Left’s diagnosis and offering halfway-house policies that don’t actually do anything to address underlying causes, more basic thinking is required.

Energy is widely regarded as a dysfunctional market. But why doesn’t this market work while others, for example retail, do?

Is it because the shareholders and executives of utility companies are much more greedy and incompetent than the shareholders and executives of major retailers?

Or is it because, unlike in the energy sector, the government does not decide which shops are built where, what they sell and at what price?

This is indeed “basic thinking”. There are a number of reasons why even passionate privatisation advocates don’t support the idea of total deregulation of the energy market, not least because short-term profit maximisation may well be in the best interests of shareholders, but does not necessarily promote energy security or national security.

The worst that can happen with a deregulated retail sector is that some of our provincial high streets lose their character and small businesses, to be replaced by out-of-town big box stores which in turn are undermined by online shopping. The worst that could happen with a totally deregulated energy sector, on the other hand, is that the lights go out. We can have a sensible discussion about whether the current mode of privatisation is working, how it can be improved and whether more can be done to give consumers access to better information and ease of switching suppliers, but airily suggesting that the government get out of the way and allow any old punter to throw up a coal-fired power plant is to indulge in libertarian fantasy – and not even the good kind.

And then we get to the main event:

For the less-careerist, more policy-orientated MPs however, a potential pitfall is not just that they advocate variations of Leftist policies, but that they try too hard to find new ideas and wheezes whilst ignoring old ones which we know would actually work.

For starters, they should revisit policies floated between 2010 and 2015 that then failed to make it through the inevitable political wrangling of coalition government.

The reality is that for most of the major challenges the country faces, there are obvious solutions. Huge amounts of time and effort have been spent trying to explain the UK’s “productivity puzzle” but even if there are yet-to-be-fully-understood factors at play there are masses of things the government could do that would significantly increase productivity.

The tax system that punishes investment by taxing profits and not allowing businesses to write off investment in machinery and property from their tax bills. Stamp duty that gums up the housing market, preventing people from moving to take up better-paid jobs. The dreadful planning system that has driven up the cost of housing to obscene levels. The 67 per cent effective marginal tax rate on some high earners. The ongoing Heathrow third runway farce.

These are all problems with obvious solutions. No “blue-sky thinking” is required.

This “programme” of policies is to fail to see the wood for the trees. Sure, some of these ideas have merit – raising the speed limit seems sensible, while we have long known that a broken, NIMBY-enabling planning system is responsible for the ongoing housing crisis (the issue here is a lack of political will to fix it, not ignorance of the solution). Most conservatives also would agree that Gordon Brown’s questionably revenue-positive tax hike should have been repealed completely, not simply reduced by David Cameron’s equivocating administration, while this blog has been championing a third runway at Heathrow since I started writing in 2012.

But given the seismic political changes we have witnessed in British politics – the rise and fall of UKIP, the wane of Labour centrists and the Age of Jeremy Corbyn, the EU referendum and Brexit itself – it should be obvious to any outside observer that there is tremendous public dissatisfaction not confined to any one specific policy or issue, but rather at a systemic level. And looking at the state of the world – with the benefits and challenges of globalisation and automation, the ongoing massive global migration and the threat posed by radical Islam – it should be equally apparent that the standard policies of the centre-left and the centre-right are unequal to these unique challenges.

Reheating the 1980s and 1990s playbook is (in some ways) also currently being attempted by the Republican Party in the United States, and equally doomed to fail there as it is in Britain. With Donald Trump in the White House, Republican congressional leaders seized the moment to pass the big tax cut for which they have been incessantly clamouring. Fair enough. But now that they are in government rather than opposition, the tax cut came packaged with no commensurate spending cuts, meaning that the resulting bill has blown an already sizeable budget deficit wide open. After all the moralistic preaching about fiscal responsibility during the Obama years, only one Republican senator – Rand Paul of Kentucky – expressed serious reservations about this hypocrisy (and even he ultimately voted for the bill).

This approach may reap some political dividends in the short term, as individuals enjoy a slight reduction in their tax burden and certain corporations reward their long-serving employees with an unexpected bonus. But in the medium to long term, all the Republicans are doing is frittering away any remaining claim they had to being the party of fiscal conservatism, kicking the can down the road on every serious entitlement reform which needs to be considered and further sullying their brand by association with President Trump’s new protectionism.

