Time to Put the NHS to Bed

That the NHS at the time of writing has a waiting list for treatment of over 7 million patients is not a symptom of a failing organisation. It is actually an indicator that the organisation has failed. Any moves to address this public disaster without major change in how British people access health care are not so much as fruitless as re-arranging the deckchairs on the Titanic as it sinks, as it is continuing to do so to barnacle-encrusted furniture years after the doomed ocean liner has settled on the floor of the Atlantic.

It should be obvious by now that the operational model of trying (and openly failing) to provide a universal health service financed exclusively by the taxpayer does not work.

Allegedly a planned service, it is now clear that no plans were ever made by overpaid and under-skilled bureaucrats for the eventuality that the UK population would endure violent inorganic increase through barely-controlled immigration, the majority of the arrivals coming from countries with staggeringly poor health outcomes and appalling health-impacting cultural practices. The NHS has failed to respond to market forces because it is impossible for the NHS to do so.

No other major developed economy finances health services the way it is done in the UK, and health services are delivered in the EU to a considerably higher standard than they are here in the UK. When comparison is made to health provision in other countries, the ‘other country’ is always the USA, as if this represents the entirety of the developed world. Thus the statist deception in the debate over the NHS has persisted for decades.

There is a reason for this tradition of public dishonesty regarding health provision. It is because the NHS is actually a political organisation that delivers a mediocre health service as a sideline. The United Kingdom is run for the benefit of the NHS rather than the reverse, the reverse being how health services are run in other countries. Labour has been using the NHS as a political cudgel to bash the Conservatives for decades as a way of gaining power. Remember the Blairite rallying-cry of “24 Hours To Save The NHS” at election time? We are now seeing a re-run of this by Sir Keir’s government, blaming the current state of the NHS on 14 years of Conservative government. Well, really? At least the Conservatives did not chop and change Heath Secretary every two years, which is what happened under Blair and Brown. A Labour minister would barely have his or her feet under the desk before being moved on and the replacement would have to start the learning process all over again before being able to understand the responsibilities. Alternatively, no Labour Health Secretary could get out fast enough. At the very least, the Conservatives kept a minister in place long enough to address issues in an objective and competent fashion, and Jeremy Hunt deserves more recognition for his work than he gets.

Sir Keir also ignores the inconvenient truth that the NHS was split up as part of the devolution settlement. So people can compare in a honest and objective fashion how the NHS was run under Labour in Wales and the SNP in Scotland with how it was run by the Conservatives in England. It was and remains worse in both of those countries. This surely makes the argument that, irrespective of the party in power, the NHS is a disaster area wherever it operates.

At present there is a public wrangle regarding the guilt or innocence of a nurse convicted of murdering babies. This distasteful debate deliberately ignores the central fact that the 21st Century NHS was and probably is, in one way or another, killing babies. It is an obvious deflection tactic to obscure what appears to be a default institutionalised infanticide. The Hippocratic Oath seems to have been replaced by a Hypocritic version.

It is clear that the NHS is a political organisation because, unlike the government ministers who are politicians, the highly-paid but faceless technocrats who actually run the NHS are never ever held publicly accountable for their failures, such as the baby-killing and the rest. These kind of people treat avoidable deaths as a hidden statistic instead of a public tragedy. There have been numerous NHS scandals, yet the public would be hard put to actually name any of the senior managers involved or indeed the Chief Executive Officers (CEO) of the 4 NHSs (It’s Amanda Pritchard in England, Caroline Lamb in Scotland, Judith Paget in Wales, and Jennifer Welsh in Northern Ireland, and yes, I had to google their names as they never significantly appear in any news, good or mostly bad about the NHS). Compare this to the Post Office Horizon scandal, where the then-CEO’s name and those of the senior staff around her became increasingly known as the scandal broke after the Post Office lost a landmark court case, while the people who were Postal Services Minister were of less significance for the simple reason that they had also been lied to like the rest of the public and also the judiciary.

