There is plenty of concern
about the NHS. What there isn't going to be, necessarily, is very much protest. This could be for a few reasons. Mass rallies lost
credibility for many after they were ignored in our government's
determination to invade Iraq. Second, the appeal of going down to
London to be kettled for the day is limited, is a headcount on the
Strand really so much more pursuasive than a tally of retweets? Third, it might be that the most angry are the least able to march. But
beyond all of that, there's also the lack of really compelling alternatives
to the path we're taking. We can shout all we like, but I'm
struggling to spot other policies waiting in the wings.
Labour
finally got associated with a coherent message with #dropthebill and
the risk register work has gradually developed into wide
consternation, not least amongst groups who were probably involved in
providing evidence for it. And there's no doubt that huge amounts of committed people are campaigning hard and effectively. What doesn't seem clear to me is what would happen if
the bill did get dropped. I've had glimpses of the work NHS staff
have put in to prepare for what they have seen as the inevitable.
They've gritted their teeth and worked through years of uncertainty,
which would be considerably extended if the bill was dropped,
especially if we had yet more limbo period to thrash out what was going to happen next.
Many of the changes so far (if you take out the cuts, which you really shouldn't) are structural and I've seen good arguments put forward that local
authorities are the right place for their teams. But if it came to an
election, voters would need to be reassured that Labour's policy
wouldn't be the same with a slightly different colour.
There was little to suggest a different course under the previous
government. Yes, Stoke has benefited hugely from health centres and
hospitals which are just being completed now, but many were funded under
PFI initiatives which enriched the private sector by turning a lot of
taxpayer money into profit and calling it debt. Super-rich company
directors don't build hospitals; construction workers, engineers and
associated trades do. Call me a radical, but would it be so bizarre
to just collect taxes to pay for hospitals and then hire those
people directly?
If I was casting round for an idea that
was better than asking the Queen for help, I'd look back to the
people who won power all those decades ago and managed to get the NHS
created in the first place. What can we learn from them? We take
the NHS for granted and it's probably fair to say that the people who
aren't angry or worried aren't imagining a Britain without it. The
politicians of my lifetime, at least the ones who have hung onto power, have often been apologetic about the presence of a cradle-to-grave health service, at times
treating its recipients like spongers rather than deserving citizens.
Where is the party standing proud and saying that the NHS, as it was
originally imagined not after years of fragmentation and
reorganisation, is just what we still need? Why have we been allowing
departments to become so stressed and stretched that people die or
get treated inhumanely? What is wrong with us that we can't see the
problem in declaring people fit to work while they are receiving
chemotherapy? When did we stop seeing that one very good reason for funding people through university is that, statistically, better educated people are healthier? Where are the leaders reminding us
that we are a country that fights side-by-side together in peace as
well as wartime? (Sidenote: they are in some places, like the Tolpuddle Festival, but that doesn't flow well with heartfelt rhetoric of this post)
A lifetime NHS which links up with
everything else and treats people like responsible citizens is the
only way to chip away at our timebombs. Public health officials can
be heard speaking out to say that exercise is one of the greatest
tools we have to prevent expensive ill health. Yet exercise
programmes are often still funded without too much fanfare because
media departments are worried about the headlines and politicians are
too frightened of newspapers whose commercial interest is in keeping
us all in fearful, passive consumption. The NHS has done an amazing
thing in lengthening people's lives, but we have a way to go to make
sure that everyone's old age is dignified and full of joy. As a taxpayer I object every time anyone suggests that we want to see
some sort of retribution meted out upon people who had the bad
manners to call upon the help of the state. A trusting, caring
society with good systems of accountability does not need to constantly worry
whether others are fiddling the system, but it seems our distrust is
filtering from the top all the way down.
Healthcare is not just the
responsibility of the NHS or just national government, but local
government too. It's a whole infrastructure of different services
that connect together and if they are all made fragile through cuts
there is the prospect of the whole lot collapsing. The common thread
is that they are supposed to be within the remit of the people we
vote for. Without bold politicians in amongst their parties and their
communities listening, getting stuck in and debating every view and
putting more people onto platforms until the different figureheads
look and sound even a little bit different to each other, our
movement has a limited choice: fight in ways we don't really believe will work, or stay quiet. We need to start talking, planning and imagining what the future could look like.