Likewise, rebooting Thatcherism for the 21st century with no introspection or modification is no solution to our present challenges. Thatcher’s privatisation programme and her government’s rollback of the worst excesses of the socialist post-war settlement were vital, and saved this country from likely terminal national decline. There are few more ardent fans of Margaret Thatcher than myself. But to pretend to oneself that the same bag of tricks will get Britain out of an entirely different set of problems four decades later is dangerous self-deception.

One gets the strong sense that the rising profile of backbench MP and Brexit Ultra Jacob Rees-Mogg, refreshing though he can be (on matters other than Brexit) for the forthrightness of his views and his refusal to disavow deeply held values, is also a symptom of this nascent reactionary movement within contemporary British conservatism, the idea that we need only find a new leader who looks and sounds like a traditional Tory in order to repeat past Tory success.

But what Alex Wild and this nascent Thatcherism Redux movement fail to realise is that Britain has entered an unstable period of political discontinuity, a time of serious national challenges, threats and opportunities where the tried-and-tested policies of the past no longer work effectively nor command majority political support. Be it Corbyn’s unreconstructed socialism, reanimated Thatcherism or whatever Theresa May’s inarticulable vision of government happens to be (nobody really knows), none of these options command the kind of enthusiasm or political support on which strong governments with mandates for change are built.

There is no tax cut which can address the fact that Britain’s public pension system is becoming little more than a national Ponzi scheme propped up only by high levels of immigration (itself a solution with rapidly diminishing returns). There is no privatisation scheme which can deliver meaningful healthcare reform within the incredibly narrow Overton window established by the high priests of the NHS. There is no instant productivity fix, or any lasting solution to that intractable problem which does not involve a much wider conversation about how our education system currently fails to churn out school leavers, apprentices, technical diploma holders and university graduates equipped to walk into the jobs of tomorrow – let alone reach back to help those adults struggling to adapt on their own.

These are some of the real root causes of voter dissatisfaction with the status quo. Public polling may not yet always the right questions in order to draw this broader, inchoate dissatisfaction out into the open, but the pressing nature of these challenges should be evident to anyone involved in strategic political thinking (apparently a particular weakness in the current Tory Party).

The absolute last thing that the anaemic British conservative movement needs, just as it starts to awaken to the danger in which it has placed itself, is for a new movement to come along peddling false reassurance that new challenges do not in fact require new policy solutions, and that there is no problem too big to be effectively cured by tax cuts and deregulation. Yet this message, if allowed to go unchallenged, may prove to be especially attractive to a Conservative Party in which only a handful of MPs are awake to the need for ideological renewal.

For many senior Conservatives – including Theresa May’s uniquely uninspired senior lieutenants and likely successors – the message that they can succeed by adopting the government equivalent of painting by numbers effectively absolves the government of any need to think for themselves, to acknowledge that the dogmas of the quiet past are inadequate to the stormy present.

And that’s what makes the siren song of Thatcherism Redux so potentially dangerous.

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NHS Defenders Value Ideology Over Healthcare Outcomes, But Voters Increasingly Disagree

Samuel Hooper3 Comments

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A startling new poll from the Reform think tank suggests that the public’s devotion to government-provided healthcare may be a mile wide but only an inch deep, threatening to burst the leftist bubble of blind, uncritical NHS worship

Today being Valentine’s Day, a predictably saccharine hashtag is trending on Twitter as British people exhort one another to #LoveYourNHS.

And so begins another round of unthinking, unending hymns of praise to the National Health Service, egged on by ideological zealots who wake up in a cold sweat at the mere thought of anyone but the government directly providing all healthcare services in the land, and amplified by thousands of well-meaning but uncritical Britons who have been indoctrinated to believe that because the NHS once delivered their baby / set their broken leg / dug out their inflamed appendix / scooped them off the road after they walked in front of a bus they now owe their eternal thanks not to the medical professionals who helped them, but rather to the bureaucratic system which (dis)organised their care.

