Onward to 100!

Nearly everyone turning up to the NHS 75 birthday party will be anxious about the state of health of the organisation. It’s looking its age. It seems to keep forgetting things (like people on waiting lists), we were all worried whether it would get through COVID; and now it seems to be of an age where it’s a bit phobic about new technology.

(Before I go any further with these heartfelt analogies a reminder that I am the same age as the NHS and often feel all these issues personally  – especially having just been asked and failed to use a new piece of software!)

But at the same time as having these anxieties we turn up to the party, nearly all of us, with a deep gratitude for how it has helped us in the past and what it means to us morally – compared to the shabby nature of many other parts of our life. We have a deep, deep need for it to get better and to have a wonderful fourth quarter of a century.

This will NOT be easy. In fact, it will be very hard – but it will be possible, and it will involve most of us.

Most of my posts are about what those difficult issues will be and how change will be key to the NHS getting to a happy 100th birthday, but what I want to do today is to concentrate on the very big politics that will be necessary if the NHS is going to make it.

It’s no secret that some parts of the right of politics don’t like the NHS. They didn’t when it was born, and have seen it as, at best, an anachronism and at worst a blot on the British psyche.

And I don’t want to play to the gallery by suggesting that there are dark forces out there in hiding waiting to ride in and destroy the NHS.

What I do want is to point out is that forces are publicly preparing for a long political campaign, starting now and really getting going after the next election.

The Daily Telegraph for example (once the house newspaper of the Tory Party but nowadays mostly seeing the Party as being too left wing) has commentators writing about what should be done to the NHS and more importantly how to do it.

On January 11th Allister Heath wrote an article called “The NHS is dead – and it’s dragging the rest of the country down with it”

(Don’t you just love the self-restraint of that title? You just now that when you read something with a title like that the language of the article will be similarly restrained.)

“Millions will go private over the next few years, paying for operations or taking out insurance. Private GP services will boom. This will begin to normalise independent health care undermining the pernicious idea that it is somehow wrong to pay for health.

Yet this won’t be enough. As with Brexit, truly radical change to funding and delivery of health care will require a professionally executed grassroots campaign for change followed by a referendum. The struggle must begin immediately and needs to be fronted by concerned doctors and nurses, including whistleblowers who have seen the destruction wreaked by an amoral bureaucracy. The public will trust medical professionals’ motives but not those of MPs, economists and business leaders.

I regularly speak to GP’s or consultants who tell me in confidence that European or Australian style insurance scheme is the obvious answer and that copayments are necessary to discourage frivolous demand They back fines for missed appointments, highlight the mismanagement corruption holding back many NHS trusts and tell me they want to leave the country. Such people possess the moral high ground:  they need to go public and fight for the modern non-ideological public private universal health service that Britain deserves.

Voters will probably want to give Labour one last chance to fix the NHS but when Keir Starmer falters just as badly as the Tories the electorate will rapidly become desperate for alternatives. If the reformers play their cards right and start campaigning today, a political revolution of a magnitude equal to Brexit could be possible before the end of the decade.”

Let’s walk through that timetable. A referendum on the future of the NHS will not be in the Conservative Manifesto for 2024 and, as he prophesies, voters will probably elect a Labour Government. That would mean the timetable for his referendum is probably at least 8 years or more away. So, he is arguing to ‘start campaigning today’ and for at least 8 years and then winning a referendum. (I think if he works through his timetable, he would see that it can’t be done by the end of this decade).

Unless we all start to think hard about the big politics of this issue those that want to keep the NHS will be hit with an emotionally powerful, clinician fronted, hedge-fund backed campaign which will elaborate the current problems of the NHS as being completely endemic to its principles. I don’t think this will ‘start now’. But it will start soon.

To defeat this campaign the first thing we must do is demonstrate that iover the next five years the NHS can improve its delivery, expand good practice and modern technology and can work with the public to increase their healthy life years. If, by 2029, all the indicators that at present are pointing downwards are, in the experience of the public, pointing upwards, people will not vote for a political party that offers them a referendum on the NHS. Above all others  it is better public experiences of the NHS that will change the outcomes of this campaign. In 1997 35 % of the public were satisfied with the NHS. In 2010 it was 70%.

OK five years will be tough – but do-able.

The second thing is that we must be prepared. You can’t run such a campaign in secret if you want the public involved – and they’ve been kind enough to announce their intentions. Let’s keep our eyes open..

Brexiteers won because they were good at playing on  emotions.So let’s think about the emotions we can develop around these three words,

National – that worked pretty well in the Brexit referendum. I look forward to hearing the same people that said they wanted the British nation to take back control say they didn’t mean it for health.

Do we not believe in National?

Health – the most important part of most individual and family experience

Do we not believe in Health?

Service – the experience that people clapped the NHS staff for during Covid and the experience that ‘the services’ in the army, navy and air force provide for us.

Do we not believe in Service?

Let’s not be blindsided, eh??