NHS wreckers can’t accept that the British public still supports him | Polly Toynbee


“Are we falling in love with the NHS? This bystander question is ricocheting around right-wing media in a storm of attacks on the NHS. They expect problems if next month’s NHS pay review bodies recommend deeper real pay cuts for staff who are already earning considerably less than in 2010. The aim of these Tory attacks is clearly to to see that blame lies squarely with the NHS itself, not the government.

Here’s a sample of that right-wing groundswell, for Guardian readers who may not see the anti-NHS rhetoric that Tory politicians and voters soak up daily.

The Mail says the NHS has made us “the sick man of the world”. “It’s time to realize that the NHS is not a ‘religion’ – our hospitals are not the envy of the world,” berates Trevor Kavanagh of The Sun. “The NHS is letting us all down,” says the Spectator.

The Telegraph is pumping out such a crescendo of assault that the Health Service Journal has added its editor to its 2022 list of the 100 most influential people in health. A Telegraph editorial accuses the National Insurance tax of “largely squeezing Conservative voters in order to support an unreformed and increasingly unpopular socialized juggernaut”.

The Telegraph’s Charles Moore savors every bad news from the NHS: ‘Patients are let down by the NHS’ blind belief in its own altruism – and no politician can admit that’, and ‘Fixing with NHS governance is not the radical reform that patients crave. More intemperate onslaught from the Telegraph comes from Allison Pearson: ‘Surprise surprise the NHS has spent its windfall on yet more waste and wake-up call.’ She mocks “so many doctors on the golf course, feeling tired or dealing with urgent matters in the Dordogne”. Fellow columnist Judith Woods quips: ‘It’s time to ditch the cutesy love of the NHS’, lamenting ‘the heartbreaking sentimentality about the need to save our creaky NHS from the ‘threat’ of a social health insurance system that would raise the standards”.

The recent attacks build on a report by Civitas, the right-wing think tank, which has no shortage of ammunition as it sums up all the bad numbers easily found in the dismal state of the NHS.

The Spectator’s Kate Andrews, defunct of the opaquely funded right-wing Economics Institute, wrote in the Telegraph: “As health care delivery continues to deteriorate, criticism of the UK’s sacred cow seems – ever so slightly – more mainstream. But NHS underperformance is nothing new… [It] was failing patients long before the pandemic hit, and without serious reform it is likely to continue to do so long after.

It prompted a strong pushback from Professor Martin Marshall, president of the Royal College of General Practitioners, writing with leaders of NHS providers and the NHS Confederation, calling Andrews’ article ‘insulting and inaccurate’. “People in our NHS and our social care system are moving heaven and earth to recover ground and reduce backlogs of care while coping with the continued impact of Covid-19… Ambulance services are operating at a level never seen before… With more than 2.1 million A&E attendances, hospital emergency care had the busiest March on record… GP appointments top pre-pandemic levels. More people were seen for suspected cancer. And no, NHS leaders ‘do not see the NHS as a sacred cow that cannot be improved’.

The Telegraph hit back directly in a leading column, accusing NHS officials of ignoring ‘how the NHS is failing’ which ‘people can see for themselves’. Those who “question the experience of millions of people are engaged in a form of ‘gaslighting’ – defined as forcing someone to question their own reality”. Gas lighting!

No one denies the dire state of the NHS. Critics don’t need to stretch the truth. Not with the current waiting list of 6.2 million – the longest on record. The argument is who is to blame – and these critics are sharpening their knives for this fight. Of course, they exaggerate, gleefully sifting through the worst anecdotes from the news or from family and friends. It’s worth remembering that most treatments go well: the latest Quality of Care Commission survey of adult inpatients found that 84% “trusted the doctors…who treated them”, and 85% said “they were always treated with respect and dignity”.

Responding to lies about feathery bureaucrats, Amanda Pritchard, the director of NHS England, reminded the annual NHSConfed conference this month that only 2 pence of the NHS pound was spent on administration: “In France, it’s it’s double, and in the United States it’s four times as much. .”

Every time the NHS falls into the abyss through underfunding, it hits an existential crisis as its old ideological opponents, dormant in good years, rise from the ground like a rekindled locust plague. What got them excited this time was the latest UK social attitude survey showing that public satisfaction with the NHS had dropped to 36%. It was lower only once, at 34% in 1997, presaging the fall of a conservative government.

Hoping for a popular revolt against the NHS, critics ignore the outcome of this investigation. The reasons for dissatisfaction were obvious: waiting times for GP and hospital appointments, staff shortages and government underfunding. Only 25% think the NHS should not receive more funding. Among Labor and Conservative supporters, there were “high levels of support” for the founding principles of the NHS – 94% supporting free for everyone, 86% for tax funding.

No consolation for “reformers” who want private insurance and supplements. They always leave in the last line a coded nostalgia for this “reform”, because they know that it is badly read, and because if they have done an iota of research, they can only find facts showing that ‘it would cost everyone more, with far higher administrative costs. Their nebulous praise for other EU systems ignores that in one way or another they are more or less identical to our national insurance supplemented by income tax. The real comparison with similar countries is that France and Germany have always spent more, with many more beds, doctors and nurses per capita.

Crucially, they omit the decade of the UK’s toughest NHS funding, which began with deep cuts in the training of doctors and nurses, the effects of which we are now feeling.

They prefer facts like these: “Service ranks 15th [in the OECD] for perinatal mortality” (Kate Andrews again in the Telegraph). They never say it is a shockingly new phenomenon of this Tory decade and is, as health inequality expert Michael Marmot shows, caused more by Britain’s poverty than failures of the NHS (like so many poor health outcomes). However, rest assured: the public is not falling in love with the NHS, but with the NHS wreckers.

Polly Toynbee is a Guardian columnist


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