These odes of praise generally fall into one of a few well-defined groups. First, there are those predicated on the simple-minded assumption that no other advanced country in the world has figured out how to provide universal healthcare to its citizens:

 

Then there are those who displace their relief and gratitude at having been successfully treated or sympathetically cared for away from the medical professionals who deserve the praise toward a faceless government bureaucracy and the fifth largest employer on the face of the Earth (right after McDonalds):

 

Then there are those who just like to take any excuse to bash the Evil Tories and paint themselves as virtuous defenders of institutionalised compassion, struggling against heartless conservatives who want poor people to die in the street when they get sick:

 

Bringing up the rear are the Part-Time British Exceptionalists, leftists who normally scoff at any expression of patriotism or national pride, but who on hearing or reading the letters “NHS” immediately transform into the worst kind of stereotypical Ukipper, ranting and raving about how our healthcare system is the “envy of the world” and our country the birthplace of all that is good and compassionate, all the while furiously failing to notice the rather glaring fact that no other country in the world has copied our unique and outdated post-war system of socialised healthcare delivery:

 

And last but not least are the childishly simple gestures of reverence and affection – poems, songs and the like – which reveal the truly infantilised and subservient attitude held by many of the NHS’s loudest defenders toward the service:

 

Because these various types of people – NHS High Priest, NHS Congregant, NHS Faith Militant and so on – are so loudly vociferous in the press and on social media, I and many others had rather simplistically assumed that their angry squawking spoke for the country as a whole. But a new poll taken this year shows that in fact the British people have a far more nuanced view of the NHS and the need for serious healthcare reform than the leftist NHS hagiographers would have us believe.

The Reform think tank has published a fascinating poll, taken in January, which revealed some rather striking findings, including:

58 per cent of British voters believe that the NHS needs reform more than it needs extra money, according to a new poll commissioned by the independent think tank Reform.

64 per cent of voters believe that it should not matter whether hospitals or surgeries are run by the government, not-for-profit organisations or the private sector provided that everyone has access to care. This is 2 per cent higher than in 2014, despite the Populus poll of 2,106 people being conducted on the day Carillion went into liquidation.

The think tank finds that 59 per cent of voters would nonetheless be willing to pay higher income tax to fund the NHS. This is up from 33 per cent in 2014. On average, British voters would be willing to pay £5.25 extra a month, which is 0.4 pence in the pound of income tax.

The statistic that most of us are already familiar with is the final one – that a healthy majority (in this poll 59 percent) of Brits would be willing to pay higher income tax in order to support the NHS. We cannot escape stats and narratives like this because the media (and on this subject even the supposedly conservative-leaning newspapers are doggedly left-wing) trumpet the news from dawn to dusk.

But looking at this number alone is highly misleading, because all it tells us is that a majority of people would be willing to pay more money for the NHS, not whether they want to do so or even believe that it is necessary. And that is where the other two statistics come in, rather awkwardly for NHS defenders who loudly insist that everything would be perfect if only we firehose more taxpayer money at the same, unreformed system.

We learn in the first bullet point that a full 58 percent of voters believe that the NHS needs reform more than it needs more money, which suggests that contrary to the prevailing narrative, voters are not automatically opposed to significant reform and in some cases might even welcome it if the reforms were woven into a coherent, comprehensive plan to improve healthcare outcomes for patients. And who can seriously argue that the NHS could not do more to find even top-line efficiency savings when we see non-jobs and full-time union rep roles draining local trust budgets?

 

But it is the second bullet point which is truly surprising – the fact that a full 64 percent of voters don’t give two hoots whether the hospital or medical facility where they receive treatment is government-owned and operated or run by non-profit or even private service providers.

This flies in the face of everything that we are told about public opinion towards the National Health Service. We may as a country (wrongly) favour the re-nationalisation of the railways, but when it comes to healthcare it appears that we are far more pragmatic, preferring what works to leftist ideology or sentimentality for a system which has operated since 1948.

From the Reform blog:

This is an important message for politicians who have questioned the premise of the outsourcing model following Carillion’s liquidation. The reality is that public services would grind to a halt without private and third-sector involvement. Almost one-third of government spend (£242 billion) is spend on external providers for goods and services from paperclips to the trident nuclear deterrent. The NHS spent £54 billion on external suppliers in 2014-15. This model has delivered value for money through increased competition. While the execution of some contracts can be improved, it seems voters are more concerned with access to services than ideological arguments on either side.

Why this growing openness to non-government provision? It could potentially be a case of “the grass is greener on the other side” – the rail operators are already privatised, and so dissatisfaction is more likely to be expressed in terms of a desire to roll the system back to a previous state, whereas NHS delivery (particularly hospital care) is almost always government-provided, making fresh alternatives seem more appealing. This is very likely a factor.