To ‘save’ the NHS, Sir Keir has announced a 10-year plan. This is utopian nonsense and further exposes Sir Keir as a charlatan and a fraudster. In essence he has put the entire country on a 10-year NHS waiting-list. It also embraces the fiction that Britain only has to work hard for a decade to arrive at a healthcare paradise in the end. This is the kind of socialistic thinking that underpinned the operation of the USSR, that all it would take to achieve success was to follow the plan rather like a latter-day collectivist Dorothy on a blood-red brick road. Real life does not work that way. Nothing ever truly ends, apart from human life. Proper management uses decisions based on objective reality and feasible outcomes, not visions of paradise. The NHS fails because this objective reality is routinely ignored and replaced by a socialist fantasy promoted by vested interests, not the least shifty communistic politicians seeking to evade awkward questions. Sir Keir knows with absolute certainty that he will not be Prime Minister in 2034 and will never be held to account for his under-thought fantasy policy.

This has happened before. In July 2000, just before the Parliamentary summer recess, Tony Blair announced a 10-year plan for the NHS. I remember clearly shouting into my car radio the morning after at the obvious flaw, which was that Blair would not be Prime Minister 10 years later, and whoever was the current Health Secretary would also be gone a lot sooner, so no-one would ever be held accountable for these ridiculous promises.

And so it turned out. Part way through this decade of vanity politics, the alleged plan resulted in the Mid-Staffs scandal where vulnerable patients on the wards were neglected and abused to deaths that were never acknowledged by the government, who instead pushed forward so-called experts to state that while seriously ill people had suffered terribly at the hands of medical professionals, none had died prematurely as a result of the mistreatment. So that was all right, then.

No NHS manager or medical professional was ever prosecuted over the suffering, and this may explain why the heavily-unionised NHS appears to have become a magnet for serial killers and bullies. They will rarely be caught, unless they are videoed in the act, and if they are un videoed, their guilt will be disputed as is now happening once again. Part way through Blair’s quickly forgotten 10-year plan, baby-killing activities were discovered at Furness General Hospital. There were no prosecutions, again.

So Sir Keir is simply following the Blair playbook. History is repeating itself, and Labour are depending on most people not having long memories or not actually having lived here for decades. More people, some of them babies, will die unnecessarily.

This farce cannot go on. The British public deserve a better standard of health care, not rehashed Soviet-style propaganda. And it is starting to happen. The NHS is now beginning to die of natural causes. A tacit exit strategy from the clearly obsolete 1930s-style statist public service model devised in the era of Hunger Marches is beginning to take form.

Of all organisations, it is a left-leaning think tank that has discovered that there is increasing acceptance amongst the public that people will have to go private for non-urgent treatment. This is on the back of a British Social Attitudes survey that shows that public satisfaction with the NHS has collapsed to 29%. While the same survey also shows public adherence to the statist model, the acceptance of the need to go private can only increase.

And this is how the NHS will die. Employment benefits will increasingly include private health insurance, allowing employees access to quick and efficient services away from the NHS whose own workload would decline accordingly. The NHS will increasingly become a service dealing with health emergencies. It will also provide care for those who do not have private insurance. Any criticism of this pathway will be purely ideological, complaining of a “two-tier” system, and demanding, through the abolition of private healthcare, a one-size-fits-all healthcare service of the kind that is now badly failing the British people.

The criticism of socialists will be of the same kind they had over the growth of academies and free schools, when it was seen as unfair that some pupils could receive a good quality education while others languished in “bog-standard comprehensives”. John Prescott, Tony Blair’s version of Angela Rayner, while deputy Prime Minister, went on record to state, “My argument is that middle-class parents are concerned, and rightly so, about the quality of education for their children, which sadly is not the same for working-class parents,” he said. “If you set up a school and it becomes a good school, the great danger is that’s the place they want to go to.”. So quality education is a “great danger”. The same perverse logic applies to left-wing health campaigners demanding the persistence of the NHS and the elimination of rival providers.

