The NHS row: my final word
I’m in France, with patchy internet and mobile coverage, but I sense that a row has been generated in my absence. Journalists keep calling me to ask for comments. The ones from print newspapers are polite, and offer juicy fees. The broadcasters tend to begin, without preamble, “Do you stand by your statement that…?”
As far as I can tell, three separate charges ae being laid against me. First, that I have insulted NHS workers. Second, that I want to impose a US-style healthcare system on Britain. Third, that I have made criticisms overseas that I wouldn’t make in Britain.
Let’s take these in order.
Start with how I insulted the 1.4 million NHS workers. Here’s what I said: “I don’t want to imply that, because we have a bad system, it doesn’t contain good people. A lot of very generous, very patriotic people become doctors, even though they’re working in a system that doesn’t maximise their utility, because they have a calling to help other people.”
Pretty rude, eh? I suppose I should have learned manners from the NHS’s founding spirit, Nye Bevan, who described Conservatives as “lower than vermin”. Nor do I believe – as Peter Mandelson seems fatuously to be claiming – that Britain should adopt a US-style insurance-based system. While in the States last week, I repeatedly emphasised that I thought their set-up could be improved, that costs were too high, that litigation drove up premiums and that powers could be shifted from big insurance companies to individuals.
There is a difference between saying that the US shouldn’t adopt the British model and saying that Britain should adopt the American model. Think about it for a few seconds and you’ll see that it’s quite an obvious difference. If you want to go in for shorthand categorisation by country, the model I’ve been pushing for is one of personal healthcare accounts, a system most closely approximated in Singapore, whose people enjoy a higher level of healthcare than Britons do while paying considerably less for it. Nor can it be repeated often enough that Singapore – like every developed country – pays for the healthcare of those citizens who can’t afford it.
No one I know wants a system where the poor go untended. Nor will you find such a system outside the Third World: it really isn’t a British peculiarity. After ten years in the European Parliament, I have found that the only foreign admirers of the NHS are those on the serious Left. Mainstream social democrats on the Continent do not, as a rule, argue for a heathcare system funded wholly out of general taxation.
The third charge – that I should, as Labour’s Tom Watson puts it, “say it in Britain” – is the most asinine of all. I have been saying it in Britain for years. I’ve written a book all about how to shift power from bureaucracies to consumers. It’s called The Plan: Twelve Months to Renew Britain, it’s been in Amazon’s top 30 best sellers for nine months, it has become the best selling political tract in Britan and you can buy it here. In it is a lengthy chapter on healthcare which sets out how Britain compares with other countries in terms of survival rates, waiting times and so on, and proposes to replace the NHS with transferable savings acounts (which, to repeat, since some of my critics seem deliberately mulish on this point, would be met by the state for those who lacked the wherewithal).
Now, you can agree or disagree with my views. But to ignore them for ten months, pick them up when they are attacked by John Prescott, and then – then – to complain that I haven’t expressed them in Britain, strikes me as a bit much.
Of course, that isn’t how these rows work. Almost no one who has phoned me seems to have watched what I said in full. If they had, they would have seen that I conceded that there is majority suport for the NHS in Britain (although I believe this is partly based on the false premise that free treatment for the poor is a unique property of the British model), and that my views did not reflect those of my party leadership. Still, I do wonder at the tone and nature of the criticism. It seems to be based on playing the man rather than the ball.
My detractors say that I’m out on a limb, that I’m in the pay of the insurance companies, that I’m insulting those who have had successful treatment from the NHS. (What? How?) If supporters of the status quo were truly confident of their case, surely they would extend their logic.
I mean, why shouldn’t the state allocate cars on the basis of need, with rationing by queue? Or housing? Or food? I am reminded of the debate over asylum ten years ago, or Europe ten years before that. Remember the way even the most moderate and tempered proposals for stricter border controls were decried as “playing the race card”? Or, earlier, the way any suggestion that the EU wasn’t democratic was dismissed as “xenophobia”? Remember how keen supporters of the existing set-up were to shut down any argument?
There are good and honourable people who support the NHS; and there are good and honourable people who don’t. Is that really such an extreme thing to say? Anyway, if you’re a journalist, I’m afraid you’ll have to make do with this as my last word on the subject until I get back. If you want a dispassionate discussion of healthcare – rather than a “Tory row” story – please get in touch after 25 August. The rest is silence.
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