But such is the strength of public feeling on the issue – with 64 percent supporting radical change – that I don’t think “grass is greener syndrome” can account for the entirety. On the contrary, it seems as though the Left have massively overplayed their hand, thinking that they stood on a rock-solid foundation of obstinate support for preserving the NHS in aspic when in fact they are on a bed of quicksand.

Interestingly, the Left have likely done this to themselves, to a large extent. Having bleated for decades that we have only X or Y number of days to “Save Our NHS” only for the NHS to persist through Tory and Labour governments alike, and with left-wing commentators, members of the NHS Industrial Complex and alarmist agitators like Owen Jones penning articles suggesting that the “NHS as we know it” has in fact already been abolished, perhaps the general public has finally tired of their endless hysteria and started to take it for what it is – cynical emotional manipulation.

And if there really is a new openness to healthcare reform, then all it would now take to finally break free from British healthcare exceptionalism – the blind devotion to a tattered post-war consensus dogma which suffocated all previous impetus for healthcare reform – is a purposeful, visionary government with a clear mandate to lead and a Cabinet brimming with talent and political courage.

Oh well.

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

Samuel HooperLeave a comment

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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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NHS Heresy, Part 4 – Junior Doctors Would Sell Out The NHS In A Heartbeat, If The Price Was Right

Samuel HooperLeave a comment

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Brave and principled defenders of Our NHS? The junior doctors would knife Aneurin Bevan’s vision in the back and happily serve an Evil Tory privatised healthcare system (how awful) if the price was right

Few people have been pronounced more saintly in 2016 than the holy NHS Junior Doctors, whose brave, principled and not-at-all-about-money industrial dispute with Jeremy Hunt and the Evil Tor-ee government has seen these humble, altruistic folks fight bravely and against the odds to safeguard the future of Our Blessed NHS.

Oh, wait. Nope. Turns out that most of those cherub-faced stethoscope swingers would throw the NHS under the bus and see the National Health Service privatised if it meant more money flowing into their pockets.

Kristian Niemietz of the IEA reports:

While I never believed for a second that the junior doctors’ strike was a People’s Struggle against the demonic forces of neoliberalism, I did believe that most junior doctors had convinced themselves of it. I was under the impression that they sincerely believed that that they were fighting The Just Cause on behalf of The People. Slogans like “Save our NHS” were everywhere, after all, and we always find it easy to convince ourselves that what is good for us also happens to be good for everybody, even if in roundabout ways.

And yet, in a recent survey of almost 10,000 junior doctors, 93% said they would accept “complete privatisation” of the NHS if it resulted in “substantially” increased salaries. Surely, some will dismiss these figures as a vicious smear, while others will accuse junior doctors of hypocrisy and opportunism. I think neither response is appropriate.

In practice, many doctors already act in accordance with the preferences expressed in this survey. Last year, about 8,600 UK-trained doctors went to work abroad, with Australia being a particularly popular destination. Australia has a universal public insurance system, in which the government commissions and pays for most healthcare, but in which the delivery is largely private and market-based. They are not doing anything immoral, because there is nothing immoral about private, market-based healthcare; in fact, the Australian system produces some of the best outcomes in the world. Come to think of it, even in the UK, most GPs are self-employed, not NHS employees. This means that technically, they are part of the dreaded – whisper it – private sector.

It would, however, suit junior doctors to quit the populist, anti-capitalist posturing. And the rest of us should try to keep our anti-capitalist knee-jerk responses in check. Even when it comes to healthcare.

My emphasis in bold. And you read that correctly – 93% of all those doctors who love to paint the NHS logo on their faces and protest Jeremy Hunt would happily live in an Evil Tory dystopia of privatised healthcare if it meant they were paid a market wage.

Niemietz is kinder and more understanding in his piece than I am inclined to be. Personally, I think that the junior doctors’ strike was just another example of the NHS Industrial Complex – that vast connected web of connected special interests who have a direct stake in the world’s fifth largest employer continuing to operate along broadly the same lines as it does at present – flexing its muscles and throwing the entire country under the bus for their own economic gain. But that’s just cynical old me.

There is no disputing, however, that nearly every tawdry public (and private) sector dispute in modern history has been justified by the protagonists on the supposed grounds of “public safety”, whether it is London Tube drivers suddenly becoming concerned about safety on the Underground in time to tack an extra day onto their Christmas holidays, Southern Rail train drivers convinced that taking over responsibility for opening and closing their train doors will lead to regular platform bloodbaths, or the sainted junior doctors.

