“Are we falling out of love with the NHS?” That Spectator question ricochets around the rightwing media in a hailstorm of attacks on the NHS. They expect trouble if next month’s NHS pay review bodies recommend deeper real pay cuts for staff already earning considerably less than in 2010. The aim of these Tory attacks is clearly to see that blame lands squarely on the NHS itself, not on the government.
Here’s a sample of this rightwing groundswell, for Guardian readers who may not see the anti-NHS rhetoric that Tory politicians and voters imbibe daily.
The Mail says the NHS has made us “the sick man of the world”. “It’s time to realise the NHS is not a ‘religion’ – our hospitals are not the envy of the world,” blasts Trevor Kavanagh of the Sun. “The NHS is failing us all,” says the Spectator.
The Telegraph emits such a powerful crescendo of assaults that the Health Service Journal has added its editor to its 2022 list of the 100 most influential people in health. One Telegraph editorial accuses the national insurance levy of “squeezing largely Tory voters in order to prop up an unreformed, and increasingly unpopular, socialised behemoth”.
The Telegraph’s Charles Moore relishes every bad news NHS story: “Patients are failed by the NHS’s blind belief in its own altruism – and no politician can admit it,” and “Tinkering with NHS governance is hardly the radical reform patients crave.” More intemperate Telegraph assaults come from Allison Pearson: “Surprise surprise, the NHS has spent its windfall on yet more waste and wokery.” She takes a swing at “so many doctors on the golf course, feeling fatigued or attending to pressing matters in the Dordogne”. Her columnist colleague Judith Woods rails: “It’s time to ditch the mawkish NHS love-in”, bewailing “hand-wringing sentimentality about the need to preserve our creaky NHS from the ‘threat’ of a social health insurance system that would raise standards”.
Recent attacks draw on a report from Civitas, the rightwing thinktank, not short of ammunition as it adumbrates all the bad numbers easily found in the parlous state of the NHS.
The Spectator’s Kate Andrews, late of the opaquely funded rightwing Institute of Economic Affairs, wrote in the Telegraph, “As healthcare delivery continues to worsen, criticism of the UK’s sacred cow seems – ever so slightly – more mainstream. But underperformance in the NHS is nothing new … [It] was letting down patients long before the pandemic hit, and without serious reform is likely to continue to do so long after.”
That drew a sharp riposte from Prof Martin Marshall, the chair of the Royal College of General Practitioners writing with the leaders of the NHS Providers and NHS Confederation, calling Andrews’ article “insulting and inaccurate”. “People throughout our NHS and social care system are moving heaven and earth to recover ground and reduce care backlogs while dealing with the continuing impact of Covid-19 … Ambulance services are working at a level never seen before … With more than 2.1 million A&E attendances, hospital emergency care saw the busiest March on record … GP appointments are exceeding pre-pandemic levels. More people have been seen for suspected cancer.” And no, NHS leaders “do not see the NHS as a sacred cow that cannot be improved”.
The Telegraph hit straight back in a leader column, accusing NHS officials of ignoring “how the NHS is failing” which “people can see for themselves”. Those “challenging the experience of millions are engaged in a form of ‘gaslighting’ – defined as making someone question their own reality”. Gaslighting!
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 people – the longest on record. The argument is about who is to blame – and these critics are sharpening their knives for that fight. Of course they exaggerate, gleefully cherrypicking the worst anecdotes from the news or family and friends. It’s worth remembering that most treatments go well: the Care Quality Commission’s latest adult inpatient survey found 84% “had confidence and trust in the doctors … treating them”, and 85% said “they were always treated with respect and dignity”.
Answering falsehoods about featherbedded bureaucrats, Amanda Pritchard, the head of NHS England, reminded the annual NHSConfed conference this month that just 2p in the NHS pound was spent on administration: “In France, it’s double that, and in the USA, it’s four times.”
Whenever the NHS falls into the abyss through underfunding it hits an existential crisis when its ancient ideological opponents, dormant in the good years, creep out of the earth like a revived locust plague. What excited them this time was the latest British Social Attitudes survey showing that public satisfaction with the NHS had plummeted to 36%. It has only ever been lower once, at 34% in 1997, presaging the fall of a Tory government.
Hoping for a popular revolt against the NHS, critics ignore the rest of this survey. 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 get more funds. Across Labour and Tory supporters there were “high levels of support” for NHS founding principles – 94% backing free for everyone, 86% for funding through taxes.
No solace there for the “reformers” wanting private insurance and top-ups. They always leave to the last line a coded yearning for this “reform”, because they know it reads badly, and because if they have done an iota of research, they can only find facts showing it would be more expensive for all, with far higher admin costs. Their nebulous praise for other EU systems ignores that, one way or another, they are more or less the same as our national insurance topped up with income tax. The true comparison with similar countries is that France and Germany have always spent more, with many more beds, doctors and nurses per head of population.
Above all, they omit the UK’s decade of its harshest NHS funding ever, which began with deep cuts to doctor and nurse training, whose effects we feel now.
They prefer facts like these: “The service ranks 15th [in the OECD] for perinatal mortality” (Kate Andrews again in the Telegraph). They never say that this is a shocking and novel phenomenon of this Tory decade, and is, as the health inequalities expert Michael Marmot shows, caused more by British poverty than NHS failings (like so many bad health results). However, take heart: the public is not falling out of love with the NHS, but with the NHS wreckers.