This article by Rufus Hound was originally published in the New Statesman on 9th September 2014.
Whatever else it has done, Scotland’s referendum debate has finally woken many south of the border to the once-creeping, now-galloping privatisation of their own NHS. Hell, even Andrew Marr talked last weekend, on prime time Sunday morning TV no less, about the dangers of TTIP – a trade partnership between the UK and US – for the health service. So THANK YOU. Thank you Scotland for shining a light on the pillaging of our national health service.
When I stood as a candidate in the Euro elections in May, I found that while most people supported the NHS, most were pretty much in the dark about what this government – and, sadly, the Labour government before it – have done to undermine the principles that hold the NHS together. I spent a lot of time convincing voters – and sceptical journalists – that what is happening is actually happening. It shouldn’t be hard, what with all the provable facts, but it’s all so unbelievable that most people prefer the comfortable lie to the horrifying truth.
It’s not surprising. Politicians haven’t told us the truth about the NHS and their plans for it for years. When someone is planning to stab you in the back, they don’t look you in the eye. To the Scottish, watching from the sidelines as NHS England has been pulled apart, the view has been clearer – hence their fear of following England’s road. And the debate has given the English a view of their own NHS through Scottish eyes (‘Och eyes’ ?).
Realising that the future of the Scottish NHS was going to be the clincher for many undecided voters must have hit all three party leaders like a wet blancmange. Politicians don’t blanch at the prospect of the Big Lie – but the standard practice (whenever the subject of the NHS comes up) of pointing at one another and saying, “Look! Over there! He’s the liar!” wasn’t going to work this time. This was going to have to be synchronised lying.
“Look! Over there! He’s the liar,” they cried, with one accord. Naughty Alex Salmond was hiding £450 million in cuts that he’s planning to spring on the Scottish NHS once the dust has settled, and they had the documents to prove it.
Even then, the poll numbers didn’t slide significantly No-wards. It was time to bring up the big guns. Someone in a tartan hazmat suit was given the secret combination, the silo was unlocked and out rolled Gordon Brown. Better Together was going nuclear.
Who couldn’t be moved by the passion with which everyone’s-worst-enemy-turned-new-best-friend declared that, “We can guarantee that the National Health Service will be in public hands, universal, free at the point of need, as long and as ever the people of Scotland want it!” This was a true: “READ MY LIPS – I will not allow the Scottish NHS to be privatised’ moment. Masterly stuff from the man who, in office, watched the English NHS swirl down the privatisation plughole.
I could spend hours analysing what Brown’s trenchant statement did, and didn’t, say. But what’s key is that he had to at least appear to say that the NHS privatisation in England would never, ever seep north. He had no choice – any nation that has grown up with a NHS loves it and will want to keep it. That’s why none of the Three Stooges could make that speech. Because they’ve all got to get up tomorrow and say exactly the opposite to the English – and make them think that’s a really good thing.
The problem is, there’s nothing easier to lie about than the NHS.
UKIP are past masters: Fact 1) “I was sat behind some Indian bloke in A&E.” Fact 2) “There was a woman there didn’t even speak English.” Fact 3) “And she had three children.” Statistic: “Health tourists cost the NHS £2 billion a year!” (A steaming pile of lies of course, multiplying the true cost by a factor of between 25 and 35, but you get the idea.)
Anyone can do it. Try believing this. Fact 1) A Labour Government re-organised the NHS on the Tories’ market model, welcomed in the private sector to finance its building plans with private finance deals that came back to bite the NHS on the arse. Fact 2) Before the 2010 General Election, David Cameron scornfully vowed there would be no “top-down reorganisations” if he was Prime Minister. Fact 3) Within months, the Coalition announced the biggest top-down reorganisation in NHS history and, in the name of “patient choice” forcing it to compete within itself and with outside companies for our “business”, instead of co-operating for our health. Statistic: £10 billion a year to run the internal market! £3 billion for the Tory shake-up! Or shake-down, depending on how you look at it! (The costs of the private contracts terminated due to poor performance are only just starting to roll in.)
Hard to swallow, maybe, but sadly true. Everything in the NHS is now up for grabs. Let that sink in for a moment. Not just catering contracts or cleaning, but your operations, your cancer care – everything. Since private contractors can hide behind the NHS logo, you probably won’t know anything about it until things go wrong – when you’ll negatively impact the profit margins of these economic interlopers and be promptly shipped back to the NHS. When you hear statistics about what goes wrong in the NHS, ask yourself where the figures on private medicine’s mistakes and failures go. Behind the wall of commercial confidentiality, that’s where.
But it’s mostly privatisation by stealth: a nudge towards queue-jumping here, a suggestion that we should pay to see a GP there. ‘Why should this or that treatment come from the public purse at all?’, asks the Daily Mail. And one day soon we’ll have a two-tier system with the noble idea that the poorest families can expect the same quality of treatment – the same respect – as the richest families, as dead as the kids with no healthcare.
I hope that Ed Miliband has learnt something from his Scottish foray. He is rumoured to be considering an increase in NHS funding if he wins the next election. That’s good, although tinkering with general taxation would be fairer than National Insurance. But that’s not half enough for the party of Nye Bevan: he must also end the internal market by any means necessary. He must have the courage to admit the mistakes of PFI and put them right.
He must, over all, remember what the NHS is. And for that, he could do worse than re-read Nye himself. “One thing the community cannot do is insure against itself,” wrote Nye. “What it can and must do is to set aside an agreed proportion of the national revenues for the creation and maintenance of the service it has pledged itself to provide. This is not so much insurance as a prudent policy of capital investment.”
As for the Tories, the day after the Tory Health Bill was announced, Andrew Neill asked Michael Portillo on This Week, “Why didn’t they tell us?” To which Michael Portillo replied: “Because they didn’t think they could win an election if they told you what they were going to do.” Too bloody right. But now we do know.
That’s why I stood in the elections. I won’t be standing in the General Election, but a bunch of my colleagues will, and I’m looking forward to them causing some upsets. Lewisham Hospital campaigner Dr Louise Irvine is taking on the Health Secretary himself – she’s already beaten him twice in court over the threatened closure of Lewisham Hospital, so, hopefully, she can do the same at the ballot box. I mean, she did grow up in Scotland, and now we know what political ground can be gained when Caledonians defend Bevan’s egalitarian dream.
Fingers crossed it works in Godalming, too.