We have known since May that pay was the only real red line for junior doctors, though surprisingly none of their placards made reference to the desire for more cash – they chose instead to go with their “Save Our NHS” angle instead, to elicit maximum public sympathy (by whipping up maximum public fear). We have also known, thanks to the steady stream of junior doctors moving abroad to work for other, better healthcare systems than our own anachronistic NHS, that their supposed high-minded commitment to socialised, government-provided healthcare is often outmatched by the desire for a bigger pay cheque and a larger slice of finite taxpayer funds.

But now we find out that not only would many junior doctors consider abandoning the NHS and selling their services to hospitals in other countries, but that they would actively support the tearing down of Our Blessed NHS and its replacement with a privatised system here in Britain. The commitment to socialised public healthcare is literally tissue paper thin with these people, even more flimsy than the home-made banners on which they proclaim themselves to be tireless warriors fighting to defend the Best Healthcare System in the World.

Will the revelation of this hypocrisy change anything? Probably not. The Guardian and other sycophantic leftist outlets will no doubt continue to gush over the various vested interests within the NHS Industrial Complex, as instructed by High Priests like Owen Jones:

Ask a striking junior doctor why they’re taking this action, and you won’t simply hear an eloquent spiel about their contracts. It’s the very future of the NHS – which they have committed their lives to – which they fear is at stake. There are the government’s policies of marketisation and fragmentation – yes, accelerating what previous administrations did – stripping the “national” from NHS.

“Committed their lives to”? Heavens, you would think that these people had pledged themselves as members of the Swiss Guard, the Night’s Watch or the Order of the Phoenix, the way that Owen Jones talks about them, rather than simply signing up as employees of the fifth largest bureaucracy on the face of the planet.

But it is sneaky what Owen Jones does here, suggesting that people become doctors out of a desire to work in a large government bureaucracy rather than feeling the call of a vocation to heal. Other countries seem to manage to recruit and train doctors without danging the carrot of getting to work for a massive state-owned bureaucracy in front of them, but Jones would have us believe that we only have doctors and nurses because people are so dreadfully inspired by Aneurin Bevan’s rusting 1948 vision. Nonsense, of course, but very effective propaganda from the NHS Industrial Complex.

The NHS Industrial Complex is made up of many different actors, all with their own motivations. One has the ideological leftists like Owen Jones, whose entire worldview relies on supporting a monolithic state healthcare provider churning out a precisely equally dismal service to every postcode in the UK. Then one has the worker bees within the organisation itself, whose medical or bureaucratic expertise rarely qualifies them to pass judgment on the optimal healthcare system for a country of 65 million people. And then one has the vast supply chain serving the beast, which is motivated primarily by a desire to preserve and expand existing revenue streams and avoiding risky disruption.

How fortunate that this cast of villains and useful idiots is able to hide behind the junior doctors – most of whom are eminently decent people supporting a superficially worthy cause – as they press for the preservation of the status quo, the scuttling of reform and a wider pipeline direct from the bank account of every UK taxpayer direct to the fifth largest organisation in the world.

But perhaps now that we know that the NHS Industrial Complex’s most photogenic spokespeople are actually more than happy to upend the whole system, spit on Britain’s national religion and see the NHS fully privatised so long as the pay rise outweighs the public vilification, the junior doctors’ collective halo might tarnish a bit.

Still, there are always the nurses. Everyone trusts a good nurse.

 

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Save Our NHS

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Top Image: University of Liverpool Faculty of Health & Life Sciences / Wikimedia Commons

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The Seven Deadly Sins Of Momentum – NHS Edition

Samuel Hooper1 Comment

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Catastrophisation, Identity Politics, NIMBYism, Militant Trade Unionism, the NHS Industrial Complex, Ideological Echo Chambers and Socialist Fundamentalism – the Seven Deadly Sins of Britain’s NHS-worshipping Taliban

This charming missive from the Camden Momentum NHS Working Group pinged its way into my mailbox this afternoon, and in an idle moment I thought I would point out all of the things that are wrong with it, and which actively undermine the vital cause of healthcare reform and thwart necessary moves to improve healthcare outcomes for ordinary Britons, all for the sake of rigid adherence to failed socialist dogma.

The email reads in part:

Our NHS is in crisis and under attack, we must stand up and fight for it!

Please come to our Reclaiming the NHS public meeting:
– 30th November 7-9pm
– Council Chambers, Camden Town Hall Judd Street, London WC1H 9JE.

