The NHS is our modern shibboleth

Published by The i paper (25th November, 2019)

The comedian Rob Delaney has made a video for Labour about the NHS that has been watched almost five million times on Twitter alone. He is a famous actor and a funny guy but this is a serious polemic. He talks about his experience in the United States health system after being hurt in a car crash, which left him with big bills, then about the ‘extraordinary care’ of his baby son before he tragically died from brain cancer in the UK. ‘The NHS is basically the pinnacle of human achievement,’ he says, before warning that if the Tories win the election ‘the NHS as we know it will be gone’ since it will be handed to Donald Trump on a plate post-Brexit.

I appreciate the Catastrophe star’s passion since he has written so tenderly about the death of his son. And I share his fears over the Prime Minister’s damaging Brexit deal. But the idea any British politician, even one as duplicitous as Boris Johnson, would flog our health service to Trump’s family is daft. This Labour video may be smart political messaging, but while obviously heartfelt, it unfortunately taps into two tropes that corrode our health debate.

First it reinforces the idea the NHS is somehow unique and sacred; and second, that this is proved by comparison with a US system that consumes vast sums, costs more per capita than anywhere else and still fails to cover many of the poorest in society. Yet a glance at Europe, always ignored in this discussion, shows alternative models that often perform better than our own. Despite impressive improvements, the NHS does comparatively poorly on stopping deaths from heart attacks, strokes, several cancers and of new-born infants.

One often-quoted report claimed the NHS as the world’s finest system – except for its dreadful result in the most crucial category of ‘healthcare outcomes’. A study last year by four think-tanks compared the NHS to 18 similar nations and found lower-than-average life expectancy, lagging survival rates for eight of the 12 most deadly diseases and worst ‘amenable mortality’ levels – when people die from potentially preventable conditions.

This study also found Britain spends almost the average on health for rich nations. But when do you hear politicians admit such facts? Or discuss why the mental health system reverted to locking patients up rather than treating them when incarceration costs so much more? Instead, cowed by vocal medical lobbies, politicians of all hues simply profess adoration. Then they compete over who can chuck in most cash rather than dare mention any flaws – let alone seriously discuss the future of a service sucking up cash as citizens live longer and science advances with such speed.

The stances of parties on the NHS reflect wider issues in this election. So Labour, corrupted by fantasy economics, promises to outspend the Tories and ‘rescue the NHS’ despite the proposed introduction of a four-day week that would intensify the key issue of staff shortages. It vows to ‘end privatisation’ as part of its infatuation with Seventies-style socialism. But this is baffling when GPs are private contractors and outside firms perform many key tasks such as catering and cleaning, while even on frontline services such as scans and elective surgery private providers often have highest approval ratings. Meanwhile the party is so inept it has failed to make an issue of greedy private firms wrecking lives in the psychiatric sector.

Incredibly the Tories have taken the lead as most trusted party on health, such is the intensity of public contempt for Corbyn. This is hard to stomach when they have done so little to stop 2,250 people with autism and learning disabilities being held in abusive detention. Dominic Cummings, Johnson’s chief strategist, even admitted most Tory MPs ‘don’t care about the NHS’. But they have unleashed a barrage of lies and half-truths, such as claiming to be building 40 new hospitals when in reality they are upgrading six by 2025. Weekend reports of a £500m new fund for cancer drugs turned out to be £160m boost to an existing fund for one year only.

These are the tactics of a party that does not care about restoring trust. But others are little more inspiring. The Liberal Democrats repeat their old trick of pledging a penny extra on income tax to boost health and social care funding. This idea was smart and distinctive when Paddy Ashdown suggested it for schools in 1992, but now just smacks of policy vacuum. Among the ‘policies’ found in the Brexit Party’s pathetic little ‘manifesto’ is a plan to ‘have a national debate on our NHS, involving the public alongside MPs, doctors and experts’. This is, they claim, the stuff of political revolution.

The NHS is far from the ‘pinnacle of human achievement’. It is a flawed, overloaded public service. Look at revelations last week of the maternity scandal emerging at a hospital trust in Telford, the town visited by Johnson to launch his manifesto. There have been 45 confirmed deaths of babies and mothers, with 50 more infants brain damaged and 600 cases still being examined.

Once again, we see what happens when a health system is hero-worshiped rather than held accountable: lethal errors repeated, a toxic culture left unchallenged for decades and patient concerns swept aside. And once again, it took grieving families to fight indifference and intimidation to expose fatal failings of managers, medics, unions and regulators.

From Brexit to health, this election is a display of depressing incompetence, lies and stunts. Yes, the creaking NHS and crumbling social care system do need more cash. They also desperately need more staff, although Brexit worsens this crisis. But above all they need a hefty dose of honesty and realism to cure problems that go far deeper than funding and become more urgent by the day.

Categorised in: Health, home page, Public policy