The NHS: why Tory radicalism and Labour rigidity are both equally likely to kill it.

megoa4  Another plea for the ideologues to lay down their livelihoods in favour of the lives of their citizens.

The anodyne BBCNews channel plumbed new depths of banality last Friday on the Breakfast Show. Those trying to sanitise a disaster decided that a charitable retirement community for 500 pensioners of limited financial means (patronised by the Prince of Wales) should be the live setting for a programme about aged care.

It would (the handout bumf told us) be ‘looking at new approaches in ageing. With more people in the UK turning 70 in 2017 than ever before and with one in three babies born today expected to live to 100, The Whiteley Homes Trust which runs Whiteley Village says it’s time for society to embrace older age and to think differently about how we all live well in our later years’.

Ah right, so they think it’s time. I just looked at the time on my wrist, and it says ‘A gnat’s-worth of spin far, far too late to make an iota of difference’.

For me, care for the elderly cannot be separated from the concept of free and subsidised healthcare: the old need a lot more of it, both are symptoms (when properly funded) of a civilised society, and our  inglorious Health Secretary signals more virtue on the subject of old age than everything else put together.

Let’s get real here: the Liberals invented the welfare State, but it was the Labour Party that delivered on State pensions and a free National Health Service.

However, it doesn’t follow that Labour is now the right Party to equip the NHS for a very different future. Indeed, having just shifted its agenda back to 1924, it could far more easily be argued that Labour would be the Party to sink it without trace.

Aneurin Bevan’s aim was to “remove the fear of penury in old age and unaffordable medical bills from the British landscape”. As a man who has never espoused Socialism, I endorse every word of that aim. In a first world country, the goal should be that no citizen will die young, or otherwise early, as a result of limited means. That is the natural order of things among wild packs of primates, so why should we – the self-exalted Homo sapiens – settle for anything less?

However, Bevan spoke those words in 1946…as part of a campaign to attack the intransigence of the British medical establishment. I’ve read every biography of Nye (one of my great heroes) and most of his major speeches. My considered opinion for many years has been that, were he alive today, Bevan would be horrified by the way rigid orthodoxy from both Left and Right has been used to pauperise his vision.

That vision was for a nationwide, closely linked but locally run range of surgeries, cottage hospitals and hospices to be used primarily by the needy classes. The idea that he would have any truck with today’s diehard nonsense is to see Nye Bevan as a man incapable of adapting to change. He was anything but.

Without anyone of his intelligence, street savvy and determination in the contemporary Labour Party, it doesn’t follow that the creators of the NHS are the right people to preserve and nurture it

Equally, we have seen enough over the last seven years to be sure that the Conservative Party wants to replace the NHS with not just a different service, but with a completely unrelated model involving tragically unrealistic goals.

The best way to attack all neoliberal claptrap is with hard societal facts.

The US health insurance model with which Jeremy Shunt is in lust would quickly become – in the British context – a sick joke. US workers now pay an average of $1,318 out of pocket before health insurance coverage begins to cover part of their bills, up from $584 in 2005, according to a new report out from the Kaiser Family Foundation. That’s after paying an average of $89 each month for health insurance premiums up front. (And from what I’ve analysed from the trumping White Elephant that just passed Congress, it’s about to get a lot worse for nearly 120 million Americans)

I do not see the two UK Establishment Parties as equally useless on the issue of aged and health care, because the Conservatives have profoundly unpleasant planned destruction in mind, whereas the Labour Party simply wants to reverse the definition of ‘clockwise’. But I do think that, from the viewpoint of every patient of limited means, they are both equally dysfunctional.

And for me, the functional efficacy of the social weal is everything. Its rationale is neither jobs for the plebs nor bonuses and share-price profits for the élite financialisers: the raison d’etre for the NHS and ageism-free care for the elderly is the quality of life we offer to our citizens throughout their lives.

There are three sacred cows we need to slaughter humanely when it comes to quality of health provision in the UK:

  1. Free to all at the point of purchase. The emergency service should be free to every citizen regardless of rank or privilege…..but for the much better off (others in the business of wealth inequality can argue over that term) there should eventually be a bill in proportion to their wealth. The French Assurance Maladie disproves beyond any doubt the idea that means testing is unaffordable….and the assertion that Nye Bevan would’ve objected to means testing the rich is a risible defence based on nothing.
  2. A US-style assurance model would be better for the majority of citizens. That is a lie on a par with trickle-down wealth: the French model of State assurance plus mutualised top-ups for the better off is a far better aspiration, but it isn’t the best we could do.
  3. The NHS and closely related services should be exclusively in the hands of the State. There is a very real and eminently affordable alternative to that: mutualisation and  localisation of the offer, with the corporate structure ringfenced from invasion by the soiled hands of Westminster politicians, Whitehall pinstripes and City wideboys in perpetuity. The time when we could afford for UK healthcare to be an unholy mixture of political football, bureaucratic chess and bourse lottery is long gone.

    There is the wonderful wisdom conveyed by the story of an Englishman in Ireland asking a local the best way to get to Dublin. “Well sorr,” says the indigent, “If I was you, I wouldn’t start from here.”

What I’m presenting in this post is not a sort of kite to be launched in the hope that someone might salute it. The need is infinitely more urgent than that. The entire political class of the United Kingdom is in thoroughly irresponsible denial about the 200-foot wave about to descend upon the leaky ship HMS Mayflower. That Tsunami has been formed from the negligence of Whiteminster over several decades: both the illegal pension emoluments mandarins awarded themselves, and the lies MPs told in order to get elected.

Calculated pc balm from the BBC about ‘looking at new approaches in ageing’ is akin  to baling out the Pacific with a thimble in the hope of reducing sea levels. Seventy years on, it is high time we got seriously real about the dictates of age demography. Dated political syntax at PMQs contributes nothing beyond copy for the lobby correspondents. The WASPI  resistance will seem like an inconsequential blip in comparison to the angry clamour for Baby Boomers to die with dignity.

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