It is not as if the demise of the NHS by patient defection is unique amongst state organisations. The BBC, bulwark of the defence of the NHS, is also dying but through viewer defection. Hundreds of thousands of households every year stop paying the TV licence, as they switch from watching live broadcast television to streaming video services from private providers. Young people are no longer watching the BBC or other television broadcasts (especially if they can watch catch-up streaming services from the BBC’s broadcast rivals for nothing) so the BBC’s ageing audience is literally dying off and not being replaced. The allure of content on the BBC’s own iPlayer streaming service (gender-fluid Dr Who, anyone?) is not enough to keep people paying almost Ј170 a year.

The symbiosis of the BBC as a propaganda arm of the NHS while the BBC’s survival validates the statist model should be obvious. The BBC will always quote rigged statistics from slavishly pro-NHS think tanks that promote the big lie that the NHS is the best in the world at what it does, while also stifling proper debate that includes truths inconvenient to that blinkered world-view. This would explain why the BBC has persistently failed to explain properly the benefits of EU-style healthcare systems to its viewers and listeners while at the same time being a blatantly pro-EU organisation.

The state-run Post Office’s business model is also dying due to customers having defected to the Internet. The rot started when email replaced sending letters from the moment cheap dial-up modems appeared and commercial Internet Service Providers started offering services. If a parcel can now be sent using services other than Royal Mail, there is no need to buy postage stamps, and most of the other services provided by the Post Office are more conveniently available elsewhere and online.

The Horizon scandal is a symptom of the decline of the Post Office. The scandal was allowed to go on for so long because people stopped caring about the rump organisation that remained after British Telecom and Royal Mail were privatised, and the Post Office’s Public Relations strategy was to make the Post Office invisible in public life as a way to hide the truth, something made easier when branches were relocated to be out of sight at the back of branches of WHSmith, whose own footfall into its increasingly shabby stores has also declined.

The NHS itself could be split up according to function without duplication of service. There could be the Accident and Emergency service, the Ward service depending on care needs, there could also be a Public Health Emergency service, dedicated to epidemics. We have already seen the start of the latter with the creation of the UK Health Security Agency. Non-emergency services could be provided through private health insurance. For those that do not have insurance, the state could purchase private care as part of a welfare benefit.

In essence, the state would provide emergency health care to treat injuries and health incidents such as heart attacks and strokes. The poor would be protected. But everyone else would indirectly pay for treatment, as they now increasingly expect to do. The reason this is not done currently is that the NHS is not regarded as what it actually is, which is a provider of free health insurance with care indirectly paid for using the tax system as well as state borrowing. Once this perspective is used, everything else should fall into place.

At present the political will is not available, not least because there is a Labour government replete with vacuous utopianism even after the departure of Jeremy Corbyn into a Jihadist dead-end.

However it is increasingly clear that the public mood is turning against the NHS as the BBC’s statist propaganda machine is also dying. The opportunity to make occupational health insurance mandatory for businesses larger than a certain size would allow more money into the provision of private health care and this would permit the growth of private provision at the expense of the NHS. This should be a priority of any new leader of a Conservative Party that has up to now been forced to worship at the altar of the NHS by Labour threats for far too long. Once the private insurance model becomes further established, then the refocusing of the NHS as an emergency and welfare service could be progressed.

While this all may come across as an alternative utopia, it is not. Instead it is a correction of an unacceptable state of affairs. The NHS has contributed to market failure through its distortion of the provision of health care in the UK which is having serious economic and social impact. It is not a paradise that would be created by the marginalisation of the NHS, but instead a reset that would allow UK health care as a whole to face future challenges with greater confidence, and also much more money, than an organisation that is currently defined by its record on killing babies.

Replacing the NHS is quite literally a matter of life and death. The baby-killing has to stop, the waiting lists have to come down, incompetent professionals have to be held to account for failures leading to death and serious injury, and the only way to do that seems to be the replacement of the NHS by something which cannot help but be better. Of course there are no prison places for any convicted NHS felons, but that’s another issue.

Paul T Horgan worked in the IT Sector. He lives in Berkshire.

This piece was first published in Country Squire Magazine, and is reproduced by kind permission.

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