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NHS Defenders Value Ideology Over Healthcare Outcomes, But Voters Increasingly Disagree

by Samuel Hooper – 22 Feb 2018

A startling new poll from the Reform think tank suggests that the public’s devotion to government-provided healthcare may be a mile wide but only an inch deep, threatening to burst the leftist bubble of blind, uncritical NHS worship

On Valentine’s Day, a predictably saccharine hashtag was trending on Twitter as British people exhorted one another to #LoveYourNHS.

And so begins another round of unthinking, unending hymns of praise to the National Health Service, egged on by ideological zealots who wake up in a cold sweat at the mere thought of anyone but the government directly providing all healthcare services in the land, and amplified by thousands of well-meaning but uncritical Britons who have been indoctrinated to believe that because the NHS once delivered their baby / set their broken leg / dug out their inflamed appendix / scooped them off the road after they walked in front of a bus they now owe their eternal thanks not to the medical professionals who helped them, but rather to the bureaucratic system which (dis)organised their care.

These odes of praise generally fall into one of a few well-defined groups. First, there are those predicated on the simple-minded assumption that no other advanced country in the world has figured out how to provide universal healthcare to its citizens:

The NHS doesn't leave people in lifelong debt after treatment.

The NHS won't turn its back on you if you're poor.

The NHS treats access to healthcare as a human right, and despite being under pressure, it's still one of the best healthcare systems in the world.#LoveYourNHS

— Toni (@t0nit0ne) February 14, 2018


Then there are those who displace their relief and gratitude at having been successfully treated or sympathetically cared for away from the medical professionals who deserve the praise toward a faceless government bureaucracy and the fifth largest employer on the face of the Earth (right after McDonalds):

Friends & family have received treatment for cancer, mental health issues, broken arms, a split head, given birth for free, had life saving blood transfusions and more … all with tender kindness #loveyournhs

— Emma Sutton (@emmalgsutton) February 14, 2018


Then there are those who just like to take any excuse to bash the Evil Tories and paint themselves as virtuous defenders of institutionalised compassion, struggling against heartless conservatives who want poor people to die in the street when they get sick:

Almost unnoticed & with minimal fuss the NHS keeps me well & healthy. It truly is a daily miracle & one that is easy to take for granted, which would be a fatal error. If like me you #LoveYourNHS then be aware the Tories are destroying it, then do something about it.

— James Sorah (@JamesSorah) February 14, 2018


Bringing up the rear are the Part-Time British Exceptionalists, leftists who normally scoff at any expression of patriotism or national pride, but who on hearing or reading the letters “NHS” immediately transform into the worst kind of stereotypical Ukipper, ranting and raving about how our healthcare system is the “envy of the world” and our country the birthplace of all that is good and compassionate, all the while furiously failing to notice the rather glaring fact that no other country in the world has copied our unique and outdated post-war system of socialised healthcare delivery:

Happy Valentine's Day to the NHS

Nothing makes me more proud to be British, and it's disgusting that the Tories don't respect or fund our country's greatest achievement. #LoveYourNHS

— Regular Frankie Fan (@RoseTintMyWorId) February 14, 2018


And last but not least are the childishly simple gestures of reverence and affection – poems, songs and the like – which reveal the truly infantilised and subservient attitude held by many of the NHS’s loudest defenders toward the service:

Lovely to receive a copy of a poem about a patient’s outstanding care at Mansfield Community Hospital @SFHFT – thank you to Lynda Bend, Sarah Badder @FranPlatts & wider #teamSFH pic.twitter.com/MDfxBQtQ3Q

— Richard Mitchell (@RMitchell_NHS) February 7, 2018


Because these various types of people – NHS High Priest, NHS Congregant, NHS Faith Militant and so on – are so loudly vociferous in the press and on social media, I and many others had rather simplistically assumed that their angry squawking spoke for the country as a whole. But a new poll taken this year shows that in fact the British people have a far more nuanced view of the NHS and the need for serious healthcare reform than the leftist NHS hagiographers would have us believe.

The Reform think tank has published a fascinating poll, taken in January, which revealed some rather striking findings, including:

58 per cent of British voters believe that the NHS needs reform more than it needs extra money, according to a new poll commissioned by the independent think tank Reform.

