10 – How was the Government persuaded to make a U turn on the NHS surcharge for migrant workers?

On Friday May 15 I posted about the fact that some NHS migrant staff had to pay a surcharge for using the NHS that they worked for. I suggested that it was wrong that,

“If any of those paying the surcharge became ill – they would only receive NHS services because they had paid – while those they treat pay nothing.”

On Monday 18 the Government introduced its Immigration Bill for second reading in the House of Commons ensuring that the NHS surcharge became a political issue which reverberated throughout the week. They held the line until the Thursday afternoon U-turn – when they dropped the surcharge.

Odd fact first. The timing of last week’s politics were all down to the Government. It was Government that made the NHS surcharge a big political issue by introducing their Immigration Bill and Government that raised the media stakes that led to them having to carry out their U turn later in the week.

How does something like that happen? There are really important lessons here for those of us that want to influence Government policy post-Covid.

The Government felt they were untouchable on the issue of immigration. The very recent election, on the back of the Brexit battle, had left them absolutely sure that they had public opinion on their side. Indeed, reintroducing the Immigration Bill was an attempt by them to get back to the surefooted communication plan that had worked so well between July 2019 and January 2020. Talk to your electoral base. Deliver something for your base and batter everyone that disagrees with you.

We’ve seen, over the last few months of its hesitant communications strategy, that the Government doesn’t really know how to do ‘consensus’. They introduced the Immigration Bill last Monday because they believed it gave them an opportunity to get back to what they were good at. They did not have to do it last week.

In the Government’s mind the ‘debate’ on the Bill was very simple. This is what we were elected to do. The fact that next January the country would not have enough migrant staff to carry out important jobs if the Bill passed was of no interest. Result a majority of 100.

That was why when the PM was asked on Wednesday about the NHS surcharge he was happy to stick to his line.

So what happened in just over 28 hours? There are two linked things I want to highlight. First storytelling, and then how to argue.

The first breakthrough last week was to change the Government’s mind on another piece of unfairness. From April this year relatives of any NHS professional staff who died from Covid were to be given indefinite right to remain in the UK. This recognised that relatives of  migrants who had given their lives for the rest of us would, because of that sacrifice, have the right to stay with the rest of us in our (now their) country. Their act of sacrifice – so the argument went – meant that our country could become their country.

However, we then learnt that from April this rule only applied to NHS professional staff and not to support staff. Cleaners, porters and all those other vital staff could lose their lives keeping the rest of us safe and, if they did, the state would deport their relatives. I know that sounds unbelievable but, from April 1 until last Wednesday, that was what the Government were doing on our behalf.

The thing that happened on Wednesday evening was that this policy met Hassan Akkad. A film maker from Syria who arrived in the UK in 2015 had last month joined Whipps Cross hospital as a cleaner, disinfecting Covid wards. (In what world do people live if they don’t see that those disinfecting Covid wards are key workers??)

In his own words Hassan Akkad is a storyteller. He looks around him and sees stories of real people living real lives that matter to him (and to the rest of us).

His story contained the point that, as he said,

If I die fighting the coronavirus my partner isn’t allowed an indefinite leave to remain” 

And, as a storyteller, he was respectful of his audience. He said to the Prime Minister,

Please reconsider and I hope to hear back from you, thank you

That’s the lesson for the rest of us – storytelling plus politeness.

On Wednesday night the Government changed its mind and extended citizenship rights to the relatives of all migrant NHS staff who die fighting the virus.

Anyone getting this Government to change its mind on an issue of immigration is worth a lot of study. The first important point is lyrical.

We have been taught that we need to tell stories. People who make political arguments often say you should not personalise an argument but if your aim is to change the minds of ordinary people, they are wrong. Individual lives exemplify very big issues. Someone who disinfects Covid wards puts themselves in danger, protecting all of us. (We understand that). If they die (something we are all worried about). Their partner would be deported. (WHAT?!). It’s a simple story and we recognise it could be told a few thousand times.

I think the Prime Minster knew that the next story might involve someone whose life had been saved by 2 foreign nurses..

We need to argue through stories.

The second lesson to learn is how you make an argument.

Between ourselves, in this blog, there is no point in me ranting about what a bad thing the surcharge was. Such a rant might make me feel better (a self indulgent form of argument) but it will not change a single mind. In the last few years both political parties have typified arguments as ways in which they can each be more correct in their beliefs. They each use arguments of strong internal morality to batter the others.

To change the mind of this Government we need to create and use forms of argument that will try to persuade a few million people who in the past have agreed with the government, to change their minds.

If they say migration is bad – simply saying “no, it’s good” – hasn’t worked very well.

Successful arguments have hooks in them that directly relate to the morality of those who disagree with you. So in changing the NHS surcharge the hook is that the people who disagree with you about migration actually agree that NHS staff are all heroines and heroes, saving our lives.  “Yes I can agree with that”.

But this bigger story, the agreement hook, is out of kilter with that part of the story where we punish some of them by expecting them to pay for the NHS in which they work – saving our lives. These two bits of the same story doesn’t make sense to people. If they are hero’s and heroines why are we punishing them? It is the incongruity of these two parts of the argument that makes it so telling..

What people want to do with an incongruent story is to make it whole. With this story this can happen in one of two ways. They can say that these people are not heroic – which is very hard since they are saving our lives – or they can remove the punishment that the state is handing out.

This is how we need to frame arguments. Find something the person you are arguing with agrees with. Then use the part of the argument they disagree with. Then challenge them to make the argument whole.

Two YouGov opinion polls last week make this point,

The majority of Britons (58%) believe that immigrant social workers should  not have to pay to use the NHS (43% of conservative voters)

When asked whether immigrants generally should have to pay for the NHS 62%  say yes.

You may feel that this is contradictory. It isn’t. It means that people make very different judgements about workers who work in the NHS.

My point is not to argue from outrage.

And also, if we continue to learn from Hassan Akkad, be polite. He said to the Prime Minister “Please reconsider and I hope to hear back from you, thank you

This tone works much better.