I know some people say the NHS is like a religion in this country, but this is getting ridiculous.
Downing Street has launched a Twitter campaign called “We love the NHS”. Sarah Brown says “We love the NHS — more than words can say”. Andy Burnham says “Over the moon about strong support for NHS — an institution I will defend to my dying day”. Gordon Brown says the “NHS often makes the difference between pain and comfort, despair and hope, life and death. Thanks for always being there”.
Daniel Hannan happened to criticise the NHS on American television recently. Labour have jumped on Hannan’s criticism, painting it as “unpatriotic”. He has even been accused of being a traitor. Labour have reverted to nationalism (the scoundrels). Their criticism has a flavour of anti-Americanism too — as if the only two possibilities are American-style healthcare and British-style healthcare. Gordon Brown is preposterously described as “defending” the NHS from American criticism, as if it somehow needed defending from America.
How absurd this all is. Criticising the NHS is no more unpatriotic than criticising the police. And we shouldn’t “love” government institutions, even if we respect them.
This is dog-whistle politics at its worst. There’s no substance to it — it’s nothing more than loving Big Brother followed by a Two-Minutes’ Hate. However, it’s working. It’s mobilising Labour supporters, and distracting attention from the fact that Labour have no healthcare policies. It’s classic Labour tactics: no arguments; just straw men and emotions. They’re poisoning public debate, when we should be discussing how to improve the NHS (as Hannan has in fact done), not having a competition to see who loves it most.
Labour really are the stupid party.
A lot of “evidence” spewed out to prove the brilliance of the NHS is, in fact, anecdotal and illogical.
To take an example from the “We Love the NHS” facebook group:
“I love the nhs, as I was given tremendous support by the staff at my local GP’s surgery when attempting to lose weight. I was able to see the nurse every two weeks in order to check my progress, and I have no doubt that the weight I’ve lost would have taken ten times longer to lose (if at all).”
The author makes the mistake of crediting the success of the surgery staff to the NHS. Under any other system, the clinic would still be running and he’d probably be able to get the new wonder-drug “Alli” on prescription. I cannot imagine that a doctor, a nurse, a paramedic, an orderly, the janitor, (etc.) get up each morning and say to themselves “right, well, I work for the NHS so I’ll work extra hard today!”. On the contrary, the red tape, paperwork and bureaucracy surely gets in the way of treating patients?
Many people seem to take criticism of the NHS as a personal attack on its individual members of staff. This is stupid. I’ve worked for Boots for three years, but if someone criticised the company I wouldn’t be personally offended at all (possibly because I’m responsible for most of the problems in store).
Furthermore, there is some confusion between “The Americans do not wish to implement a British system” and “The British should implement an American system” – they really are completely different statements. I do not think the American healthcare system is ideal, as there is little competition and the HMOs create fairly large monopolies for themselves. Dan Hannan points to the Singaporean system; I personally like the French system where surgeries, hospitals, clinics, etc. are managed autonomously, by a business or a charity, and patients are free to go wherever they please, based on price and/or quality of care. The state then reimburses the cost of the healthcare on a sliding scale, so that the genuinely disadvantaged pay only very little and those who can easily afford treatment are expected to cough up themselves. The other advantage of this is, of course, is that fewer people make appointments for frivolous and unnecessary reasons (such as countersignature of passports and sore throats).
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Remarkably, the NHS’s most distinctive characteristic is that it is very cheap, something sure to be of interest to the excitable tax cutters amongst us. One can argue endlessly about whether the care it provides is better than that offered in say the United States (different pieces of evidence, like infant mortality and cancer survival, tend to conflict) but with respect to cost the figures are unambiguous. The UK spend 10 per cent of its GDP on healthcare, compared with 16 per cent in the US and 11 per cent in France. Germany and Canada also pay out more than we do. Interestingly, the country that supplies excellent healthcare most efficiently is Singapore, which spends only 3 per cent of GDP. Whilst it has the personal health accounts that have seduced Daniel Hannan, the government indulges in savage price fixing that might trouble delicate libertarian consciences.
The claim of Singaporean price-fixing appears to be a canard.
“Singapore did not institute provider-side price controls, instead depending upon competition to bring down costs.”
“The price mechanism and keen attention to incentives facing individuals are relied upon to discourage excessive consumption and to keep waste and costs in check by requiring co-payment by users.”
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http://archbishop-cranmer.blogspot.com/2009/08/dan-hannan-defender-of-faith.html
Well the Singaporean price-fixing appears to be disputed (see the seemingly judicious Tucci study), though I’ll admit that I took The Times on trust when first referring to this. Note as well that the HKPRI study that seems to support your case, after stating that Singapore ‘depend[ed] on competition to bring down costs’ concedes that ‘hospitals competed on technology rather than price, leading to widespread duplication of expensive medical equipment and high-technology services. In addition, competition for physicians between the public and private sectors escalated physician earnings.’ (http://www.hkpri.org.hk/bulletin/11/tehweihu.html) This tendency rather resembles that in the private schools ‘market’ (a dubious term perhaps given that many of its participants are charities).
Interestingly, the Library of Economics and Liberty describes Singapore as ‘no libertarian healthcare \paradise\ [noli me tangere quote marks added]‘
Though the blog you link to objects to it, I suspect the point about Singaporean authoritarianism is a valid one. There is no doubting that Singapore would trouble delicate libertarian consciences : it is described by Freedom House as only ‘partly free’ and has experienced only one contested democratic election (in 1993). There is evidence more widely that under authoritarian regimes inflation tends to be artificially depressed without direct government intervention. Whilst I would never compare Singapore (or indeed the Obama Administration, though some are less fastidious here) to the Third Reich, the latter does supply a telling if extreme example of this.
It is also perhaps worth mentioning that Singaporean demand control, by forcing users to pay as far as possible for their own healthcare, introduces incentives that may be valuable from a budgetary perspective but are often thoroughly perverse from a medical one. Note also that this demand control (not price-fixing) is the ‘Medisave’ after which ‘health expenditures rose faster’ according to the HKPRI. Whatever the murky truth about price fixing, it would appear that co-payment is at least as dubious.