The junior doctors strike has alerted us all that our NHS is being stolen from us. It can only be saved by a massive public campaign. Since Jeremy Corbyn was elected leader of the Labour Party by a landslide, we have parliamentary backing to stop and reverse privatisation. Come and hear about:

  • 80% of NHS staff are women. Over 30% are immigrant. Hear what they have to say on the impact privatisation has already had on the NHS and emergency services.
  • Find out which local services are threatened by cuts and privatisation (Sustainability & Transformation Plans – STPs).
  • Plan together what we can do to stop this.

The Seven Deadly Sins of Momentum and assorted other NHS-worshippers that I have identified are as follows:

1. Catastrophisation. Perpetually suggesting that the NHS is on the brink of destruction. Leftists have been making these breathless allegations during Tory administrations going back to the 1950s, including some long spells of Conservative rule, and yet miraculously the NHS survives – and with it, our unthinking devotion to government-provided healthcare. The hysterical alarmism card is really starting to get quite tiresome at this point. The NHS is far more likely to bury all of us (after quite possibly hastening us toward an early demise) than we are to bury the NHS.

2. Identity Politics. There is always time for identity politics now. If NHS acolytes can find an ethnic, gender or sexuality angle to support their argument they will inevitably do so, because they know just how fatal an allegation of institutional racism or sexism can be.

3. NIMBYism. A monolithic, socialised government healthcare delivery organisation must ration and allocate resources across the country in the most efficient way possible if it is to stand a chance of functioning correctly. Yet at every opportunity, NHS worshippers protest reorganisations that would close small and failing departments in favour of building regional centres of excellence because despite living in the age of the car and the air ambulance, these people come out in hives if they are not within five minute’s walk an NHS building at all times.

4. Militant Trade Unionism. Leaked emails revealed months ago that the junior doctors’ strike was nothing more than a tawdry, grubby pay dispute, with BMA chiefs and key junior doctor agitators deliberately hoodwinking the public by pretending that it was a high-minded dispute about public safety or indeed the very future of the NHS. Of course, every grubby public sector strike in history has been defended on the grounds that participants are engaged in a selfless stand for public safety, and in 2016 we really should be capable of seeing through these left-wing political antics.

5. Supporting the NHS Industrial Complex. The UK’s National Health Service is the fifth biggest employer on the face of the Earth, employing nearly as many people as global fast food giant McDonald’s and many more than the Indian railways, all to service a country of just 65 million people. When nearly the entirety of Britain’s healthcare sector is nationalised, there is inevitably a vast ecosystem of suppliers, support businesses, lobbyists and vested interests with every incentive to maintain the status quo so that they can continue milking the system. But such is the reflexive, unquestioning love that many have for the NHS that we never really stop to consider whether it is run for our benefit, or for the benefit of those vested interests. Just as the military-industrial complex has been a very real phenomenon in the United States of America following World War 2, so the NHS-industrial complex is a real phenomenon in modern Britain. We should be less credulous and recognise this fact.

6. Ideological echo chamber. As the UK general election, Brexit and the election of Donald Trump as US president have shown, by living in an hermetically sealed ideological bubble in which people talk only to others of the same political viewpoint, consume only news sources which validate their existing biases and mistake social media “clicktivism” with real activism and change, leftists end up talking to themselves while ignoring the wider country. The NHS cultists can continue to share social media memes and infographics all they like, but they are only preserving the failing status quo and making it impossible for reformers to be heard.

7. Socialist fundamentalism. Nothing reveals the NHS cultists’ devotion to socialist ideology over and above actual healthcare outcomes more than their blind, hysterical insistence that all privatisation must be eliminated and every NHS service brought back in-house as a matter of ideological purity rather than clinical value. These people will only be happy when the government (through our tax pounds) funds and delivers every single aspect of healthcare, from support functions like laundry, catering, cleaning, construction, marketing, staffing and management through to the front-line clinical work. Never mind the fact that no other advanced country in the world successfully operates a healthcare system as completely nationalised as the one which they favour. Forget learning from best practice around the world, or (heaven forbid) trying something new and bold. No, NHS cultists insist that Britain is to be a socialist beacon to the world, and if you or I have to die because of substandard care in order to glorify their vision of socialised healthcare then so be it.

What do you think? Would you change any of these Seven Deadly Sins, or add any others?

Please share your thoughts in the comments.

 

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NHS Junior Doctors Contract Strike

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