64 per cent of voters believe that it should not matter whether hospitals or surgeries are run by the government, not-for-profit organisations or the private sector provided that everyone has access to care. This is 2 per cent higher than in 2014, despite the Populus poll of 2,106 people being conducted on the day Carillion went into liquidation.

The think tank finds that 59 per cent of voters would nonetheless be willing to pay higher income tax to fund the NHS. This is up from 33 per cent in 2014. On average, British voters would be willing to pay £5.25 extra a month, which is 0.4 pence in the pound of income tax.

The statistic that most of us are already familiar with is the final one – that a healthy majority (in this poll 59 percent) of Brits would be willing to pay higher income tax in order to support the NHS. We cannot escape stats and narratives like this because the media (and on this subject even the supposedly conservative-leaning newspapers are doggedly left-wing) trumpet the news from dawn to dusk.

But looking at this number alone is highly misleading, because all it tells us is that a majority of people would be willing to pay more money for the NHS, not whether they want to do so or even believe that it is necessary. And that is where the other two statistics come in, rather awkwardly for NHS defenders who loudly insist that everything would be perfect if only we firehose more taxpayer money at the same, unreformed system.

We learn in the first bullet point that a full 58 percent of voters believe that the NHS needs reform more than it needs more money, which suggests that contrary to the prevailing narrative, voters are not automatically opposed to significant reform and in some cases might even welcome it if the reforms were woven into a coherent, comprehensive plan to improve healthcare outcomes for patients. And who can seriously argue that the NHS could not do more to find even top-line efficiency savings when we see non-jobs and full-time union rep roles draining local trust budgets?

Does the NHS really need more funding? When you are paying £50,000 a year for a "Diversity Officer" position instead of to nurses are you surprised that this State-run healthcare system has problems? #FundOurNHS https://t.co/LjpM8w3X6s

— John M Knox (@johnmknox1) February 3, 2018


But it is the second bullet point which is truly surprising – the fact that a full 64 percent of voters don’t give two hoots whether the hospital or medical facility where they receive treatment is government-owned and operated or run by non-profit or even private service providers.

This flies in the face of everything that we are told about public opinion towards the National Health Service. We may as a country (wrongly) favour the re-nationalisation of the railways, but when it comes to healthcare it appears that we are far more pragmatic, preferring what works to leftist ideology or sentimentality for a system which has operated since 1948.

From the Reform blog:

This is an important message for politicians who have questioned the premise of the outsourcing model following Carillion’s liquidation. The reality is that public services would grind to a halt without private and third-sector involvement. Almost one-third of government spend (£242 billion) is spend on external providers for goods and services from paperclips to the trident nuclear deterrent. The NHS spent £54 billion on external suppliers in 2014-15. This model has delivered value for money through increased competition. While the execution of some contracts can be improved, it seems voters are more concerned with access to services than ideological arguments on either side.

Why this growing openness to non-government provision? It could potentially be a case of “the grass is greener on the other side” – the rail operators are already privatised, and so dissatisfaction is more likely to be expressed in terms of a desire to roll the system back to a previous state, whereas NHS delivery (particularly hospital care) is almost always government-provided, making fresh alternatives seem more appealing. This is very likely a factor.

But such is the strength of public feeling on the issue – with 64 percent supporting radical change – that I don’t think “grass is greener syndrome” can account for the entirety. On the contrary, it seems as though the Left have massively overplayed their hand, thinking that they stood on a rock-solid foundation of obstinate support for preserving the NHS in aspic when in fact they are on a bed of quicksand.

Interestingly, the Left have likely done this to themselves, to a large extent. Having bleated for decades that we have only X or Y number of days to “Save Our NHS” only for the NHS to persist through Tory and Labour governments alike, and with left-wing commentators, members of the NHS Industrial Complex and alarmist agitators like Owen Jones penning articles suggesting that the “NHS as we know it” has in fact already been abolished, perhaps the general public has finally tired of their endless hysteria and started to take it for what it is – cynical emotional manipulation.

And if there really is a new openness to healthcare reform, then all it would now take to finally break free from British healthcare exceptionalism – the blind devotion to a tattered post-war consensus dogma which suffocated all previous impetus for healthcare reform – is a purposeful, visionary government with a clear mandate to lead and a Cabinet brimming with talent and political courage.

Oh well.

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